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BACKGROUND: Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYNs knowledge, attitudes, and perceptions towards a PBDP. METHODS: Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. RESULTS: Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYNs role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. CONCLUSION: Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinicians ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.

Weight change trajectory from diet and lifestyle interventions typically involves rapid weight loss followed by a weight plateau after approximately 6 months. Changing from one weight-loss diet to another at the time of the plateau could instigate renewed weight loss. Therefore, our secondary analysis aimed to assess trajectory of weight loss in a 12-month, randomized, cross-over study. Forty-two adults were randomized to eat a healthy low-fat or healthy low-carbohydrate diet for 6 months then switched to the opposite diet for an additional 6 months. Regardless of diet assignment, participants experienced rapid initial weight loss, which slowed between 3 to 6 months. After switching diets at 6 months, weight modestly decreased until 9 months, but at a rate slower than the initial 3 months and slower than the rate from 3 to 6 months. This suggests that the weight loss plateau typically seen at 6 months is physiological and cannot be overcome by simply switching to a different weight-loss diet.

ImportanceIncreasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).ObjectiveTo compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention.Design, setting, and participantsThis single-center, population-based randomized clinical trial of 22 pairs of twins (N = 44) randomized participants to a vegan or omnivorous diet (1 twin per diet). Participant enrollment began March 28, 2022, and continued through May 5, 2022. The date of final follow-up data collection was July 20, 2022. This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins. Primary analysis included all available data.InterventionTwin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks. Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks.Main outcomes and measuresThe primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8). Secondary outcome measures were changes in cardiometabolic factors (plasma lipids, glucose, and insulin levels and serum trimethylamine N-oxide level), plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being.ResultsA total of 22 pairs (N = 44) of twins (34 [77.3%] female; mean [SD] age, 39.6 [12.7] years; mean [SD] body mass index, 25.9 [4.7]) were enrolled in the study. After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration (-13.9 [5.8] mg/dL; 95% CI, -25.3 to -2.4 mg/dL), fasting insulin level (-2.9 [1.3] μIU/mL; 95% CI, -5.3 to -0.4 μIU/mL), and body weight (-1.9 [0.7] kg; 95% CI, -3.3 to -0.6 kg).Conclusions and relevanceIn this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet. Clinicians can consider this dietary approach as a healthy alternative for their patients.Trial registrationClinicalTrials.gov Identifier: NCT05297825.

The Genomics Education Partnership (GEP), a consortium of diverse colleges and universities, provides support for integrating genomics research into undergraduate curricula. To increase research opportunities for underrepresented students, GEP is expanding to more community colleges (CC). Genomics research, requiring only a computer with Internet access, may be particularly accessible for two-year institutions with limited research capacity and significant budget constraints. To understand how GEP supports student research at CCs, the authors analyzed student knowledge and self-reported outcomes. It was found that CC student gains were comparable to non-CC student gains, with improvements in attitudes toward science and thriving in science. The early findings suggest that the GEP model of centralized support with flexible implementation of a course-related undergraduate research experience benefits CC students and may help mitigate barriers to implementing research at CCs.

This article builds on Yuval-Davis's (2006, 2007, 2011) theories of belonging, in order to relay how practitioners can support unaccompanied asylum-seeking children (UASCs) in developing a positive sense of belonging in educational spaces in England. To do so, the article synthesises literature surrounding theories of belonging, UASCs' educational access in England and practices supporting UASCs' educational attainment and sense of belonging. Further, the article considers interviews with a social worker, English for speakers of other languages (ESOL) teacher, charity sector staff member, legal expert and government workers in East England, all of whom work with UASCs. Interview analysis seeks to understand how practitioners believe UASCs find a sense of belonging in the educational spaces that they inhabit. After presenting the interview findings, the article builds on scholarly literature related to supporting UASCs' education by discussing how practitioners, including all staff who interact with UASCs in school, college or residential accommodation spaces, can work to facilitate UASCs' sense of belonging in educational spaces in England. The article recognises that practitioners can do so through learning to speak with low-level ESOL students, developing trauma awareness and reflexively approaching their relationships with UASCs. Thus, the article provides policy recommendations to support practitioners in doing so.

BackgroundThis research prioritization aimed to identify major research gaps in maternal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic.MethodsWe adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area.ResultsWe identified top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on availability, access, care-seeking and utilization of MNCAH services and potential solutions.ConclusionsWe call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.

This paper probes theories of justice underpinning the concept of equity to deconstruct the term and ascertain how best to equitably support refugee and asylum-seeking youth in U.S. schools. Building upon theories posited by John Rawls, Michael Sandel, and Amartya Sen, the paper aims to extend beyond ideal theory into a theoretical framework of equity with operationalizing potential. Recognizing refugee and asylum-seeking youth as part of the U.S. social contract and therefore bound to government support, the paper represents that equitable education for these young people in our globalized world is essential from both a human rights and economic perspective. Such equitable education will only be achieved when universal minimum standards are offered to everyone and made inclusive, so that all are invited to fully participate as culturally respected learners and knowledge producers in academic spaces.

Objective: This study aimed to evaluate the factor structure of the Depression Anxiety and Stress Scale (DASS‐21) among caregivers of young children in Southeastern Europe. Background: The DASS‐21 is a widely used measure in prevention and intervention research with families. Studies regarding the scale's psychometric properties among caregivers, particularly from non‐Western countries, are limited and additional research is required. Method: The DASS‐21 was administered to N = 835 primary caregivers from North Macedonia, the Republic of Moldova, and Romania. Competing models were tested with confirmatory factor analysis (CFA). Measurement invariance was assessed using multigroup CFA (MGCFA). Bifactor dimensionality and reliability indices were used to evaluate the validity of the composite and subscale scores. Results: A tripartite bifactor model with two specific factors (depression and anxiety) and one general factor (negative affectivity) represented the data well. This model showed cross‐country configural and partial metric invariance. Dimensionality and reliability indices supported a unidimensional interpretation of the measure, with the general negative affectivity factor accounting for a substantial share of the variance (82%) compared to the specific factors of depression (10%) and anxiety (8%). Conclusion: The tripartite model best represented the data. Configural and partial metric invariance were verified for this model. Dimensionality and reliability indices, however, indicate that the DASS‐21 functions best as a general measure of negative affectivity. Implications: Future intervention studies involving caregivers from Southeastern Europe should consider using the DASS‐21 as an overall measure of negative affectivity and utilize the composite score instead of the subscale scores. [ABSTRACT FROM AUTHOR]

PurposeTo explore whether reducing substance misuse through a brief motivational intervention also reduces aggression and HIV risk behaviours.MethodsParticipants were enrolled in a randomized controlled trial in primary care if they screened positive for substance misuse. Substance misuse was assessed using the Alcohol, Smoking and Substance Involvement Screening Test; aggression, using a modified version of the Explicit Aggression Scale; and HIV risk, through a count of common risk behaviours. The intervention was received on the day of the baseline interview, with a 3-month follow-up.ResultsParticipants who received the intervention were significantly more likely to reduce their alcohol use than those who did not; no effect was identified for other substances. In addition, participants who reduced substance misuse (whether as an effect of the intervention or not) also reduced aggression but not HIV risk behaviours.ConclusionsReducing substance misuse through any means reduces aggression; other interventions are needed for HIV risk reduction.

Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3-8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists, satisfaction surveys, and engagement in home practice activities. Qualitative data included parent interviews, facilitator focus groups, and transcripts from parent groups and facilitator supervision sessions. Results: Quantitative results show high levels of participant involvement, implementation, and acceptability. Thematic analyses identified seven themes related to program feasibility: (a) supporting participant involvement, (b) engagement in collaborative learning, (c) strengthening facilitator competency, (d) delivering nonviolent discipline skills, (e) contextualizing content, (f) receptivity to existing practices, and (g) resistance to new skills. Discussion: Findings suggest that parenting programs derived from evidence-based principles may be feasible in South Africa when situated within a culturally relevant context.

Purpose: Violence against children increases in adolescence, but there is a research and practice gap in research-supported child abuse prevention for the adolescent years. A pilot program for low-resource settings was developed in collaboration with nongovernmental organizations, government, and academics in South Africa, using research-supported principles. Method: This study used a pre-post design to test initial effects of a 10-session parenting program with 60 participants (30 caregiver-adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show medium to large program effects in reducing child abuse and adolescent problem behavior, as well as large effects in improvements of positive parenting, and perceived parent and adolescent social support. Discussion: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behavior in rural South Africa through parenting programs. Further development, testing and longer term follow-up are required to ascertain potential for scale-up.

AimsTo assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country.MethodsA randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 months.ResultsAlthough rates of at-risk alcohol use and drug use did not differ by treatment arm at follow-up, patients assigned to the Brief Motivational Intervention had significantly reduced scores on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) for alcohol-the most prevalent substance.ConclusionBrief Motivational Intervention may be effective at reducing at-risk alcohol use in the short term among low-income young adult primary care patients; additional research is needed to examine long-term outcomes.

Traditionally, seafood assessments and subsequent ratings have guided choice and responsible sourcing of sustainable seafood based primarily on environmental concerns, with limited to no consideration to multi-faceted human dimensions that form an integral part of these complex socialecological systems. For wild-capture marine fisheries around the world, and particularly in developing countries, human dimensions remain underrepresented in sustainability ratings, where the focus has traditionally been on larger, data-rich commercial fishery components that report predominantly on ecological and management considerations. Yet, addressing the diverse and complex nature of marine social-ecological systems remains critical to achieve global sustainable seafood systems that balance ecological and societal needs to benefit both nature and people. This paper champions the integration of human elements into seafood sustainability guides, building on work reviewing how best to integrate human dimensions into traditional seafood assessments under the World Wide Fund for Nature (WWF) - drawing on examples from South Africa. While the paper does not prescribe a blueprint for implementation, this review highlights challenges and opportunities to include human rights violations and small-scale fisheries in existing sustainable seafood guides from a South African perspective. There is a need for sustainability considerations to move beyond fish to better represent how these socialecological systems feed into oceanic cultural norms and nutrition. This translates to shifting from an ecological focus to include human dimensions to better represent complex marine social-ecological systems and drive equitable change within local and global seafood industries. [ABSTRACT FROM AUTHOR]

This study investigates the co-occurrence of intimate partner violence (IPV) against mothers and their risk of perpetrating child maltreatment (CM) in North Macedonia, the Republic of Moldova, and Romania. Risk factors for IPV, CM, and their co-occurrence were identified. Two samples (N 1= 112, N 2 = 701) of mothers with children with behavioral problems were assessed. IPV was reported by 64% of mothers, CM by 96%, and their co-occurrence by 63%. Mothers exposed to emotional IPV reported more physical and emotional CM. Mothers exposed to physical IPV reported more physical CM. Motheŕs own history of CM and offspring's behavior problems were associated with IPV and CM co-occurrence. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the psychometric properties of three versions of the Parenting Scale (PS; original PS, 13‐item version, and 10‐item version) in three European middle‐income countries. Background: The PS is one of the most frequently used questionnaires for measuring dysfunctional discipline strategies. Although its validity has been extensively investigated in American samples, there are mixed results regarding the recommended number of items and subscales, raising the question of replicability across European middle‐income countries. Method: Multigroup confirmatory factor analysis (MCFA) and item response theory (IRT) were applied to N = 835 parents from North Macedonia, Moldova, and Romania. Results: All three versions were significantly correlated with parental‐ and child‐related variables. Confirmatory factor analysis indicated the best model fit for the 10‐item version, and configural and partial metric invariance across countries could be established for this version. Item response theory analyses also supported this measure. Conclusions: Our findings show that the 10‐item version performed better than the 13‐item version and the original PS both overall and on the country level. Reliability values were somewhat lower than reported in studies from the United States. Implications: The 10‐item version constitutes a promising short measure for assessing dysfunctional parenting in European middle‐income countries for researchers and practitioners. [ABSTRACT FROM AUTHOR]

Aggressogenic parenting styles are associated with increased rates of callous and unemotional traits, and in turn, with antisocial behaviours. Traumatic brain injury is also associated with antisocial behaviour, but not callous and unemotional traits specifically. No study has previously investigated these three variables, aggressogenic parenting, traumatic brain injury, and callous and unemotional traits, in a single study. The study setting was Cape Town, South Africa. The sample included high school boys (N = 54), aged 13–21 years in an observational, descriptive study. We hypothesised that boys who reported that they had sustained a traumatic brain injury and who had been exposed to aggressogenic parenting would display increased levels of callous and unemotional traits, and that those with traumatic brain injury but had experienced positive parenting would display lower levels of such traits. The main measures included the Comprehensive Health Assessment Tool, the Inventory of Callous/Unemotional traits, and the Alabama Parenting Questionnaire. Results show that almost 41% (22/54) of participants reported sustaining a traumatic brain injury. Aggressogenic parenting significantly moderated callous and unemotional traits only in participants with traumatic brain injury, F(1.46) = 4.76, p = .03, while positive parenting and substance use did not. In conclusion, traumatic brain injury in the presence of aggressogenic parenting is associated with greater callous and unemotional traits in this sample of adolescent boys. [ABSTRACT FROM AUTHOR]

Despite the fact that natural disasters occur more commonly in low and middle income countries than in wealthier countries, we know relatively little about how these disasters are experienced in such contexts. South Africa presents an especially telling example in which it is clear that natural events are affected profoundly by sociopolitical factors, including the spatial design of the apartheid city. We report here on interviews with twenty survivors of the biggest shanty town fire in the history of Cape Town, South Africa. The narratives of participants demonstrate that in order to understand the human cost of such disasters it is as important to understand the politics of the precursors of the disaster as well as what occurred subsequent to the disaster. The South African case, like that of Hurricane Katrina, underscores the fact that disaster, far from being an acute event which happens to individuals, is better understood as part of a far longer sociopolitical process affecting individuals, groups, and, indeed, societies.

Gangs have a long history in Cape Town and children tend to begin involvement around age 12. Children's views on causes of children's involvement in gangs and appropriate interventions, were sought for inclusion in policy recommendations. Thirty focus group discussions were held with in- and out-of-school youth in different communities. Participants identified failing social structures as the causes of gangsterism. They recommended interventions to enable social structures to provide a wide range of opportunities for positive youth development, rather than programmes narrowly focused on gangs.