Level III.

Level II.

Background: Tools and systems to improve mental health have been understudied in low-resource environments, such as sub-Saharan Africa. This study explores depression amongst women participating in a community-based intervention combining savings- and lending-groups, entrepreneurial training and other skills training. Aims: This study aims to determine whether depression decreases with more program participation, and the extent to which social capital variables may explain these changes. Method: Survey data were gathered in June 2018, within 6 months of group formation, and again in June 2019 from 400 women participants in the program. Data between 2018 and 2019 were compared using Wilcoxon rank-sum and Chi square tests. Inferential statistics included random effects regression models and general structural equation models. Results: At 1-year follow-up, depression and loneliness amongst Kenyan women ( n = 400) participating in the program had decreased. Social capital remained higher within groups than within the broader community, and mediated the association between program participation and decreased depression. Conclusions: Findings suggest this novel, community-based intervention has the potential to benefit mental health. Future research, including a randomised control trial, is required to establish (1) the extent of the program’s benefits and (2) the program’s application to particular subject areas and population segments.

* Spinal deformities frequently develop in patients with osteogenesis imperfecta. Scoliosis is more prevalent and complex in more severely affected patients with osteogenesis imperfecta.* Nonoperative management of spinal deformity in osteogenesis imperfecta with bracing is not effective in preventing curve progression. Bisphosphonates have shown a positive effect on bone density but do not prevent progression of deformity.* Operative management is challenging and can range from noninstrumented fusion to segmental pedicle screw fixation with cement augmentation. Recent studies have shown safe and effective use of modern instrumentation for treatment of osteogenesis imperfecta scoliosis and advocate for cement augmentation to decrease instrumentation failure.

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