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Overweight, including its severe form obesity, among children and adolescents has risen rapidly in Latin America. Schools play a critical role in addressing this growing public health challenge, as they offer a structured setting to implement preventive interventions targeting nutrition literacy, physical activity, and the food environment. The aim of this article is to describe the effectiveness of school-based interventions for preventing overweight in Latin America and whether existing policies, programs and other initiatives in the region align with the best available evidence. Among the 27 interventions included, most were conducted in Chile (41%), used a pre–post design (41%), adopted a preventive approach (85%), and reported positive effects (52%). Effective interventions included activities on nutrition literacy, physical activity, nutritious foods and diets, provision of free and safe drinking water (e.g., water that is free from microbial contamination and suitable for drinking), and healthy food environment. Experimental studies showed that the duration of effective interventions ranged from two months to two years and were primarily directed at primary school students including parents and teachers. Argentina, Chile, Colombia, Mexico, Peru, and Uruguay had multi-component policies and programs under a regulatory framework (e.g., laws or regulations passed by a government) based on the best available evidence to prevent overweight in school-aged children and adolescents. Only a limited number of countries have implemented these interventions. Ensuring program sustainability is critical to inform evidence-based childhood overweight prevention policies in the region. Policymakers should use the best scientific evidence to guide childhood overweight prevention strategies.

Aim This article is a report of a study protocol designed to examine the effects of guided clinical reasoning on the quality of the Advanced Nursing Process—the evidence‐based version of the traditional nursing process. It aims to describe the theoretical framework—Kirkpatrick's evaluation model, the key concepts and the instruments for the planned study. Design A complex experimental intervention study using data and method triangulation is proposed. Methods Registered Nurses (N = 92), nursing records (N = 180) and 24 patients will be included. Nurses’ knowledge and attitude will be evaluated by questionnaires/tests, their clinical performance by observations. Patients’ perspective will be addressed by qualitative interviews and patient records by using the instrument Quality of Diagnoses, Interventions and Outcomes revised (Q‐DIO R). Discussion Kirkpatrick's model (including quantitative and qualitative methods) is providing evaluations from different perspectives on the quality of the Advanced Nursing Process and on intervention effects.

Aim This study aimed to assess (a) nurses' knowledge and their attitude towards the Advanced Nursing Process—nursing assessment, diagnoses, interventions, outcomes, (b) the quality of the Advanced Nursing Process and (c) relationships with patient characteristics. Design A cross‐sectional, descriptive correlational study was performed. Methods Ninety‐two registered nurses and ninety nursing records of six hospital wards were included. In January 2016, a knowledge test, a self‐assessment tool for measuring nurses' attitude (PND) and the Quality of Diagnoses, Interventions and Outcomes Revised instrument (Q‐DIO R) were applied. The correlations between nurses' knowledge, attitude, patient characteristics, organizational factors and the Advanced Nursing Process quality were investigated. Results Nurses demonstrated low levels of knowledge, positive attitudes and an average Advanced Nursing Process quality. Accurate nursing diagnoses were strong and highly significantly related to effective nursing interventions and better nursing‐sensitive patient outcomes. A higher proportion of registered nurses was related to better nursing outcomes.

Assessing motor competence is essential for evaluating the effectiveness of physical activity interventions that aim to maintain or improve older adults’ function. However, assessing motor competence in older adults who have difficulties walking or standing is challenging, because few instruments or guidelines are appropriate for these frail older adults. This article aims to describe challenges in evaluating motor function among frail older adults, discuss strategies for adapting motor function assessments to their home settings, and provide recommendations for future clinical trials so that older adults with ambulatory difficulties can benefit from motor function assessment and physical activity programs. Data came from the baseline assessment of 116 participants of an ongoing clinical trial, “Promoting Seniors’ Health with Home Care Aides (Pro-Home)”. Our results demonstrated that the Pro-Home study involved participants who would be typically excluded from clinical trials and that the two instruments selected or developed for Pro-Home (Short Physical Performance Battery, Pro-Home Ankle Range of Motion Measure) captured a wide range of lower extremity motor competence with no or few missing data. Recommendations for future studies include knowing the target population thoroughly, developing trust and rapport with all parties involved, and continuously collaborating with interviewers who conduct assessments.

Introduction: Sickle cell disease (SCD) is a genetic disorder that is widely observed on a global scale and known for its substantial negative impact on health and mortality. The purpose of this research was to explore how SCD influences the outcomes of acute coronary syndrome (ACS) and Percutaneous Coronary Intervention (PCI). Methods: A retrospective observational analysis was conducted using the National Inpatient Sample (NIS) data for the year 2020. Adult patients with concurrent ACS and SCD diagnoses were included in the study. Demographic information, clinical characteristics, in-hospital outcomes, and PCI complications were examined and compared between ACS patients with and without SCD. Results: Among a total of 779,895 ACS patients, 1495 had coexisting SCD. SCD patiets exhibited distinct demographic features, such as younger age (mean age: 59 vs. 66 years), predominantly female (53% vs. 35%), and primarily African American (91% vs. 11%). Comorbid conditions such as hypertension and chronic lung disease were more prevalent in SCD patients. While inpatient mortality odds did not significantly differ, SCD patients demonstrated slightly shorter lengths of stay in cases of STEMI and NSTEMI/UA. Notably, SCD patients faced a statistically significant increased risk of coronary dissection, highlighting a unique complication in this population. Although an increased incidence of atrial fibrillation and acute heart failure was observed in SCD patients, statistical significance was not achieved. Conclusions: This study provides valuable insight into the intricate interplay between SCD and ACS outcomes. SCD patients presented with distinctive demographic and clinical profiles that influenced their experience with ACS. The elevated risk of coronary dissection emphasizes the necessity for tailored interventions and careful management in SCD patients. These findings underscore the need for further research to elucidate underlying mechanisms and optimize treatment strategies for individuals with both SCD and ACS.

Background: This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). Materials and methods: Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. Results: 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. Conclusions: In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.

Objective Internet addictive behaviors or internet use disorder result from abnormal internet use, including neglecting responsibilities and experiencing anxiety when offline. This systematic review analyzes technology-based interventions addressing these behaviors, focusing on effectiveness, quality attributes, and user interaction. Methods A literature search was conducted across three digital libraries and two high-impact journals, focusing on peer-reviewed articles published in Q1 or Q2 journals between January 2022 and June 2024. Studies evaluating digital addiction interventions and user interaction were included, while reviews, editorials, gray literature, and studies without clear intervention descriptions were excluded. The review covered randomized controlled trials, comparative studies, wearables, and mobile health apps. Five research questions were addressed using 17 evaluation criteria. Data extraction answered the subquestions. The review followed Barbara Kitchenham's guidelines, applying a rigorous selection and quality assessment process. Primary inclusion was verified using the Kappa coefficient for inter-rater agreement. The article's quality was evaluated with established criteria. The content adhered to PRISMA guidelines. In total, 11 articles were included. Findings The review found variability in intervention effectiveness, with personalized, real-time feedback interventions having the greatest impact on reducing screen time and addiction symptoms. Less effective interventions lacked personalization. Conclusions The study highlighted the most commonly used technology-based interventions and their effectiveness in reducing symptoms and screen time, as well as improving user satisfaction and treatment adherence. Research gaps were identified, including the need for data on quality characteristics and software requirements for personalizing interventions using new technology.

Background Depression is among the leading causes of the global burden of disease and is associated with substantial morbidity in old age. The importance of providing timely intervention, particularly those with subclinical symptoms, has thus increasingly been emphasised. Despite their overall effectiveness, a small but notable subgroup tends to be less responsive to interventions. Identifying predictors of non-remission and non-response is critical to inform future strategies for optimising intervention outcomes. Methods A total of 4153 older adults aged 60 years and above with subclinical depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] = 5–19) were recruited from JC JoyAge, a large-scale collaborative stepped-care intervention service across Hong Kong. A wide range of clinical and modifiable risk and protective factors at baseline were assessed, including depressive symptoms, anxiety symptoms, loneliness, suicidal ideation, cognitive capacity, multimorbidity, chronic pain, need for informal care due to mental health reasons, history of abuse, and sociodemographic characteristics. Separate multivariable logistic regression models were applied to identify predictors of non-remission (PHQ-9 ≥ 5) and non-response (< 50% reduction in PHQ-9) following intervention. Results The rates of non-remission and non-response were 18.9% ( n  = 784) and 23.0% ( n  = 956), respectively. Comorbid anxiety symptoms (adjusted odds ratio [aOR] = 2.08, CI = 1.72–2.51; 1.28, 1.05–1.57), loneliness (2.00, 1.66–2.42; 1.67, 1.38–2.01), need for informal care (1.86, 1.49–2.33; 1.48, 1.18–1.85), lower cognitive capacity (0.95, 0.93–0.97; 0.94, 0.92–0.96), and absence of chronic pain (0.59, 0.48–0.72; 0.76, 0.64–0.91) predicted both non-remission and non-response. Meanwhile, moderate-to-severe depressive symptoms predicted higher odds of non-remission (1.41, 1.18–1.69) and lower odds of non-response (0.28, 0.23–0.34), respectively. Subgroup analyses conducted separately in older adults with mild and moderate-to-severe depressive symptoms at baseline revealed that comorbid anxiety, loneliness, need for informal care, and absence of chronic pain were consistent predictors of non-remission. Those with non-remission and non-response showed more depression-related functional impairments and poorer health-related quality of life post-intervention. Conclusions Older adults with subclinical depressive symptoms showing comorbid anxiety, higher loneliness, need for informal care, and chronic pain may be offered more targeted interventions in future services. A personalised risk-stratification approach may be helpful. Trial registration ClinicalTrials.gov identifiers: NCT03593889 (registered 29 May 2018), NCT04863300 (registered 23 April 2021).

Ecosystems typically exhibit resilience to disturbances, yet excessive pressure can disrupt species interactions, resulting in biodiversity loss. Conservation interventions strive to safeguard ecosystems and reinstate vital ecological functions. Competition between animals plays a pivotal role in ecosystem persistence and dynamics, but its significance is often underestimated in conservation research. We conducted a global review that analyzed 147 articles, focusing on the impact of competitive interactions between animals on conservation interventions. We found a tendency for researchers to retrospectively interpret observed patterns of interactions as competitive. Negative outcomes, such as species declines, were frequently associated with competitive interactions. Despite efforts to predict outcomes using characteristics of the competition process, we found no consistent patterns of outcomes based on these characteristics. Our findings underscore the considerable influence that competition may have on conservation outcomes, emphasizing a need for proactive consideration of competition dynamics as part of planning conservation interventions. By integrating animal competition into conservation planning, monitoring, and mitigation efforts, unexpected negative impacts can be minimized, fostering more effective conservation outcomes.