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Road crash injuries are significant public health issues in many low-and middle-income countries. Every year more than 1.35 million people lose their lives due to road crashes, making it one of the leading causes of death worldwide. In 2021, 1.19 million road traffic deaths occurred worldwide. Globally, India accounts for the second-largest number of fatal road traffic crashes. Riders in the age range of 18-25 years contribute to 41.4% of India's total road crash victims. An in-depth understanding of the current traffic density, violations, and behaviours of young riders is essential for enforcement agencies, in particular, the traffic police personnel. Their perspective is relevant as they have a unique position to judge and evaluate the riding behaviours and the efficiency of the existing intervention programmes. Furthermore, their suggestions can be highly effective in developing evidence-based risk reduction programmes. The present study was conducted in Manipal, which is a locality of Udupi district in Karnataka province of Southwestern India. Seventeen in-depth interviews were conducted from October 2018 to January 2019 among traffic police personnel. Thematic analysis was done using ATLAS.ti 8 software to identify, analyse, and report themes within the data. Respondents revealed that in recent times Manipal roads have become unsafe for young riders. Factors such as speeding, using a mobile phone while riding, reckless riding, and overtaking from the wrong side were the main reasons for road traffic crashes. Interventions like the installation of traffic barricades, closed-circuit television cameras, speed breakers, and signboards at the crash hotspots, together with strict enforcement of traffic laws, were suggested by the respondents to reduce crashes. The study findings highlight the importance of traffic police personnel's views in understanding the various determinants for road crashes observed among young riders. Future research can be taken up in other settings with broader age group involvement for the target population. There is a need to establish a coordination committee that can locally organize awareness programmes involving all the stakeholders on road safety to increase the level of risk perception and reduce crashes., Competing Interests: Declarations Ethics approval and consent to participate The study was approved by the institutional ethical committee of Kasturba Medical College at Manipal Academy of Higher Education, Manipal, India (Reference number − 09/2018). Since the study involved human participants, the data collection was performed in accordance with the principles of the Helsinki Declaration. There was written informed consent before interviews on participating in the investigation. Information about the study was offered in a language understood by the informants. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

This paper aims to examine the key factors influencing young drivers' hazard avoidance in Iran. In this study, a hazard avoidance index is defined and calculated for investigating the effect of impulsiveness, behavioral, and psychological characteristics on driving hazard avoidance. A questionnaire and go-no-go and flanker computer tests as well as a driving simulator are used for collecting data from 173 Iranian drivers under the age of 30. For this purpose, different scenarios were used, such as pedestrian crossing, the presence of fixed obstacles, and animals crossing the road, whose various characteristics are also changed. Structural equation modeling and the partial least squares method are applied for investigating the relationship between different variables and the hazard avoidance index. The results show that the driver hazard avoidance index is mostly affected by variables such as inhibitory control, opposite directional response, attentional impulsiveness, motion impulsiveness, non-planning impulsiveness, disregarding the law, and lapses and error. The results could help policymakers to assess diving hazard avoidance and improve training programs related to traffic safety based on the variables that are more effective on inexperienced and novice drivers' hazard avoidance.

Stenosing flexor tenosynovitis, commonly known as trigger finger (TF), is characterized by thickening and inflammation of the flexor tendon sheath (A1 pulley), leading to painful catching or locking of the finger in a flexed position. While often associated with conditions like diabetes and hypothyroidism, this case report presents a unique instance where surgical intervention for pharmacologically resistant TF ultimately led to the diagnosis of Hashimoto's thyroiditis. This case highlights the potential for underlying systemic conditions to manifest as TF and emphasizes the importance of a comprehensive diagnostic approach in patients with persistent or atypical presentations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Llaneras et al.)

Background: Mental health in the workplace is a growing concern for enterprises and policy makers. MENTUPP is a multi-level mental health intervention implemented in small and medium size enterprises from three work sectors in nine countries. This pilot study aimed to evaluate the feasibility, delivery, and instruments for the MENTUPP intervention to inform the planning of a clustered randomized controlled trial., Methods: We administered items from the Copenhagen Psychosocial Questionnaire and the Danish Work Environment Cohort Study measuring psychosocial workplace factors. The questionnaire was answered by 382 participants at baseline, of which 98 participants also answered after six months at follow-up. We calculated mean scores of 19 psychosocial factors at baseline and conducted repeated measures ANOVAs to assess differences in eight psychosocial factors at follow-up. We also examined whether outcomes differed between work sectors and job positions at follow-up., Results: The construction sector and workers with no or a lower leadership role reported more negative working environment factors at baseline. We observed a statistically significant decline in social support from colleagues and social community at work, and a marginally significant decline in justice at work. For the rest of the constructs, we did not observe statistically significant changes., Conclusions: We found significant differences in psychosocial work environment factors among work sectors and job positions at baseline. Contrary to our hypotheses, three psychosocial work environment factors decreased at follow-up. Possible explanations are the utilization of specific psychosocial factors as resources to cope with psychosocial stressors, high participant expectations that were not met by the intervention, insufficient time for structural changes, or the intervention prompting critical evaluations of the work environment. These findings will inform the design and implementation of the forthcoming clustered randomized controlled trial, where they will also be further investigated to validate their significance., (© 2024. The Author(s).)

Complex interventions combining multiple evidence-based strategies have gained substantial traction in suicide prevention across the world. However, implementing these interventions in real-life settings is fraught with several challenges, significant resource demands, and evidence on the merits of implementing complex interventions remains a topic of debate. This study explores the real-world experiences of implementing complex interventions, including challenges, lessons learned, and the way forward. Sixteen participants (nine leaders, five implementors, and two lived experience advocates) from varied professional backgrounds and experiences were purposively recruited from six high-income countries and one low- and middle-income country. Participants were encouraged to reflect on their experiences of implementing complex suicide prevention interventions in their specific country contexts. Thematic analysis was conducted to identify, organize, and offer real-world insights into challenges, lessons learned, and what is needed as the way forward. Important themes related to challenges and lessons learned emerged: (a) stakeholder characteristics, engagement, and dynamics; (b) resources such as funding priorities and capacity; (c) contextual factors including larger sociocultural beliefs, policies, and legislation surrounding suicide and its prevention; (d) nature of lived experience engagement; (e) design and approach to interventions; (f) delivery of interventions; and (g) the scope of evaluation. The study yielded important insights into practice recommendations related to the implementation of complex suicide prevention interventions on the ground. Important pathways for designing interventions, collaboration, and stakeholder engagement for future implementation efforts were discussed. These real-life experiences and lessons learned from international experts are critical in understanding and bridging the know-do gap. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: The ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning. This study describes the epidemiology of cruciate ligament reconstruction in the ADF and demonstrates the use of Bayesian networks (BN) to predict the likelihood of fitness for ongoing service under different scenarios., Methods: Members who had knee cruciate ligament reconstruction through ADF were identified from billing data and matched to electronic medical records to extract demographic and clinical data. Outcome measure was medical fitness for ADF service up to 24 months after reconstruction. BN models were used to compare outcomes between (1) age groups according to military service, and (2) sexes according to body mass index (BMI)., Results: From November 2012 to June 2019, a total of 1199 individuals had knee cruciate ligament reconstruction (average 169 reconstructions/year). Following reconstruction and rehabilitation, 89 (7.4%) were medically unfit for service. Scenario analysis using a tree-augmented naïve BN model showed that, compared with Navy and Air Force, Army members had a higher probability of being unfit in those aged <35 years and a lower probability in those aged ≥35 years. In both sexes, those with obese BMI had the greatest probability of being unfit., Conclusion: While most ADF members were fit for ongoing military service following cruciate ligament reconstruction, service type, age, sex and BMI influenced outcome. BNs provided an interactive and intuitive method to demonstrate the impact of different variables on the outcome., Competing Interests: Competing interests: OW: This project was completed as part of a Master of Philosophy (Applied Epidemiology) and while receiving a scholarship. CLL was supported by an Australian National Health and Medical Research Council (NHMRC) Fellowship (APP1193826)., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing., Methods: Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible., Results: We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed., Conclusion: Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses., (© 2024. The Author(s).)

Introduction: Effective suicide prevention interventions are infrequently translated into practice and policy. One way to bridge this gap is to understand the influence of theoretical determinants on intervention delivery, adoption, and sustainment and lessons learned. This study aimed to examine barriers, facilitators and lessons learned from implementing complex suicide prevention interventions across the world., Methods and Materials: This study was a secondary analysis of a systematic review of complex suicide prevention interventions, following updated PRISMA guidelines. English published records and grey literature between 1990 and 2022 were searched on PubMed, CINAHL, PsycINFO, ProQuest, SCOPUS and CENTRAL. Related reports were organized into clusters. Data was extracted from clusters of reports on interventions and were mapped using the updated Consolidated Framework for Implementation Research., Results: The most frequently-reported barriers were reported within the intervention setting and were related to the perceived appropriateness of interventions within settings; shared norms, beliefs; and maintaining formal and informal networks and connections. The most frequently reported facilitators concerned individuals' motivation, capability/capacity, and felt need. Lessons learned focused on the importance of tailoring the intervention, responding to contextual needs and the importance of community engagement throughout the process., Conclusion: This study emphasizes the importance of documenting and analyzing important influences on implementation. The complex interplay between the contextual determinants and implementation is discussed. These findings contribute to a better understanding of barriers and facilitators salient for implementation of complex suicide prevention interventions.

Background: Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern., Objective: A systematic review of the literature was conducted to appraise the performance of 3 recent-generation wearable devices (Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP) in determining sleep parameters and sleep stages., Methods: Per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a comprehensive search was conducted using the PubMed, Web of Science, Google Scholar, Scopus, and Embase databases. Eligible publications were those that (1) involved the validity of sleep data of any marketed model of the candidate wearables and (2) used PSG or an ambulatory electroencephalogram monitor as a reference sleep monitoring device. Exclusion criteria were as follows: (1) incorporated a sleep diary or survey method as a reference, (2) review paper, (3) children as participants, and (4) duplicate publication of the same data and findings., Results: The search yielded 504 candidate articles. After eliminating duplicates and applying the eligibility criteria, 8 articles were included. WHOOP showed the least disagreement relative to PSG and Sleep Profiler for total sleep time (-1.4 min), light sleep (-9.6 min), and deep sleep (-9.3 min) but showed the largest disagreement for rapid eye movement (REM) sleep (21.0 min). Fitbit Charge 4 and Garmin Vivosmart 4 both showed moderate accuracy in assessing sleep stages and total sleep time compared to PSG. Fitbit Charge 4 showed the least disagreement for REM sleep (4.0 min) relative to PSG. Additionally, Fitbit Charge 4 showed higher sensitivities to deep sleep (75%) and REM sleep (86.5%) compared to Garmin Vivosmart 4 and WHOOP., Conclusions: The findings of this systematic literature review indicate that the devices with higher relative agreement and sensitivities to multistate sleep (ie, Fitbit Charge 4 and WHOOP) seem appropriate for deriving suitable estimates of sleep parameters. However, analyses regarding the multistate categorization of sleep indicate that all devices can benefit from further improvement in the assessment of specific sleep stages. Although providers are continuously developing new versions and variants of wearables, the scientific research on these wearables remains considerably limited. This scarcity in literature not only reduces our ability to draw definitive conclusions but also highlights the need for more targeted research in this domain. Additionally, future research endeavors should strive for standardized protocols including larger sample sizes to enhance the comparability and power of the results across studies., (© An-Marie Schyvens, Nina Catharina Van Oost, Jean-Marie Aerts, Federica Masci, Brent Peters, An Neven, Hélène Dirix, Geert Wets, Veerle Ross, Johan Verbraecken. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org).)