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Context: Nordic hamstring strength (NH strength) and single leg bridge test (SLBT) scores are used to predict the risk of hamstring strain injury. Although NH strength and SLBT scores may be related, the relationship between NH strength and SLBT score remains unknown. Objectives: This study investigated the relationship between NH strength and SLBT scores in university soccer players. Design: Cross-sectional study. Setting: Research laboratory. Participants: 38 male university soccer players. Main Outcome Measures: NH strength and SLBT scores. Interventions: A participant was instructed to lean forward gradually at the slowest possible speed from a kneeling posture with the knee joint flexed 90° for the NH strength measurement. Participants in the SLBT crossed their arms over their chests, pushed down from their heels, and lifted their hips off the ground as many times as they could until they failed. We investigated the relationship between NH strength and SLBT scores in the left and right sides using Spearman rank correlation coefficient. Additionally, we calculated the percentage of left–right asymmetry in NH strength and SLBT scores and investigated the relationship between these variables using Pearson correlation coefficient. Results: There were no significant correlations between NH strength and SLBT scores in the right (rs =.239, P =.16) and left (rs =.311, P =.065) legs. Furthermore, there was no significant relationship between NH strength and SLBT between-limb asymmetry (r =.073, P =.671). Conclusions: NH strength and SLBT scores could be different indexes, indicating either maximal muscle strength or muscle endurance. Thus, the findings suggested that when assessing risk factors for hamstring strain injury, both NH strength and SLBT scores should be measured. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to estimate the current nationwide prevalence of falls, injurious falls, concerns about falling, and information on fall prevention among people with multiple sclerosis. Design: This is a cross-sectional national web-based survey that included 965 adult people with multiple sclerosis. Participants self-reported falls and injurious falls experienced in the past 6 months. Participants also provided information on their concerns about falling and information on fall prevention received. Results: A total of 56% reported falling in the past 6 months. The prevalence of falls at the population level ranges between 53% and 59%. Most falls occur inside of participants' homes (68%). About 30% of fallers reported an injurious fall. Most respondents, 87% expressed being concerned about falling and 68% reported they had cut down on activities due to their concerns about falling. Among participants who received information about falling (64%), only 9% received a formal fall prevention course. Conclusions: Despite advances in falls research over the last decades, falling continues to be a highly prevalent problemfor people with multiple sclerosis. About one-third of those falls result in injuries. Concerns about falling among fallers and nonfallers affect the performance of daily activities and independence. Few people receive a formal falls prevention education or training. [ABSTRACT FROM AUTHOR]

The aims of the study were to build models using logistic regression analysis of flexibility and strength tests to prospectively predict risk factors for anterior cruciate ligament tear (ACL-tear) in female soccer (FS) players, and to determine training cut-off for risk factors of the predictive model built. A prospective cohort study of 95 female players (aged 14–33 years) was conducted. Age, anthropometric data, soccer history, lower limb range of motion (ROM) and hip maximal isometric strength (MIS) were measured. At the prospective follow-up after 12 months, 7.4% of the players had developed an ACL-tear. The model showed a significant relationship (χ2(93) = 30.531, p < 0.001) between the ACL-tear and the predictor variables (leg length, HAD-NH [hip adduction] MIS, asymmetric ROM [ankle dorsiflexion with knee extended (AD-KE) and with knee flexed (AD-KF), and HE (hip extension)], hip ROM [HIR (internal rotation) and HAB (abduction)]). The Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC) for model fit were 30.24 and 51.79, respectively. The value R2 showed good model fit, 76.5% for Nagelkerke´s R2, 71.4% for McFadden´s R2 and 67.5% for Tjur´s R2. For the screening test, cut-off for leg length of ≥0.40 m, for HIR ROM of ≤44º and for asymmetry of HE ROM of ≥5° were set, which have an acceptable (AUC ≥ 0.755) discriminatory ability for the development of ACL-tear. [ABSTRACT FROM AUTHOR]

The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green – yellow–red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers. [ABSTRACT FROM AUTHOR]

Objectives: Screening tools in which participants self-report sexual behaviors can identify people at risk of HIV acquisition for enrollment in preexposure prophylaxis (PrEP). We compared enrollment outcomes (ie, receiving PrEP vs being excluded by a counselor or declining PrEP) in Mexico's PrEP demonstration project and evaluated the validity of a 4-criteria PrEP eligibility tool in which participants self-reported risk behavior—having condomless anal sex, transactional sex, a partner living with HIV, or a sexually transmitted infection—as compared with PrEP eligibility assessed by a counselor. Methods: We recruited men who have sex with men and transwomen who were offered PrEP services in Mexico. We characterized participants according to enrollment outcome and identified underlying factors through logistic regression analyses. We calculated the sensitivity and specificity of the self-reported risk criteria, using the counselor's risk assessment as the point of reference. Results: Of 2460 participants, 2323 (94%) had risk criteria of HIV acquisition according to the 4-criteria tool; 1701 (73%) received PrEP, 247 (11%) were excluded by a counselor, and 351 (15%) declined PrEP despite being considered eligible by the counselor. Participants who were excluded or who declined PrEP were less likely to report HIV risk behaviors than those who received PrEP, and participants who declined PrEP were more likely to be transwomen (vs men who have sex with men) and aged ≤25 years (vs >25 y). The 4-criteria risk tool had high sensitivity (98.6%) and low specificity (29.8%). Conclusion: The screening tool identified most participants at risk of HIV acquisition, but counselors' assessment helped refine the decision for enrollment in PrEP by excluding those with low risk. Public health strategies are needed to enhance enrollment in PrEP among some groups. [ABSTRACT FROM AUTHOR]

Background Sidestep cutting technique is highly individual and has been shown to influence knee joint loading. However, studies assessing whether individualized technique feedback improves technique and ACL injury-relevant knee joint loads instantly in a sport-specific task are lacking. Purpose To determine the instant effects of individualized augmented technique feedback and instructions on technique and the peak external knee abduction moment (pKAM) in a handball-specific sidestep cut. Additionally, to determine the effects of technique modifications on the resultant ground reaction force and its frontal plane moment arm to the knee joint center. Study Design Controlled laboratory cohort study Methods Three-dimensional biomechanics of 48 adolescent female handball players were recorded during a handball-specific sidestep cut. Following baseline cuts to each side, leg-specific visual and verbal technique feedback on foot strike angle, knee valgus motion, or vertical impact velocity using a hierarchically organized structure accounting for the variables' association with performance was provided. Subsequently, sidestep cuts were performed again while verbal instructions were provided to guide technique modifications. Combined effects of feedback and instructions on technique and pKAM as well as on the resultant ground reaction force and its frontal plane moment arm to the knee joint center were assessed. Results On average, each targeted technique variable improved following feedback and instructions, leading to instant reductions in pKAM of 13.4% to 17.1%. High inter-individual differences in response to feedback-instruction combinations were observed. These differences were evident in both the adherence to instructions and the impact on pKAM and its components. Conclusion Most players were able to instantly adapt their technique and decrease ACL injury-relevant knee joint loads through individualized augmented technique feedback, thereby potentially reducing the risk of injury. More research is needed to assess the retention of these adaptations and move towards on-field technique assessments using low-cost equipment. Level of Evidence: Level 3 [ABSTRACT FROM AUTHOR]

Background: Laser acupuncture is a proven non-invasive treatment with effects comparable to traditional acupuncture in different types of headaches, but there is still insufficient evidence for chronic migraine (CM) in adults. We aim to investigate the efficacy and safety of laser acupuncture (LA) as an add-on preventive therapy on CM. Methods: A single-blind randomized controlled trial was conducted from January 2022 to November 2023. CM patients with unsatisfactory pharmacological effects were randomly assigned in a 1:1 ratio to receive either LA or sham treatment over a course of 8 sessions spanning 4 weeks. The co-primary outcomes were changes in monthly migraine days (MMD) and acute headache medications usage days per month from baseline. Evaluations were taken at baseline (12 weeks before randomization), at 4th week (treatment completed), 8th week and 12th week from baseline. Results: A total of 60 patients (30 in each group) were included in the intention-to-treat analyses. Baseline headache characteristics between trial groups were similar. Compared with the sham group, the LA group had a significant reduction in MMD (5.2 vs. 1.5 days at 8th week, p = 0.015; 7.3 vs. 1.8 days at 12th week, p = 0.001), and acute headache medications usage days per month (3.1 vs. 0.4 days at 4th week, p = 0.007; 3.2 vs. 0.0 days at 8th week, p = 0.005; 3.9 vs. 0.0 days at 12th week, p < 0.001). No serious adverse event was observed in both groups. Conclusions: Laser acupuncture was effective in reducing MMD and acute headache medications usage with promising safety. Specifically, the efficacy of LA exhibited a progressively more pronounced effect within the follow-up period. We suggested that LA is a promising add-on preventive therapy for CM, and trials focused on investigating the mechanism of LA's effect and its long-term effects on CM prevention are justified. Trial registration: The study was retrospectively registered at ISRCTN.org Identifier: ISRCTN11208146 (https://doi.org/10.1186/ISRCTN11208146). The registration date: 19, January, 2024. The date of first participant registration: 04, May, 2022. [ABSTRACT FROM AUTHOR]

Background: General practitioners (GPs) play a crucial role in identifying cognitive impairment and dementia and providing post-diagnostic care. This study investigates (1) how promising GP consider lifestyle changes to maintain cognitive performance in general, (2) GP beliefs about the power of modifiable health and lifestyle factors to maintain cognitive performance, and (3) whether those beliefs vary by GP age. Methods: As part of the AgeWell.de trial, GPs (n = 72) completed a process evaluation questionnaire assessing their perspectives on lifestyle changes to preserve cognitive performance in elderly patients. In greater detail, their perceived efficacy of established risk and protective factors was investigated using a 5-point Likert scale. Descriptive statistical analyses were performed for research question (1) and (2). Spearman´s rank correlations and ordinal logistic regressions were used to answer research question (3). All results were interpreted exploratively. Results: GPs rated the overall chance of lifestyle changes maintaining cognitive performance quite neutral with a median score of 3.0 (IQR = 2.0). They rated the efficacy of all the modifiable health and lifestyle factors high, with increase in physical and social activity ((Mdn = 5.0, IQR = 1.0) receiving the highest ratings with the narrowest range. Spearman's rank correlation indicated a significant positive relationship between age and the belief in "Optimization of nutrition" for preventing cognitive decline and dementia (ρ =.255, p =.041). However, ordinal logistic regressions showed no significant relationships between age and GP ratings of lifestyle change efficacy. Conclusion: These findings highlight the positive perception of GPs on the efficacy of modifiable health and lifestyle factors for preventing cognitive decline and dementia. Trial registration: The AgeWell.de trial is registered in the German Clinical Trials Register (DRKS; trial identifier: DRKS00013555, Registration Date 07 December 2017). [ABSTRACT FROM AUTHOR]

Background: There is scarcity of data exploring the dynamics of barriers to changing physical activity (PA) and eating habits during a lifestyle intervention in a primary care setting. The aim of the present study was to investigate barriers to lifestyle change before and during a primary care lifestyle intervention in adults with different sociodemographic backgrounds. Methods: Barriers to healthy eating and PA were assessed in 114 adults (age = 55 ± 9 years) using a questionnaire before inclusion in the intervention. During the lifestyle intervention, factors perceived as obstacles to reach goals for PA and healthy eating habits were collected using focus group interviews in a sub-sample of 25 adults and analyzed using thematic analysis. Results: At least 1 barrier to changing eating and PA habits was reported in 65% and 67% of the population, respectively, without differences due to sex, place of birth, and educational level. Before entering the lifestyle intervention, intrapersonal factors including lack of willpower and lack of enjoyment were the dominant barriers to PA and healthy eating, irrespective of place of birth, sex, and education level. In contrast, environmental factors such as lack of support from family and work-related constraints emerged as important barriers to overcome during the action phase of the lifestyle intervention. Conclusions: The present study highlights the dynamics of barriers to changing PA and eating habits in a primary care lifestyle intervention, emphasizing the need for barrier assessment during the different phases of an intervention to tailor support activities for successful lifestyle behavioral change. [ABSTRACT FROM AUTHOR]

Background: Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER. Methods: Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4–16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires. Results: Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low. Conclusions : The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms. [ABSTRACT FROM AUTHOR]

Background: Enhancing the current breast pump sanitization method may improve maternal satisfaction and increase a mother's likelihood of providing human milk for their hospitalized infants in the Neonatal Intensive Care Unit (NICU). Other than Centers for Disease Control (CDC) data, there is lack of studies on sanitization practices. Currently, the only option in the hospital setting for breast pump equipment cleaning is a steam sanitization plastic bag. Purpose: Using the Q. Basin will increase participant satisfaction compared to the steam sanitization bag. Methods: A multi-phased pilot study was conducted in our quaternary care NICU to test the Q. Basin, a novel design developed to wash, dry, and safely steam sanitize breast pump equipment compared to the standard steam bag. A bacterial study was conducted on breast pump equipment from 10 mothers by swabbing the equipment immediately at hour zero and 24 hours. Twenty NICU mothers concurrently evaluated their satisfaction via a 3-question survey comparing the Q. Basin and the steam sanitization plastic bag method. Results: The results showed a 20% increase in satisfaction with Q. Basin compared to the steam bag method. Implications for Practice and Research: Data analysis from the satisfaction survey concludes that mothers pumping preferred the Q. Basin as a quicker, faster, and more environmentally friendly method for breast pump part sanitization. Additional safety and materials studies are required before using the Q. Basin in the clinical environment. [ABSTRACT FROM AUTHOR]

This article examines the efficacy of a supportive housing program aiming to provide mothers in violent relationships with the practical resources to minimize child protection intervention. Drawing on qualitative interviews with program mothers, child safety officers, and program practitioners, we explore the extent to which the program enabled mothers and children to live free from fathers' violence and disengage from the child protection system. We find that, although valuable, the program did not fully mitigate the risks posed by violent fathers. We therefore argue that responsibility must be shifted onto violent fathers to change their behavior and build their parenting capacities. [ABSTRACT FROM AUTHOR]

Background: Community Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in Wakiso district Uganda on epidemic and pandemic preparedness and response including COVID-19. This evaluation was carried out to generate evidence on the outcomes of the project that can inform preparations for future outbreaks in the country. Methods: This was a qualitative evaluation carried out one year after the project. It used three data collection methods: 30 in-depth interviews among trained CHWs; 15 focus group discussions among community members served by CHWs; and 11 key informant interviews among community health stakeholders. The data was analysed using a thematic approach in NVivo (version 12). Results: Findings from the study are presented under four themes. (1) Improved knowledge and skills on managing epidemics and pandemics. CHWs distinguished between the two terminologies and correctly identified the signs and symptoms of associated diseases. CHWs reported improved communication, treatment of illnesses, and report writing skills which were of great importance including for managing COVID-19 patients. (2) Enhanced attitudes towards managing epidemics and pandemics as CHWs showed dedication to their work and more confidence when performing tasks specifically health education on prevention measures for COVID-19. (3) Improved health practices such as hand washing, vaccination uptake, and wearing of masks in the community and amongst CHWs. (4) Enhanced performance in managing epidemics and pandemics which resulted in increased work efficiency of CHWs. CHWs were able to carry out community mobilization through door-to-door household visits and talks on community radios as part of the COVID-19 response. CHWs were also able to prioritize health services for the elderly, and support the management of patients with chronic diseases such as HIV, TB and diabetes by delivering their drugs. Conclusions: These findings demonstrate that CHWs can support epidemic and pandemic response when their capacity is enhanced. There is need to invest in routine training of CHWs to contribute to outbreak preparedness and response. [ABSTRACT FROM AUTHOR]

There are few evaluations of early intervention for the prevention of anxiety disorders in East Asia, and those that exist generally evaluate outcomes to a maximum of 6–12 months. The current study evaluated the long-term effect (5 years) of an anxiety prevention program presented to preschool children and their parents in Japan. Participants for the study were 10 inhibited children 5–6 years old and their parents. The parent's and children's program comprised group sessions of a cognitive-behavioural program. Parents and teachers completed the anxious/depressed, withdrawn and behavioural inhibition at pre-post-intervention and 3-month follow-up. Five years after starting the intervention, participants were invited to a diagnostic interview, Anxiety Disorders Interview Schedule (ADIS) to examine a long-term preventive effect of the intervention. The majority of children showed a reduction in anxious/depressed, behavioral inhibition, and approximately half showed reliable change according to parents' and teachers' reports. Moreover, the results indicated that 9 of the 10 children did not met the diagnostic criteria for anxiety disorders. These results suggested that the early intervention had preventive effects because the diagnostic criteria for anxiety disorders were not met in the follow-up assessment conducted five years later. [ABSTRACT FROM AUTHOR]

Participation in outdoor sports increases exposure to ultraviolet radiation, necessitating mitigation through sunscreen use. This prospective study examined the effects of sport, setting (practice vs. competition), gender, age and geographic location on sunscreen use and education among youth athletes in various sports. Six hundred and twelve athletes ≤18 years old completed an online survey on sunscreen education and use during competitions and practices. Regardless of sport, reported sunscreen use was higher during practices than competition (p < 0.0001). Sunscreen was used most by swimmers/divers (odds ratio: OR ≥ 1.9, p < 0.001) and least by American football players (OR ≤ 0.57, p ≤ 0.001). Coaches mentioned sunscreen use the most in track and field (OR 1.84, p = 0.001) and the least in American football (OR 0.67, p = 0.03). Athletes used sunscreen more if they were female (OR ≥ 1.9 1.38, p ≤ 0.06) and younger (age OR ≤ 0.88, p < 0.001). In conclusion, youth athletes differ in sunscreen use by sport and setting, highlighting the need for continued photoprotective education. [ABSTRACT FROM AUTHOR]

The existing literature has focused little on the health-promoting role of resources for sleep. Mainly risk factors have been highlighted regarding mental health in general. Moreover, for the vulnerable age group of adolescents, resources and their relation to sleep have hardly been explored. Therefore, this study aims to investigate the predictive role of personal/social resources for the likelihood of having chronic sleep problems in adolescents. A sample of n = 131 adolescents (M = 14.31 years, SD = 1.84) completed the Sleep Disturbance Scale for Children and the Questionnaire to Assess Resources for Children and Adolescents at two measurement points about 8 months apart. Binomial logistic regressions controlling for age and sex revealed that higher levels of personal and social resources were associated with a lower likelihood of having chronic sleep problems. Especially optimism and school integration were associated with not experiencing chronic sleep problems. For the first time, this study highlighted multiple resources and their health-promoting role in adolescent sleep. Both personal and social resources seem to be relevant for preventing adolescents from chronic sleep problems. Prevention and intervention programs for sleep disorders in teenagers should especially promote optimism and school integration. [ABSTRACT FROM AUTHOR]

Instagram is the social network with the largest number of adolescent users in Italy; it is also the social network with the largest number of suicide‐related posts. Suicide is the third leading cause of death in Italy in the 15–19 age group. This study aims to describe Italian posts on Instagram related to suicide and to investigate whether there are differences in the number of likes, comments, and hashtags in relation to the characteristics of the posts. We searched for Italian‐language Instagram posts by typing '#suicidio', an Italian translation of the English word 'suicide', and found 303 posts between January and May 2022. Most of the posts were written by ordinary people, while only a small percentage of posts were written by professionals; moreover, the content was predominantly biographical and pro‐suicide, and most posts had no reference to adolescence. Posts with a neutral approach received the most likes, while posts with a negative or positive approach to suicide or that contained references to psychiatric disorders had the most hashtags. These results provide insight regarding guidelines that can be implemented for suicide online prevention and encourage psychologists to enhance online prevention and support using the online community inherent to the Instagram social network. [ABSTRACT FROM AUTHOR]

Background: Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10–17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. Methods: The study was cross-sectional, with a sample of n = 1595 pupils. The sample was stratified by clusters in city areas, grades, and the criterion of the presence/absence of in-school dental service. Dental check-ups were performed by using a commune dental examination kit. The oral hygiene simplified index (OHI; Silness and Löe) was used to assess the children's oral hygiene status. Five questions were used to determine oral hygiene habits. Results: The mean value of the OHI was 1.04. Some differences in oral hygiene scores were found for different socioeconomic variables, such as parents' education (p < 0.05): parents with vs. without a university degree—0.95/0.94 (male/female) vs. 1.06. Most of the children used manual toothbrushes (88%). Conclusions: The analysis of objective data (OHI) revealed a good level of oral hygiene, with many socioeconomic disparities. [ABSTRACT FROM AUTHOR]

Background: A challenge to implementation is management of the adaptation-fidelity dilemma or the balance between adopting an intervention with fidelity while assuring fit when transferred between contexts. A prior meta-analysis found that adapted interventions produce larger effects than novel and adopted interventions. This study attempts to replicate and expand previous findings. Methods: Meta-analysis was used to compare effects across a whole-population of Swedish outcome studies. Main and subcategories are explored. Results: The 523 studies included adapted (22%), adopted (33%), and novel (45%) interventions. The largest effect was found for adapted followed by novel and adopted interventions. Interventions in the mental health setting showed the highest effects, followed by somatic healthcare and social services. Conclusions: These results replicate and expand earlier findings. Results were stable across settings with the exception of social services. Consistent with a growing body of evidence results suggest that context is important when transferring interventions across settings. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the outcomes of adapted Parenting for Lifelong Health for Young Children to prevent child maltreatment in the Mainland China. Methods: A pre–post-follow-up study was designed and 54 Chinese parents received the eight-session online parenting intervention between February 4 and March 25, 2023. Results: Forty-one participants (75.9%) completed post-assessment and 36 (66.7%) completed 3-month follow-up assessment. Participants reported reduced child maltreatment, especially in emotional abuse and corporal punishment after the intervention, and the effect was maintained in 3-month follow-up. Improved positive parenting behaviors and decreased child externalizing behaviors were also observed for pre-, post-, and 3-month follow-up assessments. However, there were no significant changes in parental stress, parent–child relationship, parental depressive symptoms, and social support. Conclusions: The online Parenting for Lifelong Health for Young Children program for Chinese parents has shown promise in reducing child maltreatment, improving positive parenting, and decreasing children's problem behaviors, although randomized controlled trials are needed in future studies. [ABSTRACT FROM AUTHOR]

We examine population-level associations between birth spacing and child maltreatment using birth records and child welfare records for 1,099,230 second or higher parity children born in North Carolina between 1997 and 2013. Building upon previous research, administrative data linkages were used to address out-of-state migration and family-level heterogeneity in birth spacing and child maltreatment risk factors. Findings provide the strongest evidence to date that very short birth spacing of zero through 6 months from last birth to the index child's conception is a prenatal predictor of child maltreatment (indexed as child welfare involvement) throughout early childhood. Consequently, information about optimal family planning during the postpartum period should become a standard component of universal and targeted child maltreatment prevention programs. However, challenging previous empirical evidence, this study reports inconsistent results for benefits of additional spacing delay beyond 6 months with regard to child maltreatment risk reduction, especially for children of racial and ethnic minorities. These findings call for further inquiry about the mechanisms driving the connections between birth spacing and Child Protective Services assessments. [ABSTRACT FROM AUTHOR]

Female sex workers (FSWs) face prevalent violence victimization and alcohol consumption at work, yet the bidirectional pathways between these factors are not well defined. Using cohort data from 232 venue-based FSWs in Pattaya, associations of violence and alcohol use were examined within a time period and prospectively via structural equation models. Within the time period, violence victimization and alcohol use were consistently associated; by contrast, violence was not prospectively associated with FSW alcohol use. Findings define alcohol as an important risk factor for violence in sex work environments. Alcohol safety interventions should be explored as a vital component of FSW violence prevention. [ABSTRACT FROM AUTHOR]

Context: Collegiate tenpin bowling participation is increasing. Accordingly, the experience level of athletes participating, factors related to performance, as well as training workload and sport specialization are likely evolving. However, literature regarding injury rates remains extremely limited. The purpose of this study was to characterize injuries in collegiate tenpin bowlers. Design: Retrospective cohort survey study. Methods: Tenpin bowling athletes of top-ranked collegiate programs in the United States were invited to participate. Each participant completed an online survey to report on their injury history and additional factors of interest. Descriptive statistics were generated for participant characteristics, injury counts, and overall injury prevalence and recurrence. Chi-square tests were used to determine if overall injury prevalence and recurrence occurred by chance, and to evaluate the influence of gender and conditioning program participation on injury frequencies. Results: The response rate was 40.6% (101/249; N = 101). The sample was 20.02 (1.43) years old and 54.5% female. There were a total of 235 singular and recurrent injuries reported across all body parts. Upper-extremity injuries were the most common (n = 112). Injury prevalence (87%) and recurrence (75%) were more likely than chance (χ² > 21.3, both P < .001) and not different based on gender (χ² ≤ 1.1, both P ≥ .33). Injuries were more frequent in the absence of a conditioning program (χ² = 50.6, P < .001). Conclusions: Injuries and injury recurrence in elite tenpin bowlers were frequent, most common in the upper-extremity, not different based on gender, and more frequent in those without conditioning programs. Findings may serve as foundational knowledge for developing sport-specific rehabilitation and conditioning programs. [ABSTRACT FROM AUTHOR]

Background: Child and adolescent mental health is a major public health concern worldwide. The development of children's social and emotional skills helps to improve mental health and wellbeing, and prevent anxiety and depression. The school-based social emotional learning (SEL) programmes have proved effective in a number of countries. But in Mainland China, there has been no empirical research of the effectiveness on children's mental health. The study conducted a SEL programme in China during the COVID-19 pandemic and aimed to determine whether: (1) a SEL programme can reduce anxiety and depression, (2) the intervention effect is influenced by sociodemographic characteristics, (3) the programme effects change children's emotion management and communication. Methods: Participants were 230 children aged 8–12 years in the intervention school and 325 in the control school in two poor villages in central China. The study was a quasi-experimental trial, comprising 16 weekly 90-minute sessions. It used a mixed-methods design, with a quantitative survey administered at baseline, post-intervention, and 5-month follow-up, and qualitative interviews. Linear mixed effects regression modeling was used to analyse the intervention effectiveness, linear models were conducted to examine the moderation effect of sociodemographic variables, and the inductive thematic analysis approach was used for interview data. Results: The intervention had no significant effect on anxiety or depression, except that intervention school children who lived with neither parent (left behind children) reported lower depression scores than control school at post-intervention and 5-month follow-up. Qualitative interviews showed after intervention children were more able to control tempers and better communicated their thoughts and feelings, improving their relationships with family and friends. Conclusions: The programme was cheap, easy to implement, and warmly welcomed by children, schools and caregivers, suggesting it was feasible and potentially sustainable. More research is needed on the adaptation of the SEL programme in the Chinese context. [ABSTRACT FROM AUTHOR]

Background: Soilage of the surgical endoscope occurs frequently during minimally invasive surgery. The resultant impairment of visualization of the surgical field compromises patient safety, prolongs operative times, and frustrates surgeons. The standard practice for cleaning the surgical camera involves a disruption in the conduct of surgery by completely removing the endoscope from the field, manually cleaning its lens, treating it with a surfactant, and reinserting it into the patient; after which the surgeon resumes the procedure. Methods: We developed an automated solution for in vivo endoscope cleaning in minimally invasive surgery- a port that detects the position of the endoscope in its distal lumen, and precisely and automatically delivers a pressurized mist of cleaning solution to the lens of the camera. No additions to the scope and minimal user interaction with the port are required. We tested the efficacy of this troCarWash™ device in a porcine model of laparoscopy. Four board-certified general surgeons were instructed to soil and then clean the laparoscope using the device. Representative pre- and post-clean images were exported from the surgical video and clarity was graded (1) digitally by a canny edge detection algorithm, and (2) subjectively by 3 blinded, unbiased observers using a semi-quantitative scale. Results: We observed statistically significant improvements in clarity by each method and for each surgeon, and we noted significant correlation between digital and subjective scores. Conclusion: Based on these data, we conclude that the troCarWash™ effectively restored impaired visualization in a large animal model of laparoscopy. [ABSTRACT FROM AUTHOR]

Introduction: Disposable duodenoscopes and duodenoscopes with disposable endcaps are being used in clinical practice to reduce or eliminate the risk of transmitting infections. The study aim was to assess perceptions and experiences regarding the use of these duodenoscopes among advanced endoscopy fellows in a nationally representative sample. Methods: A 17-item electronic survey was sent to 74 advanced endoscopy training programs. The survey was completed by 50 participants and their responses were included for analysis. Results: Most participants were from academic training programs (82.7%) and identified as being in their 7th year of post graduate training (92%; PGY-7). Participants performed an average of 414 ERCPs. 29% reported difficulty with cannulation using disposable duodenoscopes versus 15.7% with duodenoscopes with disposable endcaps (vs. standard duodenoscope). 96% of trainees perceived disposable duodenoscopes as not cost effective and 92% stated they would not use this device during independent practice. 100% of trainees stated that they would use duodenoscopes with disposable endcaps during independent practice. For their most challenging cases, 90% of trainees preferred using standard reprocessable duodenoscopes while no trainee indicated they would prefer using a disposable duodenoscope in this scenario. 82% of participants stated that disposable duodenoscopes and disposable endcaps should be used exclusively or preferentially for high-risk patients citing cost, functionality, and concerns regarding environmental impact. Discussion: Advanced endoscopy fellows perceive disposable duodenoscopes as impacting technical maneuverability. Concerns about functionality, cost effectiveness and environmental impact are barriers to adoption. [ABSTRACT FROM AUTHOR]

Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes evidence related to burnout in Catholic clergy and potential modulating variables. Following the PRISMA methodology, systematic searches in different scientific databases identified 17 studies, revealing that burnout is related to age, personality traits, and type of priesthood. No relation between burnout and social support, self-care, spiritual practice, or workload was detected. It is necessary to adapt conceptual models to the peculiarities of burnout among clergy, extending assessment strategies and introducing working and organizational perspectives in the analysis of modulating variables, and in the development of prevention and intervention programs. [ABSTRACT FROM AUTHOR]

Simple Summary: Hereditary breast cancer represents a significant proportion of breast cancer cases worldwide, and BRCA1 and BRCA2 explain the majority of these. Less frequent genes with variable penetrance remain less characterized in Colombia. This study explores the characteristics and outcomes of 82 breast cancer patients with germline pathogenic/likely pathogenic variants (PVs) treated and followed at the Instituto Nacional de Cancerología, Colombia (INC-C) from 2018 to 2021 as part of an Institutional Hereditary Cancer Program implementation. We described the distribution of germline PVs among the different breast cancer molecular subtypes in this cohort of carriers. We observed that most PVs were in known breast cancer susceptibility genes, and PVs in BRCA2 were the most frequent. Notably, we observed that patients with disease progression were predominantly carriers of PVs in the BRCA2 gene. This study aimed to investigate prognosis and survival differences in 82 breast cancer patients with germline pathogenic/likely pathogenic variants (PVs) treated and followed at the Breast Unit of the Instituto Nacional de Cancerología, Colombia (INC-C) between 2018 and 2021. Median age at diagnosis was 46 years, with 62.2% presenting locally advanced tumors, 47.6% histological grade 3, and 35.4% with triple-negative breast cancer (TNBC) subtype. Most carriers, 74.4% (61/82), had PVs in known breast cancer susceptibility genes (i.e., "associated gene carriers" group, considered inherited breast cancer cases): BRCA2 (30), BRCA1 (14), BARD1 (4), RAD51D (3), TP53 (2), PALB2 (2), ATM (2), CHEK2 (1), RAD51C (1), NF1 (1), and PTEN (1). BRCA1-2 represented 53.7%, and homologous recombination DNA damage repair (HR-DDR) genes associated with breast cancer risk accounted for 15.9%. Patients with PVs in non-breast-cancer risk genes were combined in a different category (21/82; 25.6%) (i.e., "non-associated gene carriers" group, considered other breast cancer cases). Median follow-up was 38.1 months, and 24% experienced recurrence, with 90% being distant. The 5-year Disease-Free Survival (DFS) for inherited breast cancer cases was 66.5%, and for other breast cancer cases it was 88.2%. In particular, for carriers of PVs in the BRCA2 gene, it was 37.6%. The 5-year Overall Survival (OS) rates ranged from 68.8% for those with PVs in BRCA2 to 100% for those with PVs in other HR-DDR genes. Further studies are crucial for understanding tumor behavior and therapy response differences among Colombian breast cancer patients with germline PVs. [ABSTRACT FROM AUTHOR]

Relationship partners' impacts on health are not fully captured by existing measures. A measure that applies to a prevention context and accounts for both partners' perspectives is needed. This work developed and assessed the psychometric properties of the novel Partner Investment in Health scale (PI-H). A cross-sectional design assessed participants (N = 261) using an online survey. Exploratory factor analyses were used to determine the PI-H factor structure. Items assessed the person's investment in their partner's health and their perception of their partner's investment in their health. A 2 factor structure underlying 24 items on the PI-H scale was supported. Factors represented 1) the respondent's investment and 2) the respondent's perception of their partner's investment. The PI-H significantly correlated with related measures (e.g. relationship satisfaction, dyadic and communal coping; p <.05). A full PI-H scale, two subscales, and a short version of the scale (8 items) are presented. Correlations demonstrated convergent validity and suggested the PI-H is distinct from existing constructs. Theoretical implications and applications are discussed. [ABSTRACT FROM AUTHOR]

Objective: To report data from a point pressure ulcer (PU) prevalence survey on prevalence, PU categories, locations and preventive interventions at one Norwegian nursing home. Methods: A cross‐sectional research design was used. One nursing home in Norway participated in the prevalence survey in 2020. The data were collected on one selected day. A total of 74 out of 88 residents (84.1%) participated. Descriptive statistical analyses were run. Results: The overall prevalence of PUs was 27% amongst all participants in the nursing home, who together had a total of 57 PUs categorised as category I–III. One major finding was that the most common site of the PUs was on the residents' toes. Interestingly, the prevalence of PUs in the residents' sacrum was considerably low. The most frequently used PU preventive interventions were foam chair cushions, nutritional supplements and pressure‐reducing heel protection. Conclusion: This study identified a high prevalence of PUs, predominantly on residents' toes. Although preventive strategies were implemented, their application appeared limited. Implementing obligatory care packages and annual nationwide PU surveys might be worth considering in municipalities. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a substantial public health issue faced by youth, with disparities along lines of race, gender, and sexual orientation. Using an intersectional framework, the current study describes the prevalence of self-reported IPSV victimization across intersecting social positions among adolescents. High school students who completed the 2019 Minnesota Student Survey were asked whether they had ever experienced IPSV. Using exhaustive Chi-Square Automatic Interaction Detection (eCHAID), responses were modeled using five indicators: racial/ethnic identity, transgender/genderqueer/genderfluid identity, sex assigned at birth, sexual orientation, and school location. The prevalence of IPSV victimization within each end group identified by the eCHAID varied from 2.6% to 32.0%. The highest prevalence of IPSV among all students was observed in subgroups defined by multiple marginalized social positions; for example, 32.0% among lesbian, gay, bisexual, queer, pansexual, or questioning (LGBQ+) students of color who were transgender, genderqueer, genderfluid or unsure of their gender, and assigned male at birth; 22.8% among LGBQ+ students assigned female at birth and enrolled in a Greater Minnesota (outside of the Twin Cities) school; and 22.2% among Native+ or missing race LGBQ+ students assigned female at birth and enrolled in a metropolitan school. Within the eCHAID decision tree, several subsamples of students were split into two more subsamples with a twofold or greater statistically significant difference in IPSV victimization prevalence between them. Findings from this study highlight notable disparities in the prevalence of IPSV victimization among Minnesota youth and demonstrate the importance of detailing the distribution of interpersonal violence outcomes across youth with multiple marginalized identities. Findings suggest that disparities reported along one categorical axis only may miss important nuances in how risk for IPSV is distributed. Population health researchers should utilize methods that allow for the explication of complex intersections that characterize individuals' social positions in estimating the prevalence of sexual violence. [ABSTRACT FROM AUTHOR]

Aim: The risk of Type 2 Diabetes is 10 times higher after a pregnancy with Gestational Diabetes. Physical activity can independently reduce this risk, yet engagement with physical activity remains low after Gestational Diabetes. Therefore, the present study aimed to explore the barriers and facilitators to the uptake of physical activity after Gestational Diabetes in the United Kingdom, using a socio‐ecological approach. Methods: The paper was written following the Standards for Reporting Qualitative Research. Patient and Public Involvement contributed to the study's conceptualisation and design. Participants were recruited through an audit of Gestational Diabetes cases at a local Teaching Hospital in 2020. Twelve participants took part in semi‐structured one‐to‐one interviews. Reflexive thematic analysis was used to generate themes in iterative rounds of refinement. The final themes were then organised using the socio‐ecological model. Results: Participants were all over 31 years old, predominantly self‐identified as White British and were all in employment but were evenly spread across UK‐based deprivation deciles. Ten themes were generated and organised according to the four levels of the socio‐ecological model: intrapersonal (beliefs about activity, recovering from birth), social (health care professionals, family and partner, role as a mother), organisational (access and cost, environment, childcare and work) and community (connecting women with recent Gestational Diabetes). Conclusions: Many of the amenable barriers and facilitators to physical activity were beyond the intrapersonal level, based on higher levels of the socio‐ecological model (social, organisational and community). Multi‐level interventions are needed to effectively address all barriers. [ABSTRACT FROM AUTHOR]

Purpose: Food insecurity and colorectal cancer (CRC) are widely prevalent problems in the U.S. However, the long-term effects of food insecurity among people living with CRC are not well explored (e.g., risk of mortality). Methods: Data from the U.S. National Health and Nutrition Examination Survey (years 1999–2010) were linked with mortality data from the National Death Index up to 31 December 2019. Results: A total of 30,752 adults comprised the analytic sample; 222 were living with CRC and more than a tenth were food-insecure (11.6%). In our adjusted analysis, individuals who were food insecure and had CRC were 4.13 times more likely to die of any cause and 9.57 times more likely to die of cardiovascular diseases (compared to those without CRC and food insecurity). Conclusions: Colorectal cancer is among the top cancers diagnosed in American adults and more than a tenth of adult Americans with CRC live with food insecurity. Given the higher risk of mortality with co-occurring CRC and food insecurity, collaborative healthcare models can help address food insecurity and other social needs of people with CRC, and surveillance measures for food insecurity should be widely implemented across health systems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Promoting health is an important part of occupational health (OH) professionals' daily practice. Occupational health services (OHS) support work ability and prevent both work-related diseases and lifestyle-related illnesses. OBJECTIVE: We focused on how interprofessional collaboration (IPC), regardless of whether the OHS provider is public, private or in-house, influences the implementation of smoking cessation treatment and support (SCTS). We studied IPC of OH professionals in SCTS and whether they differ depending on OHS providers. METHODS: We collected data through an online survey of a cross-sectional sample of OH professionals of physicians (n = 182), nurses (n = 296) and physiotherapists (n = 96) at two different time-points, in 2013 and 2017. The questionnaire contained questions on interprofessional SCTS practices, so that we could assess how the professionals' experiences differed from each other. We used explanatory factor analysis to study the collaboration, and the Kruskall–Wallis test to detect the differences between the OH professional groups as a post-hoc data analysis. Background: OH physicians (mean 3.4, SD 1.2) and OH nurses (mean 3.2, SD 1.1) experienced smooth collaboration in SCTS whereas OH physiotherapists (mean 2.5, SD 1.1) felt excluded from IPC. In-house OH centres (mean 3.5, SD 1.0) seemed to offer the best opportunities for implementing IPC in SCTS comparing to public (mean 3.1, SD 0.9) or private (mean 2.9, SD 0.9) OHS. CONCLUSION: The IPC of OH professionals in SCTS interventions need to be rearranged. This requires boundary-crossing SCTS practices involving all professionals. All OH professionals should implement IPC in SCTS and share their specific competence. [ABSTRACT FROM AUTHOR]

Background: Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures. Aim: This original research is a systematic review and meta-analysis that aimed to investigate the impact of parental involvement on the prevention and management of childhood obesity, focusing on outcomes such as BMI z-score, exercise levels, screen time, dietary self-efficacy, and percentage body fat. Methods: Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) identified through comprehensive searches of PubMed, Scopus, Web of Science, and the Cochrane Library, including RCTs involving children aged 2–18 years with parental or caregiver participation, reporting on the specified outcomes. Data analysis was performed using RevMan 5.3, employing a random effects model. Results: A total of 5573 participants were included. The meta-analysis revealed a significant reduction in BMI z-score (MD = −0.06, 95% CI: −0.09 to −0.02, p = 0.005, I2 = 58%), a non-significant increase in exercise levels (SMD = 0.26, 95% CI: −0.01 to 0.52, p = 0.05, I2 = 52%), and a significant reduction in screen time (MD = −0.36 h per day, 95% CI: −0.61 to −0.11, p = 0.005, I2 = 0%). Dietary self-efficacy also improved significantly (MD = 0.59, 95% CI: 0.12 to 1.05, p = 0.01, I2 = 0%). However, changes in percentage body fat did not reach statistical significance (MD = −1.19%, 95% CI: −2.8% to 0.41%, p = 0.15, I2 = 0%). Conclusion: Parental involvement in childhood obesity interventions significantly impacts BMI z-score, exercise levels, screen time, and dietary self-efficacy but not percentage body fat. These findings highlight the importance of engaging parents in obesity prevention and management strategies. [ABSTRACT FROM AUTHOR]

We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66–0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries. [ABSTRACT FROM AUTHOR]

This study aimed to investigate an acute effect of foam rolling and tissue flossing of the Triceps Surae muscle on Achilles tendon stiffness, jump height and sprint performance at different time points. The participants were academic athletes (n = 32) aged between 22 and 24 years; randomly allocated into two groups: foam rolling (ROLL) and tissue flossing (FLOSS). The participants were tested at baseline and 5-min, 15-min, 30-min, 45-min, and 60-min after ROLL and FLOSS for Achilles tendon stiffness (ATstiffeness) at three reference locations: (1) tendon's origin, (2) ankle joint height and (3) intermuscular septum of the gastronomies muscle; countermovement jump (CMJ); and sprint performance at 15-m (SPRINT15 m). The analysis of stiffness revealed a significant decrease in ATstiffness from baseline to Post-60 (p ≤ 0.001) for three locations in the FLOSS group (p ≤ 0.001). In FLOSS, a significant increase was observed from Post-15 to Post-60 (all p≤0.001) in CMJ. We found also a significant decrease in SPRINT15 m in FLOSS in all-time points (p ≤ 0.001), however, SPRINT15 m decreased in Post-5 min, Post-15 min, and Post-30 min (p ≤ 0.001 for all) in ROLL. The current study suggested that both groups enhanced performance up to 60 min after the intervention, caused by mitigating excessive stiffness. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and compare the risk of dental caries in between human immunodeficiency virus (HIV)‐infected and uninfected children and adolescents. An electronic search was performed on PubMed/MEDLINE, Web‐of‐Science, Scopus, LILACS, ProQuest, and ClinicalTrials.gov up to May 2022. The critical appraisal checklist developed by the Joanna Briggs Institute was used to evaluate the quality of the included studies. Meta‐analysis was performed using the RevMan 5.4. Sixteen studies were included. A total of 3231 participants were evaluated, including 1701 and 1530 HIV‐infected and uninfected children and adolescents, respectively. The meta‐analysis revealed a higher risk of dental caries for primary dentitions in HIV‐infected children and adolescents by decayed, missing, filled tooth (dmft) (SMD:0.34; p = 0.006) and decayed, missing, filled surface (dmfs) scores (SMD:0.37; p = 0.001). Similar results were observed for permanent dentition, with increased dental caries in HIV‐infected children and adolescents with DMFT (SMD:0.32; p = 0.003) and DMFS (SMD:1.78; p < 0.0001) scores. Regarding the quality assessment, most of the included studies were moderate or good quality. However, the certainty of the evidence of the outcomes was very low. This systematic review and meta‐analysis showed higher caries severity in permanent and deciduous teeth among HIV‐infected children and adolescents. [ABSTRACT FROM AUTHOR]

Background: The objective is to summarize evidence from systematic reviews, scoping reviews, and meta-analyses evaluating the effects of any format of Internet-based, mobile-, or telephone-based intervention as a technology-based intervention in suicide prevention. Materials and Methods: This is an umbrella review, that followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelines. An electronic search was done on September 29, 2022. Data were extracted by reviewers and then methodological quality and risk of bias were assessed by A Measurement Tool to Assess Systematic Reviews-2. Statistical analysis was done by STATA version 17. Standard mean difference was extracted from these studies and by random effect model, the overall pooled effect size (ES) was calculated. I2 statistic was used to assess the heterogeneity between studies. For publication bias, the Egger test was used. Results: Six reviews were included in our study, all with moderate quality. The overall sample size was 24631. The ES for standard mean differences of the studies is calculated as - 0.20 with a confidence interval of (-0.26, -0.14). The heterogeneity is found as 58.14%, indicating a moderate-to-substantial one. The Egger test shows publication bias. Conclusion: Our results show that technology-based interventions are effective. We propose more rigorous randomized controlled trials with different control groups to assess the effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder and developmental disabilities (ASD/DD) face barriers to participation in health promotion programs due to the lack of available and/or affordable programs and trained staff at recreation centers. Children with ASD/DD in Korean immigrant families are one of the most underserved minority groups due to language, racial/ethnic discrimination, and stigma and shame within their own ethnic community. However, little research is available on development, implementation, and evaluation of a culturally adapted community health promotion program in this population. The purpose of this study is to assess effectiveness of a pilot program for children with ASD/DD from first-generation Korean immigrant families. The pilot study used a quantitative, quasiexperimental design (one-group design with pre- and posttest) following a seven-week health promotion program. We recruited 15 children with ASD/DD, ages nine through 16, from first-generation Korean immigrant families. The findings of the study suggest that the pilot program was effective in gaining nutrition knowledge and increasing physical involvement among participants. Given the fact that Asian immigrants are a fast-growing population and that nearly 75 percent of them were born abroad, development and evaluation of a community-based, culturally adapted health promotion program is urgently needed. [ABSTRACT FROM AUTHOR]

This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai'i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were "refuse" (saying no), "explain" (providing reasons for vaping refusal), "avoid" (avoiding people or places where e-cigarettes were used), and "leave" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities. [ABSTRACT FROM AUTHOR]

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Simple Summary: Albino patients in rural Africa have a very high risk of skin cancer. We have conducted several cooperative campaigns in recent years focusing on the care of this population in a rural area of Malawi and have reached some important conclusions. Primary prevention is fundamental and, in addition to education, providing adequate clothing offers more sustainable and long-lasting photoprotection and is more effective than offering sunscreen sporadically. However, at present, secondary prevention focused on frequent follow-up and early diagnosis of treatable lesions is what really makes the difference in many patients affected by squamous cell carcinoma, who otherwise will eventually die. To achieve this, it is essential to have funding and local collaboration with a comprehensive organization prior to visits by using teledermatology and frequent campaigns of qualified health staff who, in addition, help in the training of local personnel. Background: We have conducted cooperative campaigns focusing on albino patients in a rural area of Malawi. What have we learned? Methods: Three surgical campaigns were performed in Nkhotakota district (2019–2023). Albino clinical and tumor characteristics were collected. Results: Between 22 and 75 albinos were evaluated in each campaign (mean age < 28 years old). Most patients did not use sunscreen in a way that provided optimal photoprotection. Regarding tumors, the proportion of basal and squamous cell carcinomas ranged from 1:1 to almost 2:1. Of 156 albino patients, 34 attended more than once. However, of the 19 patients with 30 tumors operated on in 2021, only seven were assessed the following year (12 were lost to follow-up). At least 14 albinos with locally advanced tumors were evaluated. Conclusions: Distributing photoprotective clothing could be more efficient or perhaps an earlier measure of sunscreen in rural Africa as it does not require permanent repositioning. Very-high-risk patients (previous interventions with positive margins or high-risk tumors, intense actinic damage, and new tumors constantly appearing, especially those presenting SCCs) require close follow-up and treatment and represent our main target. Secondary prevention with Malawian collaboration and the use of teledermatology is essential for patient tracking, as they are able to offer curative treatments. [ABSTRACT FROM AUTHOR]

Social media can be used to raise awareness about health issues, especially concerning the importance of periodical screening. The present study aims to identify the role of social media awareness campaigns in the early detection of breast cancer, with a focus on Romania, a country with a high female mortality due to this disease. The research is performed using a survey, based on an online questionnaire, which was self-administered by the respondents included in two samples selected from a Facebook community of Romanian women. Sample A was composed of 1945 women who were not exposed to periodic campaigns regarding the importance of screening for the prevention and early detection of this type of disease, and Sample B was composed of 289 women who were exposed to such annual campaigns within the last 5 years. The results outline several differences among respondents from the two samples regarding their awareness of prevention necessity, as well as the frequency and chosen methods for breast cancer screening. The findings hold important implications for public authorities, which must intensify their efforts in raising women's awareness regarding the importance of screening for the early detection and prevention of breast cancer. [ABSTRACT FROM AUTHOR]

Purpose: Ultra-processed food (UPF) intake has increased in recent decades, yet limited knowledge of long-term effects on cardiovascular health persists and sex-specific data is scant. We determined the association of UPF intake with incident cardiovascular disease (CVD) and/or hypertension in a population-based cohort of women. Methods: In the Australian Longitudinal Study on Women's Health, women aged 50–55 years were prospectively followed (2001–2016). UPFs were identified using NOVA classification and contribution of these foods to total dietary intake by weight was estimated. Primary endpoint was incident CVD (self-reported heart disease/stroke). Secondary endpoints were self-reported hypertension, all-cause mortality, type 2 diabetes mellitus, and/or obesity. Logistic regression models assessed associations between UPF intake and incident CVD, adjusting for socio-demographic, medical comorbidities, and dietary variables. Results: We included 10,006 women (mean age 52.5 ± 1.5; mean UPF intake 26.6 ± 10.2% of total dietary intake), with 1038 (10.8%) incident CVD, 471 (4.7%) deaths, and 4204 (43.8%) hypertension cases over 15 years of follow-up. In multivariable-adjusted models, the highest [mean 42.0% total dietary intake] versus the lowest [mean 14.2% total dietary intake] quintile of UPF intake was associated with higher incident hypertension [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.10–1.74; p = 0.005] with a linear trend (ptrend = 0.02), but not incident CVD [OR 1.22, 95% CI 0.92–1.61; p = 0.16] or all-cause mortality (OR 0.80, 95% CI 0.54–1.20; p = 0.28). Similar results were found after multiple imputations for missing values. Conclusion: In women, higher UPF intake was associated with increased hypertension, but not incident CVD. These findings may support minimising UPFs within a healthy diet for women. [ABSTRACT FROM AUTHOR]

There is a dearth of research examining the relationship perspectives of Latina young people, a population that reports disproportionate rates of teen dating violence (TDV). This strengths-based, qualitative study utilized critical narrative inquiry to explore Latinas' relationship perspectives through in-depth interviews. Rigorous analysis revealed participants' desire for freedom from violence/abuse, open communication, independence, and egalitarian values in relationships, while reporting relationship models and media representation as their main influences on relationship perspectives. Our findings demonstrate that although patriarchal gender norms influence romantic relationships with Latinx cultures, many participants rejected traditional gendered power dynamics that can lead to violence, providing important information for practitioners seeking to promote healthy relationships among this population. [ABSTRACT FROM AUTHOR]

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care. [ABSTRACT FROM AUTHOR]

Falls are commonly associated with knee osteoarthritis and represent a significant financial burden on the healthcare system. Therefore, the discovery of physical therapists' attitudes and practices regarding fall screening and prevention among patients with osteoarthritis should be investigated. Moreover, this study aimed to identify barriers that might limit its implementation among this population. A cross-sectional study design was used to collect the data. The electronic survey targeted licensed physical therapy professionals who currently work in clinical or academic settings in Saudi Arabia. The data were analyzed descriptively and inferentially using chi-square. Two hundred and six licensed physical therapists completed the survey, 119 females (57.8%) and 87 males (42.2%). The results of the structural equation modelling analysis showed that intention to use fall screening and management strategies was positively associated with the history of falls, identifying risk factors of falls, and documentation of risk factors of falls (p ≤ 0.0001). The most reported barriers to implement fall screening and prevention were lack of knowledge (n = 92, 45%), lack of training/skills (n = 84, 41%), and time constraints (n = 57, 45%), followed by patient compliance with 38% of the responses. The findings highlighted the importance of identifying the key opportunities for knowledge translation in clinical practices to enhance the sufficient implementation of fall screening and management in osteoarthritis care. [ABSTRACT FROM AUTHOR]

In this follow-up study, we aimed to assess the effectiveness of the "I do not smoke, I exercise" anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t-test revealed a significant improvement in students' knowledge about smoking (t217 = −5.605, p < 0.001, d = 0.38) and perceived behavioral control (t220 = −2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high (M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context. [ABSTRACT FROM AUTHOR]