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Increasing evidence suggests a bidirectional relationship exists between levels of health literacy (HL) and cognitive impairment in later life. However, it is unclear whether low levels of HL can lead to a higher risk of dementia. This systematic review explored prospective cohort studies to find out whether HL is a risk factor for incident dementia in older adults. A search was conducted in Medline, PsycINFO, Embase, PubMed and Scopus and 5450 documents were initially retrieved. The grey literature and references of the selected papers were also consulted. Papers were selected and assessed by three researchers independently. Findings were reported in line with the PRISMA guidelines and quality appraisal was conducted using the STROBE checklist. Four studies were included for quality appraisal, data extraction and synthesis, all of which were conducted in the United States between 2014 and 2018. Adjusted analyses showed that in all studies people with low levels of HL had a significantly higher risk of incident dementia over time than people with adequate levels of HL. Low HL or total literacy (financial plus HL) was also a risk factor for mild cognitive impairment in two studies, irrespective of an Alzheimer's disease genotype. There was a statistically significant positive association between total literacy scores and the post-mortem amount of plaques and tangles suggestive of Alzheimer's disease. Our findings suggest that low levels of HL might lead to higher future dementia risk. However, as only a few longitudinal studies have been conducted in this area, further research is needed to establish the role of HL as a key risk factor for dementia. Researchers should use standardized HL-specific measurement tools so that future studies in this area are robust and comparable. Primary health care professionals might wish consider individual's HL when planning and implementing dementia risk reduction in order to improve its long-term effectiveness. [ABSTRACT FROM AUTHOR]

Over the last two decades, opioid-related mortality rates have increased dramatically to become a serious public health concern in the United States. Opioid-related mortality has reached epidemic levels in certain rural areas of the U.S., such as Appalachia, New England, and the Mountain West, while remaining relatively low in others, such as the Delta South and Great Plains. Explanations for geographic variation in opioid mortality are unclear, contributing to ineffective policies and interventions. The goal of this article is to summarize the existing literature on the opioid epidemic in the rural U.S. to help guide intervention efforts. This paper 1) describes geographic heterogeneity in opioid-related mortality, with a focus on rural areas, 2) summarizes factors that likely contribute to this heterogeneity, and 3) discusses potential strategies for addressing the opioid epidemic in the hardest-hit rural communities. The information presented in this paper dispels the myth that the opioid epidemic is disproportionately rural, and demonstrates that the magnitude of the epidemic has varied considerably across different rural areas. This paper provides important insights for public health professionals, treatment practitioners, researchers, and policymakers as they work toward solutions that take into account the diversity of rural communities and the dynamic nature of the opioid epidemic. [ABSTRACT FROM AUTHOR]

New approaches to universal eating disorders prevention and interventions targeting macro-environmental change are greatly needed, and research-to-policy translation efforts hold promise for advancing both of these goals. This paper describes as a policy-translation case example an academic-community-government partnership of the Strategic Training Initiative for the Prevention of Eating Disorders, Multi-Service Eating Disorders Association, and the office of Massachusetts Representative Kay Khan, all based in Massachusetts, USA. The partnership's research-to-policy translation project focused on dietary supplements sold for weight loss and muscle building, which have been linked with serious injury and death in consumers. Youth and people of all ages with eating disorders and body dysmorphic disorder may be especially vulnerable to use these products due to deceptive promises of fast and safe weight loss and muscle gain. The research-to-policy translation project was informed by a triggers-to-action framework to establish the evidentiary base of harm to consumers, operationalize policy solutions to mitigate harm through legislation, and generate political will to support action through legislation introduced in the Massachusetts legislature to restrict sales of weight-loss and muscle-building dietary supplements. The paper concludes with lessons learned from this unique policy translation effort for the prevention of disordered weight and shape control behaviors and offers recommendations for next steps for the field to advance research and practice for universal, macro-environmentally targeted prevention. [ABSTRACT FROM AUTHOR]

Abstract: Recognizing the need for evidence to inform policies, strategies, and programs to care for vulnerable children, the U.S. Government convened an Evidence Summit on Protecting Children Outside of Family Care on December 12–13, 2011, in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used to achieve the goals of the Summit. A multistep process was undertaken to identify the appropriate evidence for review. It began by identifying crucial focal questions intended to inform low and middle income governments and the U.S. Government about effective systems for protecting children outside family care. This was followed by a systematic attempt to gather relevant peer reviewed and gray literature that would inform these focal questions. The search processes, methods used for screening and quality reviews are described. In addition, members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliographies. These teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. This was the first U.S. Government Evidence Summit originating in the U.S. Agency for International Development Global Health Bureau and valuable lessons were learned on the identification and assessment of evidence informing complex development challenges. [Copyright &y& Elsevier]

>1.2 million people in the United States have a personal history of melanoma skin cancer and are at increased risk for disease recurrence and second primary melanomas. Many of these individuals do not follow recommendations to conduct regular, thorough skin self-examinations that facilitate early disease detection and do not sufficiently engage in sun protection behaviors. In this project, we are conducting a randomized controlled trial of an innovative, tailored, theory-driven Internet intervention—called mySmartSkin—to promote these behaviors among melanoma patients. This paper outlines the study design and characteristics of the study sample. A total of 441 patients were recruited (40.9% response rate) and randomized to the mySmartSkin or a Usual Care condition. Participants complete surveys at baseline and 8 weeks, 24 weeks, and 48 weeks later. The primary aim of the project is to examine the impact of mySmartSkin versus Usual Care on skin self-examination and sun protection behaviors. The secondary aim focuses on identifying mediators of the intervention's effects. In an exploratory aim, we will examine potential moderators of the impact of the intervention. At baseline, the recruited participants had a mean age of 61 years, 49% were female, 7.5% met criteria for having conducted a recent, thorough skin self-examination, and the mean score on the index of sun protection behaviors was 3.3 (on a scale from 1 to 5). The results of the project will determine whether the mySmartSkin intervention is efficacious in promoting skin self-examination and sun protection behaviors among individuals diagnosed with melanoma. Trial registration: ClinicalTrials.gov NCT03028948 [ABSTRACT FROM AUTHOR]

Evidence-based treatments (EBTs) for childhood disruptive behavior disorders, such as Parent-Child Interaction Therapy (PCIT), have limited availability in community settings. Recent research highlights the importance of implementation support models to ensure full adoption and sustainability of an EBT. Although other EBT protocols have been disseminated using the learning collaborative (LC) model, these methods are only now being applied to PCIT. This paper will describe the first PCIT learning collaborative conducted in the US. Community clinicians successfully completing the program demonstrated high levels of treatment fidelity and coding reliability, and families who completed treatment through the program reported significant improvements in child internalizing and externalizing behaviors and parenting behaviors and stress. These preliminary results suggest community clinicians are successful in implementing PCIT with the support of the LC. • Community clinicians learning PCIT show high levels of fidelity and reliability. • Children exhibit improved internalizing and externalizing behavior problems. • Parents show improved interactions with children and reduced parenting stress. • Training completion varied with clinician comfort with EBTs and coaching parents. • Treatment completion did not vary by client or community characteristics. [ABSTRACT FROM AUTHOR]

• Child maltreatment is a complex problem requiring interdisciplinary collaboration. • A fellowships program was designed to support maltreatment prevention scholars. • The program created a densely connected interdisciplinary network of fellows. • Scientific collaborations between fellows increased over time. Child maltreatment is a complex problem requiring interdisciplinary collaborative research to generate innovative solutions. The Doris Duke Fellowships for the Promotion of Child Well-Being were designed to identify and nurture emerging scholars committed to child maltreatment prevention and create a supportive interdisciplinary learning network. This paper examines connectivity within the collaborative network created by the fellowships program using longitudinal social network data. Participants were 120 individuals selected as Doris Duke Fellows during their doctoral training at universities in the United States. Fellows completed annual, voluntary web-based surveys to assess their interactions with other fellows during the past year. Social network analysis methods were used to assess the strength and quality of the learning network over a four-year period. Across four years of data, there were increases in the number of connections, proportion of cross-cohort connections, and proportion of interdisciplinary connections. Network analyses showed a highly connected network consisting of primarily medium- and high-quality connections between fellows from different disciplines. The number of scientific journal articles authored by two or more fellows grew substantially over time. Findings indicate the collaborative network created by the fellowships program is growing and strengthening over time. The new Child Well-Being Research Network extends the fellowships network to a broader group of scholars and professionals to advance diversity, equity, inclusion, and justice in the field of child well-being research. [ABSTRACT FROM AUTHOR]

Background: Many intervention efforts targeting student drinking were developed to address US college students, which usually involves underage drinking. It remains unclear, if research evidence from these interventions is generalizable to university and college students of legal drinking age, e.g., in Europe.Objective: To evaluate the effectiveness of a translated and adapted version of the eCHECKUP TO GO, applied as stand-alone web-based electronic screening and brief intervention (e-SBI), in German university students at risk for hazardous drinking.Methods: A fully automated web-based two-arm parallel-group randomized controlled trial was conducted. Participants were randomized to an e-SBI or assessment-only (AO) condition. The current paper analyzed students with baseline AUDIT-C scores ≥3 for women and ≥4 for men (sample at baseline: e-SBI [n=514], AO [n=467]; 3-month follow-up: e-SBI [n=194], AO [n=231]; 6-month follow-up: e-SBI [n=146], AO [n=200]). The primary outcome was prior four weeks' alcohol consumption. Secondary outcomes were frequency of heavy drinking occasions, peak blood alcohol concentration, and number of alcohol-related problems.Results: Mixed linear model analyses revealed significant interaction effects between groups and time points on the primary outcome after 3 and 6months. Compared to students in the AO condition, students in the e-SBI condition reported consuming 4.11 fewer standard drinks during the previous four weeks after 3months, and 4.78 fewer standard drinks after 6months. Mixed results were found on secondary outcomes.Conclusions: The results indicate that evidence on and knowledge of web-based e-SBIs based on US college student samples is transferable to German university students of legal drinking age. However, knowledge of what motivates students to complete programs under voluntary conditions, although rare, is needed. [ABSTRACT FROM AUTHOR]

While there have been important recent advances in the development of effective universal prevention and intervention programs, it is not yet clear how to engage large numbers of students in these programs. In this paper, we report findings from a two-phase pilot study. In the first phase, we used a population-level, online survey to assess eating disorder symptom level and habits/attitudes related to service utilization (N=2180). Using validated screening tools, we found that roughly one in three students has significant symptoms of eating disorders or elevated weight concerns, the vast majority of whom (86.5%) have not received treatment. In the second phase, we referred students to online prevention and selective/indicated intervention programs based on symptom classification (N=1916). We find that program enrollment is highest for students in the indicated intervention (18.1%) and lowest for students in the universal prevention (4.1%). We find that traditionally-emphasized barriers such as stigma, misinformation, and financial limitations do not appear to be the most important factors preventing treatment-seeking. Rather students report not seeking help for reasons such as lack of time, lack of perceived need, and a desire to deal with the issue "on my own." Findings offer insight into the treatment-seeking habits and attitudes of college students, including those barriers that may be overcome by offering online programs and those that persist despite increased access to and convenience of relevant resources. [ABSTRACT FROM AUTHOR]

Context: High blood pressure is an important risk factor for cardiovascular disease and stroke, the leading cause of death in the U.S., and a substantial national burden through lost productivity and medical care. A recent Community Guide systematic review found strong evidence of effectiveness of team-based care in improving blood pressure control. The objective of the present review is to determine from the economic literature whether team-based care for blood pressure control is cost beneficial or cost effective.Evidence Acquisition: Electronic databases of papers published January 1980-May 2012 were searched to find economic evaluations of team-based care interventions to improve blood pressure outcomes, yielding 31 studies for inclusion.Evidence Synthesis: In analyses conducted in 2012, intervention cost, healthcare cost averted, benefit-to-cost ratios, and cost effectiveness were abstracted from the studies. The quality of estimates for intervention and healthcare cost from each study were assessed using three elements: intervention focus on blood pressure control, incremental estimates in the intervention group relative to a control group, and inclusion of major cost-driving elements in estimates. Intervention cost per unit reduction in systolic blood pressure was converted to lifetime intervention cost per quality-adjusted life-year (QALY) saved using algorithms from published trials.Conclusions: Team-based care to improve blood pressure control is cost effective based on evidence that 26 of 28 estimates of $/QALY gained from ten studies were below a conservative threshold of $50,000. This finding is salient to recent U.S. healthcare reforms and coordinated patient-centered care through formation of Accountable Care Organizations. [ABSTRACT FROM AUTHOR]

In 2012, the first National Plan to Address Alzheimer's Disease in the United States (U.S.) was released, a component of the National Alzheimer's Project Act legislation. Since that time, there have been incremental increases in U.S. federal funding for Alzheimer's disease and related dementia research, particularly in the areas of biomarker discovery, genetic link and related biological underpinnings, and prevention studies for Alzheimer's. A central theme in each of these areas has been the emphasis of cross-sector collaboration and private–public partnerships between government, non-profit organizations and for-profit organizations. This paper will highlight multiple private–public partnerships supporting the advancement of Alzheimer's research in the context of the National Plan to Address Alzheimer's. [ABSTRACT FROM AUTHOR]

In 2012, the media paid extra attention to lean finely textured beef (LFTB), an inexpensive lean beef product extracted from low-valued fatty trim. The media’s negative portrayal of LFTB as an unnecessary and unsavory additive to ground beef products corresponded with a spike in reports over a 6-month period. Since LFTB is often used in ground beef, it is likely that consumption of LFTB-based ground beef products and other meats could be affected. This paper used weekly meat production and sales data to assess how media depictions of LFTB affect consumer demand. We used a Central Bureau of Statistics model to test whether media portrayal affects the consumption of aggregate meats and beef cuts: pork, chicken, turkey, Choice beef, Prime beef, Select beef and ground beef. Results indicate that media portrayal of LFTB, measured by the number of articles on the subject weighted by consumer readership, did not lead to significant changes in consumer demand across meats or within the beef category immediately. However, consumer purchases of pork, turkey and Prime beef were affected two weeks or greater after news reports of LFTB surfaced. Nevertheless, those effects were temporary and waned or disappeared during later weeks. Our look at the LFTB controversy informs food policy by studying the media sources from which consumers obtain their information. As the temporary effects of news media on consumer demand for aggregate meats and disaggregate beef cuts suggest, consumers may benefit from receiving their news from industry and government sources instead. [ABSTRACT FROM AUTHOR]

Across the domains of youth risk behavior, suicidality is a significant concern for parents and professionals alike, requiring ongoing efforts to better understand and prevent rising trends. Recent examinations of suicidal behaviors in the United States over the last decade revealed an increase in emergency and inpatient hospital settings. Of importance, seasonal variations were demonstrated, finding the lowest frequency of suicidality encounters in summer months, and observed peaks in the fall and spring, during the school year. Given these findings and the fact that youth spend nearly half of their time at school, consideration of youth suicide in the school environment is critical. This paper will review the trends of youth suicide within the school context, exploring factors such as at-risk youth, bullying, relevant legal issues, and the current state of crisis response in school settings. Recommendations for prevention, intervention, and postvention will be provided. The authors propose that school professionals play a vital role in addressing youth suicide and will aim to provide guidance on effective crisis response within the school context. • Recent research supports the growing rates of youth suicidality and the school context is an ideal setting for prevention. • Variety of prevention programming available, requiring additional research and replication. • Prevention, intervention, and postvention efforts are imperative and are implemented variably across school districts. • School professionals are an integral part of the prevention of and crisis response to youth suicide. [ABSTRACT FROM AUTHOR]

Abstract: Policy strategies for injury and violence prevention influence systems development, organizational change, social norms, and individual behavior to improve the health and safety of a population. Injury and violence prevention professionals should consider how their issues resonate with various audiences, including policy makers, the public, and other decision makers. As the cost of healthcare continues to rise and greater demands are placed on the healthcare system, the use of public health policy becomes increasingly critical to protect the public''s health and prevent injury and violence and its related morbidities and disabilities (Degutis, 2011). This article highlights some impactful policy successes from the field, allows us to reflect on the Injury Center''s 20th anniversary, and describes steps to address injuries and violence into the future. The purpose of this paper is to discuss policy as a public health strategy and the critical role it plays in injury and violence prevention. [Copyright &y& Elsevier]

Abstract: Introduction: Children ages 5-14years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury. Objectives: This paper compares children''s bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation. Methods: This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household. Results: Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9years) and older (10-14years) children, and in all four regions of the country. Conclusions: While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal. [Copyright &y& Elsevier]

Abstract: The natural tetracyclic schweinfurthins are potent and selective inhibitors of cell growth in the National Cancer Institute’s 60-cell line screen. An interest in determination of their cellular or molecular target has inspired our efforts to prepare both the natural products and analogues. In this paper, chemical synthesis of analogues modified in different olefinic positions, and preliminary results from studies of their biological activity, are reported. [Copyright &y& Elsevier]

Abstract: Rebuilding depleted fishery resources is a worldwide problem. In the U.S., the Magnuson Stevens Fishery Conservation and Management Reauthorization Act (MSRA) of 2007 requires that “Conservation and management measures shall prevent overfishing while achieving, on a continuing basis, the optimum yield from each fishery…”. However, translating this legal mandate into tangible goals and actions presents several technical challenges, especially for resources that have been chronically over-exploited. For example, maximum sustainable yields and biomass reference points are poorly estimated for stocks that have been overfished for a long period of time and are poorly defined unless sufficient data are available from periods of low-fishing mortality rates and relatively high-stock sizes. The conundrum of how to set meaningful rebuilding goals given limited information on the population dynamics and trophic interactions of a rebuilt stock can generally be addressed through adaptive management procedures incorporating learning about density-dependent population dynamics. Monitoring changes in life history parameters and recruitment is critical for successful rebuilding strategies realizing the full yield potential of rebuilt stocks while periodic re-evaluation of rebuilding targets is also needed to address uncertainties due to density dependence, trophic interactions or environmental factors. This paper summarizes the development and implementation of goals and strategies to rebuild New England groundfish stocks over the past decade. Management is particularly challenging because the true yield and population size potentials of these interacting stocks is unknown due to chronic overfishing throughout the modern history of the fishery, uncertainty in compensatory/depensatory population dynamics and in the degree of stationarity in environmental control of groundfish recruitment. [Copyright &y& Elsevier]

Abstract: Purpose: Endometrial carcinoma is the most common cancer of the lower female genital tract in Europe and the United States. Faced with the growing incidence of endometrial cancer in Europe and around the world, scientists, doctors and public health professionals are becoming more concerned with identifying effective preventive measures for this condition. This review paper presents the existing knowledge about modifiable risk factors leading to endometrial hyperplasia and endometrial cancer and highlights the need for more studies in this area. Design/Methods: Extensive literature review of modifiable risk factors for endometrial cancer and endometrial hyperplasia has been performed. Additionally, biomarker approaches to cancer monitoring, existing therapies for endometrial hyperplasia and factors affecting patient survival are reviewed. Results: Obesity and inactivity are two of the major risk factors associated with the development of endometrial cancer and endometrial hyperplasia. Other modifiable risk factors include dietary habits, exercise and the use of hormonal therapy. Similar factors, along with cancer biomarkers, may play an important role in the early detection of endometrial cancer and survival after the diagnosis. The majority of these factors fit well with the unopposed oestrogen theory. Diet and exercise programmes are currently not integrated into a standard treatment programmes for patients with endometrial hyperplasia or endometrial cancer. Conclusions: More studies are needed to investigate modifiable risk factors for endometrial cancer and endometrial hyperplasia. Existing therapies for endometrial hyperplasia target hormone imbalance, which is just one aspect of endometrial cancer development. Next generation therapies for endometrial cancer and endometrial hyperplasia patients should include diet, exercise and weight loss plans, which would target other modifiable aspects of endometrial cancer risk. [Copyright &y& Elsevier]

This paper uses the US Health and Retirement Study to explore linkages between neighborhood conditions and stages of the disablement process among adults aged 55 years and older in the United States. We consider multiple dimensions of the neighborhood including the built environment as well as social and economic conditions. In doing so, we use factor analysis to reduce indicators into eight neighborhood scales, which we incorporate into two-level logistic regression models along with controls for individual-level factors. We find evidence that economic conditions and the built environment, but not social conditions, matter. Neighborhood economic advantage is associated with a reduced risk of lower body limitations for both men and women. We also find for men that neighborhood economic disadvantage is linked to increased chances of reporting personal care limitations, particularly for those aged 55–64 years, and that high connectivity of the built environment is associated with reduced risk of limitations in instrumental activities. Our findings highlight the distinctive benefits of neighborhood economic advantage early in the disablement process. In addition, findings underscore the need for attention in the design and evaluation of disability-prevention efforts to the benefits that accrue from more physically connected communities and to the potential harm that may arise in later life from living in economically disadvantaged areas. [Copyright &y& Elsevier]

In the past decade, prevention science has emerged as a discipline built on the integration of life course development research, community epidemiology, and preventive intervention trials [Am. Psychol. 48 (1993) 1013; Am. J. Community Psychol. 27 (1999) 463; Kellam, S. G., & Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically based preventive intervention trials. In J. McCord & R. E. Tremblay (Eds.), Preventing antisocial behavior: interventions from birth through adolescence (pp. 162–195). New York: Guilford Press.]. Prevention science is based on the premise that empirically verifiable precursors (risk and protective factors) predict the likelihood of undesired health outcomes including substance abuse and dependence. Prevention science postulates that negative health outcomes like alcohol abuse and dependence can be prevented by reducing or eliminating risk factors and enhancing protective factors in individuals and their environments during the course of development. A growing number of interventions have been found to be effective in preventing adolescent tobacco, alcohol, and other drug abuse, delinquency, violence, and related health risk behaviors by reducing risk and enhancing protection. During the same decade, comprehensive community-based interventions to prevent adolescent health and behavior problems have been widely implemented in the U.S. with federal and foundation support. Despite the advances in the science base for effective preventive interventions and the investments in community-wide preventive interventions, many communities continue to invest in prevention strategies with limited evidence of effectiveness [Am. J. Public Health 84 (1994) 1394; J. Res. Crime Delinq. 39 (2002) 3; J. Community Psychol. 28 (2000) 237; J. Community Psychol. 28 (2000) 237; J. Consult. Clin. Psychol. 67 (1999) 590; Eval. Program Plann. 20 (1997) 367.]. Translating prevention science into community prevention systems has emerged as a priority for prevention research [J. Community Psychol. 28 (2000) 363; J. Appl. Behav. Anal. 28 (1995) 479.]. The Communities That Care (CTC) prevention operating system is a field-tested strategy for activating communities to use prevention science to plan and implement community prevention systems. CTC provides tools that assist communities to use local data on risk and protective factors to identify elevated risks and depressed protective factors in geographic areas where levels of risk are high and levels of protection are low and then to implement tested, effective preventive interventions that reduce the identified risks and enhance protection in these [Developmental Research and Programs. (1997). Communities That Care: a comprehensive prevention program. Seattle, WA: Author; Developmental Research and Programs. (2000a). Communities That Care: a comprehensive prevention program. Seattle: Author; Hawkins, J. D., Catalano, R. F., et al. (1992). Communities That Care: action for drug abuse prevention (1st ed.). A joint publication of the Jossey-Bass social and behavioral science series and the Jossey-Bass education series. San Francisco: Jossey-Bass]. The CTC system is widely implemented, and process evaluations of CTC suggest that it can assist communities to develop more effective prevention systems. This paper describes the background and use of the CTC operating system and results of evaluations of implementation of the system. [Copyright &y& Elsevier]

Background: Prescription opioids played a major role in the current opioid overdose epidemic. High rates of opioid prescribing and dispensing exposed many people to opioids, and high-dose opioid prescriptions (e.g., 90 morphine milligram equivalents [MME] per day) contributed to increases in opioid overdoses. The Centers for Disease Control and Prevention (CDC) Prevention for States (PfS) program provided funding to jurisdictions ("PfS recipients") with a high burden of opioid-involved overdoses. This paper examines associations between strategies addressing high-dose opioid prescribing and changes in high-dose opioid dispensing.Methods: Monthly opioid dispensing data (2014-2019) from IQVIA Xponent were analyzed using longitudinal growth models (LGM) to compare high-dose opioid dispensing rates in the 29 jurisdictions that participated in PfS with rates in non-PfS jurisdictions. Additional models examined associations between specific PfS activities and changes in high-dose dispensing among PfS recipients.Results: High-dose dispensing rates decreased significantly in both PfS and non-PfS jurisdictions from 2014 to 2019. Rates of high-dose opioid dispensing rates in PfS jurisdictions were not significantly different than those in non-PfS jurisdictions (p = 0.07). Among PfS recipients, multiple activities were associated with decreases in high-dose dispensing rates over time, including moving towards real-time prescription drug monitoring program (PDMP) reporting (p < 0.001) and implementation of opioid dispensing interventions for insurers/ health systems (p < 0.05).Conclusions: High-dose opioid dispensing rates decreased throughout the United States from 2014-2019. As the drug epidemic continues to evolve, implementation of prevention activities by state and local partners is important. These findings highlight two potential prevention strategies and activities that jurisdictions can utilize. [ABSTRACT FROM AUTHOR]

Objectives: In 2016, the US Surgeon General issued a Call to Action to address adolescent e-cigarette use and school-based prevention interventions are an effective component of comprehensive tobacco control. This study describes the development and dissemination of CATCH My Breath, an e-cigarette prevention program for middle and high school students.Methods: Starting in 2014, a university and nonprofit collaboration designed, formatively evaluated, pilot tested, and disseminated the CATCH My Breath Program (CMB). The team used Social Cognitive Theory to develop the program and Diffusion of Innovations Theory to disseminate the program. Dissemination strategies were applied beginning in 2016. This paper describes the application of both theories and the resulting reach of CMB.Results: Since dissemination began, CMB has been rapidly adopted, following the typical diffusion normal curve. As of June 2020, approximately 4,000 schools in the United States have adopted the program, 70,000 teachers have taught the program, and 1,400,000 students have been exposed to program materials.Conclusion: The application of Social Cognitive Theory and Diffusion of Innovation Theory resulted in effective prevention results and rapid, widespread adoption of the CMB. This level of adoption and implementation represents 25% of the school marketplace. CMB should be considered as the school component of the recommended combustible and e-cigarette prevention and control toolkit, alongside mass media, marketing restrictions, retail access, taxation, flavor ban, and FDA premarket approval. Other public health interventions seeking rapid adoption should consider applying principles of Diffusion of Innovation as a guide for development and dissemination. [ABSTRACT FROM AUTHOR]

• Programs are more effective at reducing bullying among boys than girls. • US programs are less effective at reducing bullying among girls and boys. • Programs conducted outside of the US are effective with both boys and girls. • Certain features of the included studies had an impact on the outcomes by gender. This paper presents the results from a meta-analytical review of the effectiveness of bullying prevention programs for boys and girls. A systematic search of three online databases was conducted of evaluations published between 1990 and 2018. The abstract review returned 352 articles, after full-text review the search yielded a final sample of 22 articles. The overall whole sample results suggest that bullying prevention programs are effective at reducing bullying among boys, but not girls; however, further analysis revealed that the programs are effective for both boys and girls outside of the United States, and ineffective for both boys and girls within the United States. Overall (both within and outside the United States), boys who participated in a bullying prevention program had 15% (95% CI: 1.01–1.31, p <.05) higher odds of a reduction in bullying victimization compared to boys in the control group, while boys and girls outside of the United States had 34% (95% CI: 1.11–1.62, p <.01) and 21% (95% CI: 1.00–1.62, p <.05) higher odds of a reduction bullying victimization. The findings suggest that prevention programs are largely effective at reducing bullying victimization, particularly among boys, but might be less effective among girls overall, and for both boys and girls within the United States. Future research needs to explore the impact of prevention programs on girls, as well as the divergent effect of programs within the United States compared to internationally. [ABSTRACT FROM AUTHOR]

Abstract: 4-Methylimidazole (4-MEI) is found in a wide array of food products. The National Toxicology Program (NTP) recently conducted a two-year feeding cancer bioassay of 4-MEI in B6C3F1 mice and F344/N rats. In rats, NTP found “equivocal evidence of carcinogenic activity” in females based on increased incidences of mononuclear cell leukemia and “no evidence of carcinogenic activity” in males. However, dose-related, statistically significant decreases in multiple tumors were observed in both male and female rats exposed to 4-MEI in the NTP bioassay. For example, 4-MEI was associated with a 25-fold decrease in the incidence of mammary tumors among high dose females. NTP noted briefly that the decreases in certain tumors, including mammary tumors, were greater than could be attributed to body weight alone. The present paper provides a more detailed evaluation of the evidence that 4-MEI exhibits tumor preventive activity in the rat based upon the results of the NTP bioassay. Reduced body weight offers a partial explanation for the reduction in tumors, but does not appear to be the primary cause of the decreased tumor incidences, indicating that 4-MEI itself may possess an ability to prevent tumor formation. [Copyright &y& Elsevier]

This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes. Although there is increasing attention to training in pain management in medical schools and medical residency programs, educational opportunities remain highly variable, and the need for additional clinician training in the recognition and treatment of pain as well as opioid use disorder has been recognized. Mandated use of private, federal and state educational and clinical initiatives such as Risk Evaluation and Mitigation Strategies (REMS) and Prescription Drug Monitoring Programs (PDMPs) generally increase utilization of these initiatives, but more research is needed to determine the impact of these initiatives on provider behaviors, treatment access, and patient outcomes. Finally, there is an acute need for more research on safe and effective treatments for chronic pain as well as an increased multi-level focus on improving training and access to evidence-based treatment for opioid use disorder as well as non-pharmacologic and non-interventional chronic pain treatments, so that these guideline-recommended interventions can become mainstream, accessible, first-line interventions for chronic pain and/or opioid use disorders. [ABSTRACT FROM AUTHOR]

Underage drinking and its associated problems have profound negative consequences for underage drinkers themselves, their families, their communities, and society as a whole, and contribute to a wide range of costly health and social problems. There is increased risk of negative consequences with heavy episodic or binge drinking. Alcohol is a factor related to approximately 4,300 deaths among underage youths in the U.S. every year. Since the mid-1980s, the nation has launched aggressive underage drinking prevention efforts at the federal, state, and local levels, and national epidemiologic data suggest that these efforts are having positive effects. For example, since 1982, alcohol-related traffic deaths among youth aged 16-20 years have declined by 79%. Evidence-based or promising strategies for reducing underage drinking include those that limit the physical, social, and economic availability of alcohol to youth, make it illegal for drivers aged <21 years to drive after drinking, and provide mechanisms for early identification of problem drinkers. Strategies may be implemented through a comprehensive prevention approach including policies and their enforcement, public awareness and education, action by community coalitions, and early brief alcohol intervention and referral programs. This paper focuses on underage drinking laws and their enforcement because these constitute perhaps the most fundamental component of efforts to limit youth access to and use of alcohol. [ABSTRACT FROM AUTHOR]

Use of the pneumococcal conjugate vaccines among children in the U.S. since 2000 has dramatically reduced pneumococcal disease burden among adults. Significant vaccine-preventable morbidity and mortality from pneumococcal infections still remains, especially among older adults. The U.S. Advisory Committee on Immunization Practices (ACIP) has recently recommended the routine use of both pneumococcal conjugate (PCV13) and polysaccharide vaccines (PPSV23) for adults ≥65 years. These recommendations were based on the remaining burden of illness among adults and the importance of non-bacteremic pneumonia prevention in light of new evidence confirming the efficacy of PCV13 to prevent pneumococcal pneumonia among older adults. This paper reviews the evidence that led ACIP to make recommendations for PCV13 and PPSV23 use among adults, and highlights potential gaps to be addressed by future studies to inform adult vaccination policy. The changing epidemiology of invasive pneumococcal disease and pneumonia should be closely monitored to evaluate the effectiveness and continued utility of the current vaccination strategy, and to identify future directions for pneumococcal disease prevention among older adults. [ABSTRACT FROM AUTHOR]