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The World Health Organization (WHO) recommends minimum of 150 minutes of moderate intensity aerobic physical activity or 75 minutes of vigorous intensity aerobic physical activity along with at least two sessions of muscle strengthening exercises per week. Compliance with these recommendations is classified as Health Enhancing Physical Activity (HEPA). The aim of this study was to analyze the association between the HEPA and the social factors, lifestyle and dietary characteristics. We conducted the secondary analyses of the data from the Serbian National Health Survey 2019, on 12067 adult participants classified in two groups: with HEPA and without HEPA based on the compliance with the WHO recommendations. Prevalence of HEPA was 3.3% (394/12067). Multivariate logistic regression analysis showed positive association between HEPA and male sex (OR: 4.25, 95% CI: 2.68–6.73), average (OR: 3,01, 95% CI: 1.13–8.04), good (OR: 3.10, 95% CI: 1.21–7.94) and very good (OR: 4.64, 95% CI: 1.82–11.84) income quintile being single (OR: 1.85, 95% CI: 1.16–2.95), the number of portions of fruits per day (OR: 1.29, 95% CI: 1.09–1.53), the frequency fresh fruit/vegetable juice consumption (OR: 1.20, 95% CI: 1.02–1.40), and being non-smoker (OR: 1.67, 95% CI: 1.03–2.73). There was a negative association between HEPA and age (OR: 0.96, 95% CI: 0.95–0.98), BMI (OR: 0.94, 95% CI: 0.88–1.00), average self-rated health (OR: 0.18, 95% CI: 0.12–0.60), and the frequency of non-alcoholic beverages consumption (OR: 0.75, 95% CI: 0.62–0.89). Since only a small percentage of the adult population in Serbia meets the WHO recommendations for physical activity, action is required. This should involve creating future strategies and policies, as well as initiatives focused on education and raising awareness about the importance of physical activity and health. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa. Methods: We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. Results: The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%–74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43–5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39–4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16–4.49). Conclusion: This meta-analysis's findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy. [ABSTRACT FROM AUTHOR]

ABSTRACT Effective communication in pediatric dermatology is critical for accurate diagnosis and treatment, particularly in sensitive areas such as the anogenital region. Unfortunately, children and their families often use euphemisms or incorrect terms when referring to this area, and many adults lack knowledge of anogenital terminology. Pediatric dermatologists can play a unique role in educating children and their families on correct anatomical language, which enhances body awareness, empowers young patients, improves safety, and contributes to accurate medical assessments and treatment adherence. By promoting the use of correct anatomical terms, pediatric dermatologists can improve patient outcomes and foster a healthier understanding of body anatomy and health. [ABSTRACT FROM AUTHOR]

Every year, government agencies, international organisations, and civil society associations produce public communications campaigns designed to inform, persuade, and motivate behaviour regarding numerous facets of migration. Despite their increasing ubiquity, resources, and – possibly – impact, as well as the profound scientific relevance in understanding them, such campaigns remain relatively understudied and existing research is disjointed across various disciplines. This article takes three steps to propose and initiate a unified, interdisciplinary research agenda on migration communication campaigns (MCCs). First, we overview the need for a research agenda based on their increased substantive importance and scientific interest. Second, we outline what such a research agenda should look like, proposing six research themes. Third, we contribute to this proposed research agenda in two ways: with a typology of MCCs and by presenting our open-access, collaborative database to kick-start more systematic research in this field, including theoretical justifications for each variable. The database includes 301 MCCs conducted in 32 European countries between 2012 and 2022. We invite submissions of all types of MCCs globally to create a bridge between communities of academics, policymakers, and communicators. [ABSTRACT FROM AUTHOR]

Purpose: Anorectal malformations (ARMs) are rare congenital anomalies causing altered anatomy and frequent hospitalizations. Parental awareness and clear communication are crucial in family-centered care. This study assesses the impact of patient-held ARM Medical Alert Cards on healthcare providers and caregivers. Methods: Caregivers of children with ARMs, including cloacal anomalies, received Medical Alert Cards with (1) contact details; (2) disease-related information; and (3) patient-specific data. A survey evaluated these cards' effectiveness in enhancing ARM awareness among healthcare professionals and caregivers. Results: Among 33 respondents, 29 (88%) found the cards helpful in increasing ARM awareness. Both caregivers and providers found the content coherent, with a median readability score of 9 (IQR 8–10). The card layout was well-received by 30 out of 32 respondents (94%), and all noted the clarity of the contact details, facilitating patient referrals to specialized care. Most caregivers (13 out of 14, 93%) expressed willingness to use these cards in medical settings. Suggestions for improvement included adding more patient-specific information, enhancing readability, and providing visual anatomy diagram. Conclusion: Medical Alert Cards for patients with ARMs can enhance understanding of ARMs among caregivers and healthcare providers, serving as a vital tool in patient-centered management strategies tailored to individual needs. [ABSTRACT FROM AUTHOR]

Assisted coral recovery (ACR) initiatives are establishing rapidly in coral reefs worldwide, using a variety of devices and techniques. In the Great Barrier Reef (GBR, the Reef), site-scale ACR field trials are occurring at multiple sites in the Cairns-Port Douglas region through Reef stewardship activities involving GBR tourism operators, Traditional Owners, and not-for-profit organisations. It is hypothesised that these field trials and the presence of ACR devices at reef tourism sites do not negatively affect visitor experiences, and when accompanied by appropriate educational information, can potentially help to raise awareness of Reef stewardship and conservation efforts. We tested these hypotheses using a survey of 708 Reef visitors on five tourism vessels, 346 of whom reported observing ACR devices in situ during their coral reef experience. Ordinal regression tests of survey responses found no statistical relationship between respondents' observation of ACR devices and (i) their overall Reef trip satisfaction, (ii) the perceived aesthetic beauty of the site(s) they visited, and (iii) their concern about the future health of the GBR. However, Reef visitors who observed ACR devices showed significantly lower levels of concern about the use of these devices on the Reef. The perceived quality of educational information presented to respondents was among the significant factors associated with their reef trip satisfaction and perceived beauty of reef sites. Our findings have implications for ACR practitioners and proponents who are concerned about public visibility, perceptions, and support for ACR initiatives, as the scale of such initiatives is expected to increase. [ABSTRACT FROM AUTHOR]

Rice ranks as the third most important staple cereal food crop in Kenya, following maize and wheat. The demand for rice has been increasing at a faster rate than most cereals, occasionally requiring imports to meet local needs. In response, the Kenyan government has been implementing a programme to increase rice production by expanding irrigated lowland rice schemes from 32 988 to 171 676 ha, while increasing rain-fed upland production areas four-fold to 42 000 ha by 2030. However, with continued rice monocropping in irrigated lowland fields and intensification in rain-fed upland ecosystems, there is a growing concern that plant-parasitic nematodes may emerge as a significant problem across rice ecosystems. This study characterised the nematode genera associated with rice in Kenya and assessed their diversity and distribution across rice ecosystems, with a focus on Hirschmanniella species. Eleven nematode genera were identified in both ecosystems, indicating a relatively high diversity. These genera, ranked by prominence, included Hirschmanniella, Hoplolaimus, Pratylenchus, Helicotylenchus, Meloidogyne, Ditylenchus, Trichodorus, Xiphinema, Rotylenchus, Longidorus and Paratylenchus. The family Tylenchidae was also found to be an important component of the nematofauna. Both morphological and molecular analyses confirmed the presence of Hirschmanniella oryzae in irrigated lowland and rain-fed upland rice, which represents the first documented report for Kenya. A notably large molecular variation was also observed for these Kenyan populations on the 18S region, with intraspecific variation up to 10 bp difference. Understanding the diversity, distribution, and species composition of nematodes in rice ecosystems is important for raising awareness among plant protection services, farmers, cooperatives and extension agents about plant-parasitic nematodes and their challenges in rice production. Future research should build on this knowledge to support extensive studies on population dynamics and damage threshold, focusing on local rice cultivars to develop effective management strategies, including breeding programmes and other cultural practices. [ABSTRACT FROM AUTHOR]

Background: Canada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20–24 (50%) and youth aged 16–19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others' approaches to reducing cannabis-related risks and harms. Methods: This qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis. Results: The study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines. Conclusions: Youth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative. [ABSTRACT FROM AUTHOR]

Background: Persons (henceforth, women) who have hypertensive disorders of pregnancy (HDP) are at risk of premature cardiovascular disease (CVD). While largely preventable through lifestyle management, many women and clinicians are unaware of the risk. Based on prior research, we developed a question prompt tool (QPT) on preventing and managing CVD after HDP. The purpose of this study was to refine QPT design. Methods: We recruited Canadian women who had HDP and clinicians who might care for them using multiple strategies, conducted telephone interviews with consenting participants, and used qualitative description and inductive content analysis to derive themes. Results: We interviewed 21 women who varied in HDP type, CVD status, years since HDP pregnancy, age, geography and ethno-cultural group; and 21 clinicians who varied in specialty (midwife, nurse practitioner, family physician, internist, obstetrician, cardiologist), geography and years in practice. Participating women and clinicians agreed on needed improvements: more instructions, lay and gender-neutral language, links to additional information, more space for answers, graphic appeal, and both print and electronic format. Both groups identified similar barriers: clinicians lack time/willingness, and low language/health literacy and access to technology among women; enablers: translated, credible source/endorser, culturally relevant, organized by health trajectory stages; and likely benefits: raise awareness, empower women, encourage them to adopt healthy lifestyle. Women desired exposure to the QPT before or during pregnancy, while clinicians recommended waiting until postpartum to avoid overwhelming women. Similarly, most women said the QPT should be available through multiple avenues to empower them for health self-advocacy, while clinicians thought they should introduce the QPT to women, and decide when and which questions to address. To mitigate reluctance, clinicians recommended self-directed educational materials accompany the QPT. Conclusions: We will use this information to refine QPT design and plan for future evaluation. If found to be effective and widely disseminated, the QPT could improve awareness and communication about this issue, and may reduce CVD risk in many women who have hypertensive pregnancies. Ongoing research is needed to more fully understand how QPTs support patient-clinician communication, and how to alert and prime both patients and clinicians to use QPTs. [ABSTRACT FROM AUTHOR]

Background: Obesity rates among children and adults continue to accelerate in the U.S., particularly among marginalized and low-income populations. Obesity prevention and reduction policies can significantly impact population health by improving environmental conditions and increasing access to health-promoting resources. Limited research has been conducted to examine state obesity policy change over time. The primary aim of this study is to examine legislative approaches used to prevent and reduce obesity in the state of California (U.S.). Methods: We used quantitative policy surveillance methods to develop a state database of obesity-related legislation (bills, resolutions) introduced in California's legislature between 1999 and 2020. Descriptive statistics were used to examine trends of introduced and enacted policy by legislative and policy characteristics. Chi-square tests were used to determine differences in characteristics between enacted and non-enacted legislation. Legislative session and policy characteristics found to be associated with enactment were used to predict adoption in a logistic regression. Results: A total of 284 obesity-related bills and resolutions were introduced in California's legislature between 1999 and 2020 with a peak of 43 in 2005–2006. On average, 25.8 bills and resolutions were introduced each 2-year legislative cycle. Findings indicate that (a) children and schools were the most frequently specified population and setting; (b) the most common policy topics were nutrition (45%) and physical activity (33%); and (c) only 15% of legislation mentioned race/ethnicity. Overall, 24.9% of bills were enacted compared to 82.1% of resolutions adopted. Legislation to raise awareness about obesity had 5.4 times the odds of being passed compared to other topics. Yet this difference was not statistically significant in a sensitivity analysis when we excluded resolutions. Conclusions: This database can be leveraged to advance our knowledge of effective and equitable policy instruments to prevent and reduce obesity. Results reveal important policy elements that may impact legislative success, including policy topic, and contribute to a nascent evidence base for public health law research, legal epidemiology, and practice. Future work should investigate the role of policy effectiveness research and evidence on legislative policymaking. [ABSTRACT FROM AUTHOR]

Background: As part of the UK government's obesity strategy, the Food (Promotion and Placement) (England) Regulations 2021 were implemented in October 2022 to restrict the prominent placement of products high in fat, sugar, or salt (HFSS) in most retail settings. Local authority (LA) officers have been tasked with enforcement of these regulations. This qualitative study examined the perspectives of LA officers including, trading standards, environmental health, and public health officers to understand enforcement approaches and requirements to optimise business compliance with the regulations. Methods: Semi-structured interviews were conducted via MS Teams with a purposive sample of LA officers across England. Data were analysed using inductive thematic analysis. Results: The 22 participants comprised 13 officers from Trading Standards, six from Environmental Health, and three from Public Health teams. The key messages include the following: (i) the regulations are complex and do not align with existing enforcement approaches, (ii) officers' professional background will result in variable enforcement practices, and (iii) compliance assessment is an arduous task. LAs are facing resource and workforce constraints and have to prioritise regulations addressing high health risks (e.g., allergens). Therefore, officers will mostly apply a light touch approach to enforcement, raising awareness and engaging with businesses rather than issuing notices. To develop a consistent enforcement approach across LAs, officers asked for (i) further leadership from central government in the form of funding, training, and tools to determine in-scope businesses and products, (ii) cross-departmental collaboration to raise the regulations' priority at local and regional levels, and (iii) greater consumer demand for healthier retail environments. Conclusion: It is crucial to address both structural challenges such as resource allocation, workforce, and prioritisation issues as well as the inherent complexity of the regulations to strengthen enforcement efforts. Our findings highlight the necessity of supporting enforcement activities at national and regional government levels to avoid potential false conclusions about ineffectiveness of regulations. Highlights: • The UK Food (Promotion and Placement) regulations are perceived as complex and low priority by LA officers • A light touch enforcement approach could undermine effective implementation of the regulations • Funding is required to enable officers to conduct business support visits and encourage compliance • Accredited training for officers is required to facilitate common understanding of regulations • Qualitative methods provided novel insights about enforcement concerns of the pioneering Food (Promotions and Placement) regulations to reduce obesity [ABSTRACT FROM AUTHOR]

ABSTRACT Understanding the molecular signaling pathways of colorectal cancer (CRC) can be accepted as the first step in treatment strategy. Permanent mTOR signaling activation stimulates the CRC process via various biological processes. It supplies the survival of CRC stem cells, tumorigenesis, morbidity, and decreased response to drugs in CRC pathogenesis. Therefore, inhibition of the mTOR signaling by numerous bioactive components may be effective against CRC. The study aims to discuss the therapeutic capacity of various polyphenols, terpenoids, and alkaloids on CRC via the PI3K/Akt/mTOR pathway. The potential molecular effects of bioactive compounds on the mTOR pathway's upstream and downstream targets are examined. Each bioactive component causes various physiological processes, such as triggering free radical production, disruption of mitochondrial membrane potential, cell cycle arrest, inhibition of CRC stem cell migration, and suppression of glycolysis through mTOR signaling inhibition. As a result, carcinogenesis is inhibited by inducing apoptosis and autophagy. However, it should be noted that studies are primarily in vitro dose‐dependent treatment researchers. This study raises awareness about the role of phenolic compounds in treating CRC, contributing to their future use as anticancer agents. These bioactive compounds have the potential to be developed into food supplementation to prevent and treat various cancer types including CRC. This review has the potential to lead to further development of clinical studies. In the future, mTOR inhibition by applying several bioactive agents using advanced drug delivery systems may contribute to CRC treatment with 3D cell culture and in vivo clinical studies. [ABSTRACT FROM AUTHOR]

TikTok, a popular social media network, has gained an immense worldwide following because of its entertaining short video format. The main aim of this study was to understand the dynamic association between the variables TikTok addiction, impulsivity, digital maturity, and morality in young adults. For this purpose, a quantitative study with a correlational research design was adopted. Purposive sampling was used to select 423 TikTok users from private universities, with 209 males and 214 females included. The data was collected through the TikTok Addiction Scale, which has been adapted from the Social Media Addiction Scale (Sahin, 2018), the Barratt Impulsiveness Scale Version 11 (Barratt et al., 1995), the multidimensional Digital Maturity Inventory (Laaber et al., 2023), and the Moral Character Questionnaire (Furr et al., 2022). The results showed a strong significant positive relationship between TikTok addiction and impulsivity, but significant negative correlation with digital maturity and morality. Impulsivity had a strong significant negative relationship with digital maturity and morality, whereas digital maturity had a strong positive relationship with morality. The results of this study can be helpful in raising awareness about the adverse effects of TikTok addiction and in promoting digital literacy through workshops or seminars. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsLack of recruitment to clinical academic careers is of concern, and may be linked to lack of awareness and promotion of this pathway in undergraduate medical education. Our study explored undergraduate experiences which support academic career progression and potential barriers to pursuing Specialised Foundation roles in the United Kingdom.We adopted a constructivist lens and conducted interviews with specialised foundation programme (SFP) doctors and final year students who had applied for SFP positions. We analysed interview transcripts using reflexive thematic analysis.We recognised four key stages which stimulated and supported students in pursuing a clinical academic career: (1) Lighting the inner spark; (2) Igniting the fire; (3) Feeding the fire; and (4) Seeing through the smoke. Although students showed a strong inner drive, meaningful undergraduate experiences and positive interactions with academics were crucial for sparking academic interests. Participants were more often inspired by their extra-curricular activities than core undergraduate education.Early positive experiences are needed for students to overcome stereotypes and consider clinical academic careers. Medical schools should raise awareness of clinical academic careers early on, ensure all students have opportunities to participate in relevant activities with academic teams, and develop medical educators and researchers who can engage and inspire others. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusion Studying dentists' knowledge of dry mouth management is crucial for effective diagnosis and treatment, improving patient outcomes and oral health. This study aimed to evaluate their knowledge and awareness of dry mouth and its predictors.A pre‐validated online survey was administered to a convenience sample of dentists across six countries. The questionnaire evaluated knowledge in various domains, including predisposing factors, diagnosis, clinical signs and symptoms, and management of dry mouth.A total of 884 dentists participated. Knowledge and awareness of dry mouth management varied significantly between countries (p < 0.05). Overall, 34.3% of participants demonstrated good knowledge, while 53.7% had moderate knowledge. Regarding management awareness, 55.4% had good awareness and 35.5% had moderate awareness. A majority (69.2%) showed good knowledge of common signs, symptoms, and consequences of dry mouth. Significant predictors of better knowledge and awareness included the country of practice and attendance at continuing education courses on dry mouth.The findings suggest that dentists in the surveyed countries require improved education on dry mouth and its management. Dental educators and healthcare planners can use this data to design targeted continuing education activities to enhance knowledge and awareness of dry mouth. [ABSTRACT FROM AUTHOR]

Summary Background Methods Results Conclusion Anaesthetic training has always had patient safety as part of the curriculum. However, there is limited emphasis on what happens when things do not go to plan. Our aims were to understand the impact of involvement in patient safety incidents on anaesthetic trainees in our region, to describe the range of support currently offered and put forward suggestions for improvement.An initial electronic survey was sent to all anaesthetic trainees in a single UK healthcare region to capture qualitative and quantitative information on patient safety incidents. After completing the questionnaire, participants were asked to consent to involvement in a semi‐structured interview to provide a more detailed understanding of the impact of safety incidents. Data were analysed from the questionnaires and interview transcripts using descriptive statistics and thematic analysis.Thirty‐four completed questionnaires were analysed revealing 27 trainees had been involved in a patient safety incident. Ten semi‐structured interviews were conducted and six themes were identified: team dynamics (including adequacy of staffing and supportive departmental culture); context of the event; reflex immediate support post‐event; working environment pending completion of the investigation; personal impact (including physical and mental health); and suggestions for future support.This study has shown the significant impact of safety incidents on anaesthetic trainees in one training region in the UK and highlights the importance of implementing early, tailored debriefs led by trained facilitators, the value of a supportive work environment and the need to raise awareness of system‐based approaches to learning from incident investigations. Further research should guide the format and delivery of support for trainees to provide more helpful and timely interventions after patient safety incidents and reduce the risk of future harm to both patients and trainees. [ABSTRACT FROM AUTHOR]

This paper describes the design, delivery and evaluation of a module on decision making for senior managers as part of a master’s programme for current and aspiring Chief Social Work Officers (CSWO). Scotland is unique in having a statutory duty that requires local authorities to appoint a CSWO to provide strategic and professional leadership in the delivery of social work services. The CSWO also has certain statutory decision-making responsibilities and as a key decision maker is responsible for decisions that affect individual rights and liberties to an extent that other services do not. This paper describes the key decisions CSWO’s are required to undertake before describing the pedagogical approach to developing and delivering the module. Rather than seeking to teach decision making the focus of the module is on raising awareness of factors that impact decision making, shifting from intuitive to active decision making and reflecting on the decision-making process. Results are presented from a thematic analysis of a post-completion survey of participants about their learning. The results highlight the isolation and vulnerability of the role, the weight of responsibility, the complexity and challenges of decision making and how the module supports managers to engage in analytical decision making. [ABSTRACT FROM AUTHOR]

Objectives: This article aims to broaden the understanding of burnout in healthcare providers, its causes, and its reduction strategies. The objectives are to raise awareness, facilitate early intervention, and, ultimately, improve the overall well-being of healthcare providers and the quality of patient care. Methods: The study investigated healthcare-provision-associated burnout, an often-unrecognized syndrome affecting professionals worldwide, and its prevalence. it also examined the impact of burnout on patient outcomes, safety, and provider health and well-being. Here, we delve into the triad of burnout attributes: emotional exhaustion, depersonalization, and decreased personal accomplishment. Specific causes, such as work-life balance, workplace environment, and communication/teamwork, are investigated. The existing literature and studies we report explore the pathophysiological effects of burnout, including its impact on health, sleep patterns, and the alarming correlation with suicide. Results: The prevalence of burnout among healthcare providers is between 30% and 50%. Burnout is a significant factor contributing to poor patient outcomes and threatening patient safety. Furthermore, burnout can induce physical symptoms, including psychological, cardiovascular, and gastrointestinal disorders. We emphasize the importance of identifying and preventing burnout to maintain the overall integrity of healthcare providers and eliminate vulnerabilities for harm to their patients. Conclusions: Burnout awareness should be a priority from the early stages of healthcare providers' careers because it is crucial formaintaining their well-being, preventing medical errors, and sustaining high- quality patient care. The identification and prevention of burnout are deemed vital not only for the well-being of healthcare providers but also to safeguard against potential harm to patients. This article calls for in-creased awareness of burnout, its underlying causes, and the implementation of effective reduction strategies in the healthcare profession. [ABSTRACT FROM AUTHOR]

People with hearing impairments often face increased risks related to traffic accidents due to their reduced ability to perceive surrounding sounds. Given the cost and usage limitations of traditional hearing aids and cochlear implants, this study aims to develop a sound alert assistance system (SAAS) to enhance situational awareness and improve travel safety for people with hearing impairments. We proposed the VAS-Compass Net (Vehicle Alert Sound–Compass Net), which integrates three lightweight convolutional neural networks: EfficientNet-lite0, MobileNetV3-Small, and GhostNet. Through employing a fuzzy ranking ensemble technique, our proposed model can identify different categories of vehicle alert sounds and directions of sound sources on an edge computing device. The experimental dataset consisted of images derived from the sounds of approaching police cars, ambulances, fire trucks, and car horns from various directions. The audio signals were converted into spectrogram images and Mel-frequency cepstral coefficient images, and they were fused into a complete image using image stitching techniques. We successfully deployed our proposed model on a Raspberry Pi 5 microcomputer, paired with a customized smartwatch to realize an SAAS. Our experimental results demonstrated that VAS-Compass Net achieved an accuracy of 84.38% based on server-based computing and an accuracy of 83.01% based on edge computing. Our proposed SAAS has the potential to significantly enhance the situational awareness, alertness, and safety of people with hearing impairments on the road. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for one-third of all global deaths. The World Health Organization (WHO) asserts that prevention is the most effective strategy to combat CVD, emphasizing the need for non-invasive, low-cost tools to identify individuals at high risk of CVD. Atherogenic indices and heart age (HA) are valuable tools for assessing cardiovascular risk (CVR). The aim of our study was to evaluate the association between atherogenic indices and HA. Methods: A cross-sectional study was conducted involving 139,634 Spanish workers to determine the association between three atherogenic indices and HA. ROC curves were employed to identify the cut-off values for the various atherogenic indices used to estimate high HA. The cut-off points, along with their sensitivity, specificity, and Youden index, were determined, and the area under the curve (AUC) was calculated. Results: As the values of the atherogenic indices increased, so did the risk of having elevated avoidable lost life years (ALLY) HA. In the ROC curve analysis, the AUC with the best results corresponded to the total cholesterol/HDL-c atherogenic index, with an AUC of 0.803 in females and 0.790 in males. The LDL-c/HDL-c atherogenic index showed an AUC of 0.780 in women and 0.750 in men, with Youden indices around 0.4. When analyzing the AUC of the atherogenic index for triglycerides/HDL-c, the results were 0.760 in women and 0.746 in men. Conclusions: Atherogenic indices and HA show a close relationship, with an increase in these indices leading to a rise in HA values. Raising patient awareness that as their CVR levels increase, so does their HA may be useful in achieving some benefit in reducing CVR. [ABSTRACT FROM AUTHOR]

Introduction Evaluation of shunt for malfunction and blockage is a common neurosurgical clinical scenario in day-to-day paediatric neurosurgery practice. Parental concern for shunt malfunction is normally considered a reliable indication for undertaking further assessment of a child with a shunt. Accuracy of parental diagnosis of shunt malfunction likely is dependent on combination of parental knowledge and patient symptomatology and familiarity of symptoms in relation to previous shunt malfunction symptoms. There are currently no UK studies on accuracy of parental diagnosis of shunt malfunction. We undertook this study to investigate sensitivity and specificity of parental diagnosis in our tertiary paediatric neurosurgical unit to identify any factors that can be used for further education and raising awareness in parents with children with shunts. Methods We undertook a review of all referrals with suspected shunt malfunction to our tertiary paediatric neurosurgical unit over a period of 10 months. All referrals and presentations were evaluated for parental concern for likelihood of shunt malfunction and marked as yes or no. Further information gathered included demographics, age, sex, symptoms at presentation, previous history of shunt revision, cases of shunt malfunction and part of the shunt revised. Sensitivity, specificity, positive and negative predictive values and accuracy were then calculated and factors associated with positive diagnosis of shunt malfunction analysed. Results Overall, 100 referrals with suspected shunt malfunction were made over 10 months period. Mean age for children at the time of referral was 6.3 years with an M/F ratio of 42M:58F. Twenty-one shunt malfunction cases were identified leading to overall revision rate of 21%. Parental evaluation of shunt function had sensitivity of 90.4%, specificity of 10.1%, positive predictive value of 21.1% and negative predictive value of 80%. Drowsiness and higher number of symptoms at presentation were associated with true positive diagnosis of shunt malfunction. No link was identified with true diagnosis of shunt malfunction with other symptoms of shunt malfunction or previous history of shunt revision and age of the patient. Conclusion Parental diagnosis of shunt malfunction has high sensitivity and negative predictive value and low specificity and positive predictive value. Increased number of symptoms as well as drowsiness were associated with correct parental diagnosis of shunt malfunction. Educational programs and parental training can be valuable in increasing awareness about shunt malfunction signs. [ABSTRACT FROM AUTHOR]

Introduction: Cultural inclusion and competence are understood at the most basic level to be the practice of considering culture so as to provide effective services to people of different cultural backgrounds. In order to work better with clients from diverse backgrounds, alcohol and other drug (AOD) services need to offer a service that is designed to be accessible to all people, where systems in place operate in a way that considers different cultural needs. This research aimed to assess the extent to which non‐government AOD services in New South Wales are positioned to support cultural inclusion as well as to evaluate the acceptability of a cultural inclusion audit across four AOD sites. Methods: The research adopted a mixed methods approach comprising of a pre‐audit online survey (n = 85) designed to assess AOD services' attitudes and practices towards cultural inclusion, and in‐depth interviews that were conducted with nine AOD service staff and four cultural auditors to explore the acceptability of a cultural inclusion audit process. Results: Findings from the survey indicate cultural inclusion practices are limited. Interview data highlight that while staff are not fully aware of what appropriate cultural inclusions entails, they are receptive to and want a cultural inclusion program. Discussion and Conclusions: The study illustrates the benefits of implementing a cultural inclusion audit process aimed at raising awareness of what cultural inclusion entails. Including a cultural inclusion service audit is likely to enhance AOD service provision to culturally and linguistically diverse groups and thereby improve treatment outcomes. [ABSTRACT FROM AUTHOR]

PRACTICE IMPACT STATEMENTThis qualitative study examines the perspectives of forensic interviewers on the education of individuals with a disability who have been exposed to sexual abuse and violence. Data were collected through semi-structured interviews with 25 forensic interviewees in six provinces in Turkey. The data were analysed using thematic analysis. Thematic analysis results revealed four themes: types of disabilities of individuals subjected to sexual violence and abuse; family; education and sexual violence and abuse; and the effect of difficulties in self-expression during the forensic interview process. The findings emphasise the necessity for tailored, visually supported education aligned with developmental stages to prevent sexual violence. The inclusion of parents in these sexual education sessions could prove to be effective in preventing the onset of sexual abuse perpetrated against individuals with a disability. The insights provided by forensic interviewers underscore the importance of an interdisciplinary approach in developing and implementing sexual education programmes, aiming to address deficiencies in current sexual education frameworks. Personal safety and sexual education could be useful in preventing negative incidents that individuals with a disability may encounter at every stage of their lives.Our results highlight the critical importance of customised sexual education programmes for reducing the vulnerability of individuals with a disability to sexual violence and abuse. It addresses the role of identifying practical measures to address the risks associated with these individuals, promoting parental involvement, and raising awareness in the community. Interdisciplinary collaboration across various fields, such as health care, psychology, and law, and the development of inclusive sexual education initiatives, may be important for protecting the rights and well-being of individuals with a disability and their families. [ABSTRACT FROM AUTHOR]

Malaria remains a significant global health challenge, with millions of cases and high mortality rates annually, especially in low-income countries. Africa bears a substantial burden, with direct costs of malaria among children under five reaching millions of dollars in countries like Ghana, Tanzania, and Kenya. In 2021, over 610,000 malaria-related deaths were reported, 96% of which occurred in sub-Saharan Africa. Despite existing interventions, such as long-lasting insecticidal nets, indoor residual spraying, and intermittent preventive treatment, the re-emergence of malaria underscores the need for innovative preventive strategies. This study explores the potential of utilizing mobile phone caller tunes to raise awareness and promote the uptake of the RTS,S malaria vaccine. The technology acceptance model (TAM) provides a framework for understanding how users perceive and adopt new technologies. Caller tunes, a mobile phone feature that plays audio for callers waiting to be connected, have been effective in health communication campaigns in Asia and Africa. This approach could be leveraged to enhance malaria vaccine awareness, particularly in low-income countries where vaccine hesitancy is prevalent and malaria endemic. Overall, mobile technologies have significantly improved healthcare delivery in Africa, facilitating communication, monitoring, and treatment adherence in remote areas. Integrating caller tunes with health messages about the malaria vaccine could address vaccine hesitancy and improve uptake. This would require collaboration with telecommunication companies, healthcare providers, and policymakers to design culturally and linguistically appropriate messages. However, the cost of caller tune services, the need for internet access, and cultural differences are the expected challenge that may occur in this approach. Therefore, strategic partnerships and intersectoral approaches can mitigate these issues, making caller tunes a viable tool for public health communication. Raising awareness through this innovative method could enhance the adoption of the RTS,S vaccine and support ongoing malaria control efforts in Africa. [ABSTRACT FROM AUTHOR]

The article discusses the need to revise diabetes terminology in Asian countries, such as Japan, China, South Korea, and Mongolia, to combat stigma associated with terms referencing sugar and urine. A symposium at the 16th Scientific Meeting of the Asian Association for the Study of Diabetes highlighted the importance of adopting new, less stigmatizing terms for diabetes. Efforts are underway to align with global standards and improve societal perceptions of diabetes across Asia, with plans to continue discussions at the 17th AASD Scientific Meeting in 2025. The initiative aims to enhance public understanding and quality of life for individuals living with diabetes in the region. [Extracted from the article]

The diagnosis and management of malaria in non-endemic countries presents a continuing challenge. Plasmodium falciparum, which is capable of rapidly inducing severe and life-threatening multiorgan disease, is the species most frequently diagnosed in Europe and North America. To summarise the more relevant diagnostic findings and clinical features of malaria observed in non-endemic settings and to provide an update of the key management decision points using three illustrative clinical scenarios of uncomplicated and severe malaria. The discussion is based on a relevant literature search spanning the last 20 years. Recommendations are based on available clinical guidelines including those of the WHO, observational studies conducted in non-endemic settings, and, when available, extrapolation from randomised studies from malaria-endemic settings. The following topics are covered: diagnosis, including the use of molecular biology; clinical characteristics; management with a specific focus on complicated (severe) and uncomplicated malaria; and areas of resistance to available antimalarial drugs. Malaria imported to non-endemic settings, especially P. falciparum malaria, is sometimes initially overlooked and the delayed diagnosis is responsible for every year of preventable deaths. This review aims to raise awareness of malaria outside endemic countries and to provide clinicians with a practical guide for efficient diagnosis and targeted therapy for the different species involved. [ABSTRACT FROM AUTHOR]

Due to the ban of certain single-use plastics in the European Union, food contact materials (FCM) from biobased and/or biodegradable polymers are increasingly being used. Some FCM are made from wheat or rye and therefore contain gluten, which is a food allergen and known to cause celiac disease. Legislation currently does not require allergen labelling on FCM and there is only some first information that gluten from FCM can migrate into gluten-free foods. Our aim was to analyze the extent of gluten migration from six different FCM into a variety of liquid and solid foods to assess the risk of exposure for wheat allergy and celiac disease patients. We show that the extent of gluten migration depended on the properties of the material, the liquid or solid food it comes into contact with and contact time. There was no clear effect of temperature or pH value. Of the six FCM studied, wheat bran-based plates had the highest potential to release gluten with concentrations of up to 203.0 mg/L of gluten in deionized water after 30 min. To protect patients, it is important to raise awareness of the risk of gluten migration from such FCM and help patients identify and avoid gluten-containing FCM. Further, legislation needs to be adapted urgently to include mandatory labelling of allergens on these biodegradable FCM. [ABSTRACT FROM AUTHOR]

Background: Anxiety in pregnancy and postnatally is highly prevalent but under‐recognized. To identify perinatal anxiety, assessment tools must be acceptable to women who are pregnant or postnatal. Methods: A qualitative study of women's experiences of anxiety and mental health assessment during pregnancy and after birth and views on the acceptability of perinatal anxiety assessment. Semi‐structured interviews were conducted with 41 pregnant or postnatal women. Results were analysed using Sekhon et al.'s acceptability framework, as well as inductive coding of new or emergent themes. Results: Women's perceptions of routine assessment for perinatal anxiety were generally favourable. Most participants thought assessment was needed and that the benefits outweighed potential negative impacts, such as unnecessary referrals to specialist services. Six themes were identified of: (1) Raising awareness; (2) Improving support; (3) Surveillance and stigma; (4) Gatekeeping; (5) Personalized care and (6) Trust. Assessment was seen as a tool for raising awareness about mental health during the perinatal period and a mechanism for normalizing discussions about mental health more generally. However, views on questionnaire assessments themselves were mixed, with some participants feeling they could become an administrative 'tick box' exercise that depersonalizes care and does not provide a space to discuss mental health problems. Conclusion: Routine assessment of perinatal anxiety was generally viewed as positive and acceptable; however, this was qualified by the extent to which it was informed and personalized as a process. Approaches to assessment should ideally be flexible, tailored across the perinatal period and embedded in continuity of care. [ABSTRACT FROM AUTHOR]

This article discusses the challenges in managing head neck squamous cell cancer from an unknown primary (HSCCUP) due to a lack of contemporary evidence and evolving understanding of the role of human papillomavirus (HPV) in head and neck cancer. Despite these limitations, various organizations have produced guidelines for managing HSCCUP using different methodologies. The article presents the results of a consensus process involving multiple stakeholders and centers, which led to the publication of consensus statements in the United Kingdom National Multidisciplinary Guidelines. The authors of the document, Vinidh Paleri, John Hardman, Tom Roques, and Ben O'Leary, made significant contributions to the work and have no conflicts of interest to report. The peer review history of the article is available for further reference. [Extracted from the article]

Women comprise approximately 40% of the global workforce, and many women continue to work during pregnancy. Although occupational exposure limit values (OELVs) are intended to protect all workers, many OELVs may have been established without consideration of the unique changes in pregnant workers, and many chemicals lack OELVs altogether. A short educational course was developed to address the informational needs of health professionals who have responsibility to ensure a safe workplace for pregnant employees. The course was designed to raise awareness of the key elements in risk management and their application to the pregnant worker, such as physiological changes of pregnancy that influence susceptibility to exposures; guidance for nonclinical data interpretation; exposure assessment and control strategies; and risk management in practice in a diverse regulatory environment. This paper summarizes the course content and is intended to support informed risk management decision making to protect the health of pregnant workers and their offspring. [ABSTRACT FROM AUTHOR]

Limb‐girdle muscular dystrophy type 2G/R7 (LGMD2G/R7) is an ultra‐rare condition initially identified within the Brazilian population. We aimed to expand clinical and genetic information about this disease, including its worldwide distribution. A multicenter historical cohort study was performed at 13 centers in Brazil in which data from index cases and their affected relatives from consecutive families with LGMD2G/R7 were reviewed from July 2017 to August 2023. Additionally, a systematic literature review was conducted to identify case reports and series of the disease worldwide. Forty‐one LGMD2G/R7 cases were described in the Brazilian cohort, being all subjects homozygous for the c.157C>T/(p.Gln53*) variant in TCAP. Survival curves showed that the median disease duration before individuals required walking aids was 21 years. Notably, women exhibited a slower disease progression, requiring walking aids 13 years later than men. LGMD2G/R7 was frequently reported not only in Brazil but also in China and Bulgaria, with 119 cases identified globally, with possible founder effects in the Brazilian, Eastern European, and Asian populations. These findings are pivotal in raising awareness of LGMD2G/R7, understanding its progression, and identifying potential modifiers. This can significantly contribute to the development of future natural history studies and clinical trials for this disease. [ABSTRACT FROM AUTHOR]

The neurological basis for perceptual awareness remains unclear, and theories disagree as to whether sensory cortices per se generate awareness. Critically, neural activity in the sensory cortices is only a neural correlate of consciousness (NCC) if it closely matches the contents of perceptual awareness. Research in vision and touch suggest that contralateral activity in sensory cortices is an NCC. Similarly, research in hearing with two sound sources (left and right) presented over headphones also suggests that a candidate NCC called the auditory awareness negativity (AAN) matches perceived location of sound. The current study used 13 different sound sources presented over loudspeakers for natural localization cues and measured event‐related potentials to a threshold stimulus in a sound localization task. Preregistered Bayesian mixed models provided moderate evidence against an overall AAN and very strong evidence against its lateralization. Because of issues regarding data quantity and quality, exploratory analyses with aggregated data from multiple loudspeakers were conducted. Results provided moderate evidence for an overall AAN and strong evidence against its lateralization. Nonetheless, the interpretations of these results remain inconclusive. Therefore, future research should reduce the number of conditions and/or test over several sessions to procure a sufficient amount of data. Taken at face value, the results may suggest issues with AAN as an NCC of auditory awareness, as it does not laterally map onto experiences in a free‐field auditory environment, in contrast to the NCCs of vision and touch. In vision and touch, contralateral activity in sensory cortices is a neural correlate of consciousness (NCC) as the neural activity matches lateralized percepts. In hearing, this has not been thoroughly investigated. Here, we measured event‐related potentials from 13 free‐field sound sources. The neural correlate of auditory consciousness (AAN) was found; however, results do not resolve whether AAN is lateralized in response to lateral stimuli. Taken at face value, results may suggest that AAN is not an NCC of lateralized auditory experience to free‐field sound sources. [ABSTRACT FROM AUTHOR]

The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. Even during the coronavirus disease 2019 (COVID-19) lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how "conventional" disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma. [ABSTRACT FROM AUTHOR]

Purpose: Despite the use of plagiarism-checking software and current ethical guidelines in sport management journals, raising awareness of ethical concerns and potential risks of artificial intelligence (AI) applications is necessary. This paper discusses how AI affects ethical research and publishing and provides guidelines for sport management scholars to ensure quality and integrity of their research. Design/methodology/approach: A comprehensive review and critical analysis of literature was performed to evaluate research ethics, potential risks, and guiding principles for the use of AI in research. Findings: Ethical research guidelines for quantitative sport management research were proposed. The guidelines encompass seven principles for the proper use of AI and ethical conduct specific to the research methods, data analysis, and results, which would be challenging for AI to accurately replicate. Originality/value: This study provides an original contribution to the field of sport management because numerous questions concerning ethics and AI have not been addressed until now. The guidelines are suitable for use by sport management scholars, concerning the accuracy, validity, and quality of research while mitigating ethical risks in AI-generated content. [ABSTRACT FROM AUTHOR]

Head-mounted augmented reality (HMD AR) technology in construction has shown promise in enhancing operational efficiency. Concurrently, the critical role of hazard identification (HI) in ensuring worker safety is well-documented. Despite this, studies delving into HMD AR's impact on HI, especially across varying task complexities, are limited. This study aims to bridge this gap by examining the influence of HMD AR on construction workers' HI in diverse task environments. The research engaged 48 participants in an experiment to evaluate their hazard situation awareness (HSA), cognitive load (CL), and task performance (TP). These were assessed using the Situation Awareness Global Assessment Technique (SAGAT), the Situation Awareness Rating Technique (SART), the National Aeronautics and Space Administration Task Load Index (NASA-TLX), and measures of task accuracy. Findings indicated that environmental conditions significantly modulate HMD AR's effect on HI. In simple and safe scenes, HMD AR has a negligible impact on HI and might enhance hazard detection capabilities. However, in complex and hazardous situations with intense workloads, HMD AR can impair HI, potentially increasing safety risks. In other words, whether HMD AR brings opportunities or risks for HI depends on the different environmental conditions. This research contributes to the nascent field of cognitive safety in HMD AR, specifically regarding HI in construction, augmenting the current understanding and laying a theoretical groundwork for HMD AR's future safety applications in the architecture, engineering, and construction (AEC) industry. The insights gained inform the prudent implementation, training, and interface design of HMD AR on construction sites. In the context of HMD AR's rapid evolution, this study underscores the importance of critically assessing safety implications to guide the responsible utilization of new technologies. Practical Applications: The findings from this study reveal that the impact of HMD AR on HI is contingent upon the complexity and safety of the work environment. In scenes that are straightforward and safe, HMD AR has been shown to improve HI among participants. Conversely, in environments that are complex and fraught with danger, HMD AR may hinder HI, increasing the likelihood of hazards. The conclusions of this study suggest that the safety management and application of HMD AR on construction sites should consider the opportunities and risks of using HMD AR in different environmental conditions. It is advised that decision makers on construction sites evaluate the suitability of HMD AR deployment based on the specific complexities of their scenes. In instances where the potential hazards are intricate, the use of HMD AR might be inadvisable. For sites already utilizing HMD AR, it is crucial to provide additional safety training to users. Such training should aim to enhance awareness of how HMD AR might affect HI, equipping workers with the knowledge to mitigate potential risks effectively. Furthermore, developers of HMD AR technologies are encouraged to focus on improving the safety features of their products. A key area of improvement is the optimization of information density on the HMD AR display interface. By doing so, developers can help prevent cognitive overload among users, thereby minimizing any adverse effects on HI. This approach not only enhances the safety on construction sites but also ensures that the benefits of HMD AR can be fully realized without compromising worker safety. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is a leading cause of cancer-related mortality in Ethiopia, despite being preventable. Screening programs remain underutilized despite multiple initiatives. This systematic review and meta-analysis aimed to assess the pooled prevalence of intention to undergo cervical cancer screening and its associated factors among Ethiopian women, addressing a significant gap in national data. Methods and materials: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, HINARI, Google Scholar, and African Journals online were searched using specific keywords and Medical Subject Headings (MeSH). Studies were assessed using a standardized appraisal format adapted from the Newcastle-Ottawa Scale (NOS). Data extraction and analysis were performed using Microsoft Excel-10 and STATA 17 software, respectively. Heterogeneity was evaluated with the I2 statistic and publication bias was examined using Egger's test. Meta-analysis employed a random-effects model. Result: Out of the 750 articles retrieved, nine were included in this systematic review and meta-analysis. The pooled prevalence of intention to screen for cervical cancer in Ethiopia was 33% (95% CI: 9%-56%). Factors significantly associated with intention to undergo cervical cancer screening included favorable attitude (POR = 2.15, 95% CI: 1.29, 4.26), good knowledge about cervical cancer screening (POR: 3.49; 95% CI: 2.04, 6.93), and direct subjective norm (POR: 1.54; 95% CI: 1.32, 3.54). Conclusion: Based on the findings of this meta-analysis, it was observed that women's intention toward cervical cancer screening was low. Determinants identified included favorable attitude, direct subjective norm, and good knowledge of cervical cancer screening. To enhance women's intention for cervical cancer screening, strategies, and activities should be developed to positively influence perceptions among women and those who influence their decisions. Additionally, efforts to enhance public awareness about cervical cancer and its prevention are crucial. [ABSTRACT FROM AUTHOR]

Background: Osteoradionecrosis (ORN) of the upper cervical spine is a rare but severe complication of head and neck cancer radiotherapy. To raise awareness of this condition, we describe a patient with a history of nasopharyngeal carcinoma who developed ORN of the upper cervical spine and review the published literature reporting surgical management. Case presentation: A 59-year-old female patient with persistent neck pain for one month and limited range of neck motion who had undergone radiotherapy for nasopharyngeal carcinoma with a total dose of 69.96 Gy 15 years ago presented to our hospital. The patient underwent endoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch, combined with occipitocervical fusion. To better understand surgical management of ORN of the upper cervical spine, the literature published in the PubMed, Ovid MEDLINE, and Embase databases was reviewed. Our patient experienced alleviation of cervical pain and did not exhibit any postoperative complications. Since 2005, 11 cases of surgical management of ORN of the upper cervical spine (including the present case) have been published. Basilar invagination and/or atlantoaxial subluxation were observed in 4 /11 cases. Endoscopic procedures were performed in 4/11 cases, and occipitocervical fusion was performed in 8 /11 cases. Conclusion: Endoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch is a safe and effective treatment option for ORN of the upper cervical spine. Occipitocervical fusion is useful in patients with basilar invagination and atlantoaxial subluxation. [ABSTRACT FROM AUTHOR]

The global banana industry faces a significant threat from Fusarium oxysporum f. sp. cubense Tropical Race 4 (TR4). While prior research has concentrated on TR4's dissemination, reproductive conditions, and resistant banana varieties, this study employs a socioeconomic and cost-benefit analysis to explore the vulnerability of banana producers to TR4 in Colombia. It assesses the financial viability of current monitoring strategies and estimates potential losses in the event of TR4 spreading within the study area. Interviews were conducted with producers and key stakeholders in Colombia's top two banana-producing departments, Antioquia and Magdalena. The findings reveal that farming systems are highly vulnerable to TR4, particularly due to the prevalent use of corms. Producers employ preventive measures such as cement paths, fences, disinfecting stations, and footbaths to counteract TR4's spread. A cost-benefit analysis indicates that the benefits of these prevention methods significantly outweigh the associated costs, with a net present value of implementing prevention strategies per hectare of $95,389 USD and $112,527 USD in Magdalena and Antioquia and a benefit-cost ratio of 3.1 and 4.2, respectively. Considering the substantial impact TR4 could have in Colombia if it becomes more widespread, we recommend widespread adoption of preventive measures, including the construction and utilization of cement paths and disinfectant methods on all banana farms. Additionally, to enhance awareness and early detection, we propose leveraging technology, such as mobile applications (apps) and chat groups, to empower farmers in identifying and preventing the spread of TR4. [ABSTRACT FROM AUTHOR]

Background: Children with obesity may experience weight-based discrimination as a result of weight bias and stigma, which can have deleterious effects on their health and wellbeing, including increased risk of dysregulated, maladaptive, and disordered eating such as restriction, purging, and binging. Prior work has shown that weight bias occurs from healthcare workers caring for adults, but less is known about the prevalence of weight bias in the pediatric healthcare setting. Methods: We aimed to determine what proportion of pediatric healthcare professionals had attitudes of weight bias at our own institution by constructing a survey with questions from validated weight bias survey tools. Results revealed nearly half of all respondents had witnessed another healthcare professional make negative remarks about a patient with obesity, and many shared that they lacked the proper education/training and equipment to properly care for patients with obesity. Based on survey results, we created an electronic-based training module to educate healthcare professionals on weight bias and discrimination and how they may negatively affect care provided to children and families with obesity at our institution. Engagement with hospital leadership was a key strategy to ensure participation from medical and nursing/allied health staff in the survey, although only nursing/allied health leadership required the online training module resulting in limited physician engagement. Results: Feedback received regarding the training module was overwhelmingly positive. Conclusions: Our efforts illustrate that weight bias and discrimination exist in pediatric institutions, and that participation in a tailored electronic-based training module may be viewed as a helpful tool to raise awareness of how weight-based discrimination and bias can negatively affect patient care. Plain English Summary: Weight bias and discrimination are present in pediatric healthcare settings and can lead to negative health effects for children with obesity, including increased risk of dysregulated, maladaptive, and disordered eating such as restriction, purging, and binging. Scientific studies on development of methods to address weight bias among child healthcare professionals is limited. In this article, we describe how we measured weight bias among clinical providers and staff in a large pediatric teaching hospital, and how this helped us obtain approval from hospital leaders to create training to help these child healthcare professionals understand the harmful effects of weight bias. [ABSTRACT FROM AUTHOR]

AbstractDespite the ubiquity of menstruation, the area is under-researched and stigmatized. The burden of ‘managing’ periods lies with the people who menstruate (PWM). Some etiquettes and cultures ask that periods disappear/are hidden from the public sphere, however despite this, PWM continue to experience symptoms within these public spaces (pain, nausea, discomfort etc.). This paper describes a design research study in two parts: Cycles is a design project that firstly uncovers what it means to menstruate in ‘public’ and secondly explores how we can collaboratively generate conceptual solutions to contribute towards a positive future for menstrual health and well-being. Through a series of participatory and inclusive design research methods, based on storytelling the diverse experiences of a group of PWM were gathered. Subsequent analysis of the data identified a number of shared and individual stories that were re-enacted in an urban context (using Limerick City as a test bed). This research served to highlight that whilst everyone’s story with their period is individual, there is a collective lack of infrastructural, product and social support for PWM. Cycles surfaced a requirement for inclusive and equitable solutions that support PWM at the point of need whilst also raising awareness and building understanding and sympathy. [ABSTRACT FROM AUTHOR]

The article discusses the deportation of Syrian refugees from Lebanon and Turkey between 2017 and 2024. It attempts to bring light on the experiences of these refugees facing forced returns, emphasising the human consequences and complicated causes underlying such actions. The purpose of this article is to raise awareness about the deportation of Syrian refugees and the urgent need for collective action to address this humanitarian disaster and preserve the lives of vulnerable individuals affected by forced repatriation. Using the descriptive analytical approach, this article investigates the legislative frameworks and international commitments that should safeguard refugees from forced repatriation. The Universal Declaration of Human Rights (udhr), The 1951 Convention Relating to the Status of Refugees and its 1967 Protocol and rules of International Humanitarian Law will be used as a standard for the definition and legal framework of refugee’s rights. The article dives into the obstacles that host countries confront, including as social, economic, and political pressures. It also emphasises the necessity of advocacy activities and protective measures to defend Syrian refugees’ rights and well-being. The findings of the article are expected to benefit Syrian refugees and raise awareness about their situation, which will contribute preserve their lives and well-being. [ABSTRACT FROM AUTHOR]

Background: There is a high burden of hepatitis B virus (HBV) in West Africa. Over the past 20 years, West African immigration to the United States (U.S.) has been increasing. Prevalence of HBV infection in West Africa has been reported to be as high as 5–10%. Methods: We sought to understand knowledge and attitudes of and barriers and facilitators to HBV screening, vaccination, and treatment in a cohort of West African immigrants in the Bronx living with or at risk for HBV through a series of one-on-one qualitative interviews. We interviewed 23 West African immigrants and analyzed transcripts for recurring themes using Applied Thematic Analysis. We situated our analysis in the socioecological model (SEM) and adhered to the consolidated criteria for reporting qualitative research (COREQ). Results: Multiple themes emerged, most prominently themes relating to HBV knowledge/awareness, trust in U.S. healthcare providers and the U.S. healthcare system, positive social support improving healthcare access, knowledge sharing, stigma towards those with HBV, issues concerning immigration status, insurance status, and access to healthcare services. Conclusion: Raising awareness of HBV, addressing social and structural barriers such as stigma and health insurance, and improving access to culturally sensitive programs among West African communities are needed to increase HBV screening, vaccination, and linkage to care. [ABSTRACT FROM AUTHOR]

Do gender quotas increase political knowledge? While some studies suggest that quotas can positively impact women's political engagement and participation, others find null or negative effects. This paper focuses on Western Europe and argues that the implementation of quotas serves as an attention and consciousness‐raising event, potentially enhancing awareness of the political sphere. To investigate this, I propose a novel research design that capitalizes on the (quasi) exogenous shock resulting from the introduction of gender quotas. By influencing symbolic representation, quotas may enhance women's sense of empowerment, equality and willingness to engage in politics. Furthermore, the impact is expected to be more pronounced among younger women due to the heightened political socialization experienced during adolescence. Thus, the institutional change brought about by quotas is anticipated to particularly boost political knowledge among (younger) women and subsequently narrow the gender gap. To examine this hypothesis, I analyse data from 1992 to 2018 from 12 countries, of which six implemented gender quotas. Using a hierarchical Bayesian model, I assess respondents' answers to knowledge questions. The findings indicate that the introduction of gender quotas in parliamentary systems has a positive effect on reducing the gender gap in political knowledge among younger individuals, while the effects are statistically insignificant for older citizens. [ABSTRACT FROM AUTHOR]

AbstractObjective: Previous studies had explored the associations between e-cigarette use and alcohol use problems, yet they did not fully consider e-cigarette use contexts. This longitudinal study conducted a prospective examination of e-cigarette use contexts and alcohol use problems among college students. Participants: College e-cigarette users at three public universities from Fall 2019 to Fall 2020 were included (N = 377). Methods: A linear mixed model with a random intercept and random slope was employed to examine the longitudinal associations. Results: Higher frequencies of e-cigarette use (β = 0.38, p < 0.001), being hooked on e-cigarettes (β = 0.96, p < 0.01), using e-cigarettes for socializing purposes (β = 0.58, p < 0.05), and more occasions of co-using e-cigarettes with alcohol (β = 0.05, p < 0.001) were linked to more alcohol use problems. Conclusions: Intervention efforts should incorporate comprehensive screening that includes both e-cigarette and alcohol use, enhance awareness of peer influence, and provide at-risk populations with education regarding the potential synergistic effects of e-cigarette and alcohol co-use. [ABSTRACT FROM AUTHOR]

This study constitutes one of the first investigations aiming to examine the association between traumatic experiences within religious settings and symptoms of post-traumatic stress among religious lesbians, gays, and bisexuals. Furthermore, the study tested whether the anticipated positive link between those traumatic experiences and post-traumtic stress is influenced by a positive perception of God’s image. The sample consisted of 146 Israeli Jewish lesbians, gays, and bisexuals who professed a belief in God or demonstrated religious inclinations either presently or in the past. They completed self-report measures via an online questionnaire, assessing traumatic experiences within religious settings, post-traumtic stress symptoms, and positive perceptions of God’s image. The findings revealed a significant and robust positive connection between traumatic experiences within religious settings and post-traumtic stress. A positive perception of God’s image exhibited a negative correlation with post-traumtic stress but did not moderate the relationship traumatic experiences within religious settings and symptoms of post-traumatic stress. These findings highlight the significance of traumatic experiences within religious settings as a distinct potential risk factor of post-traumtic stress among lesbians, gays, and bisexuals and underscore the necessity of enhancing awareness among mental health professionals, religious leaders, and legal entities regarding the detrimental effects of those expereinces. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the prevalence of diastasis recti abdominis (DRA) and to find the possible risk factors for DRA based on two diagnostic criteria among women in long-term postpartum period. A cross-sectional study was conducted on 1000 postpartum women at five different time points (3, 5, 10, 20, and 30 years after partum, respectively). Inter-recti distance (IRD) was assessed using ultrasound imaging, while basic data were collected through self-reported questionnaires. Two diagnostic criteria, IRD > 2 cm and IRD > 3 cm, were used to present the prevalence of DRA. Univariate and multivariate analyses were employed to explore the risk factors for DRA. When using the diagnostic criterion of IRD > 2 cm for DRA, the prevalence was 36%, 31%, 22%, 26%, and 30% at 3, 5, 10, 20, and 30 years postpartum, respectively. When using the diagnostic criterion of IRD > 3 cm for DRA, the prevalence was 13%, 8%, 6%, 8%, and 10%, respectively. The results revealed that higher body mass index (BMI) was a risk factor for DRA at 10 years postpartum (p = 0.000), bigger number of parturitions was a risk factor at 3, 5, and 10 years postpartum (p = 0.000, 0.004 and 0.000), twins was a risk factor at 3 years postpartum (p = 0.001), and diabetes was a risk factor at 20 and 30 years postpartum (P = 0.000 and 0.004). (1) The prevalence of DRA in the long-term postpartum period was high, especially when IRD > 2 cm was used as the diagnostic criterion. (2) Higher BMI, bigger number of parturitions, twins and diabetes were independently associated with higher odds of DRA at different long-term postpartum time points. (3) The diagnostic criterion for DRA should be further improved to avoid excessive clinical diagnosis and treatment. (1) This study elucidated the prevalence and risk factors associated with long-term postpartum DRA, thereby enhancing clinical awareness and advocating for early intervention and prevention measures to mitigate serious adverse outcomes. (2) This study presented the research results using two diagnostic criteria, increasing comparability with existing studies. In addition, discussions on reasonable diagnostic criterion for DRA were also conducted to avoid excessive clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Globorisk is one of the prediction tools for 10-year risk assessment of cardiovascular disease, featuring an office-based (non-laboratory-based) version. This version does not require laboratory tests for determining the CVD risk. The present study aims to determine the 10-year CVD risk using the office-based Globorisk model and factors associated with the 10-year CVD risk. Methods: In this study, baseline data from 6810 individuals participating in the Fasa cohort study, with no history of CVD or stroke, were utilized. The risk equation of the office-based Globorisk model incorporates age, sex, systolic blood pressure (SBP), body mass index (BMI), and smoking status. The Globorisk model categorizes the risk into three groups: low risk (< 10%), moderate risk (10% to < 20%), and high risk (≥ 20%). To identify factors associated with the 10-year CVD risk, the predicted risk was categorized into two groups: <10% and ≥ 10%. Multivariable logistic regression analysis was employed to determine factors associated with an increased CVD risk. Results: According to the 10-year CVD risk categorization, 78.3%, 16.4%, and 5.3% of men were in the low, moderate, and high risk groups, respectively, while 85.8%, 10.0%, and 4.2%, of women were in the respective risk groups. Multivariable logistic regression results indicated that in men, the 10-year CVD risk decreases with being an opium user, and increases with being illiterate, having abdominal obesity, and low or moderate physical activity compared to high physical activity. In women, being married, and higher fiber consumption decrease the 10-year CVD risk, while being illiterate, low or moderate physical activity compared to high physical activity, having abdominal obesity, opium use, and being in wealth quintiles 1 to 4 compared to quintile 5 increase the risk. Conclusions: Considering the factors associated with increased CVD risk, there is a need to enhance awareness and modify lifestyle to mitigate and reduce the risk of CVD. Additionally, early identification of individuals at moderate to high risk is essential for preventing disease progression. The use of the office-based Globorisk model can be beneficial in settings where resources are limited for determining the 10-year CVD risk. [ABSTRACT FROM AUTHOR]