Search

Background and aims: This paper assesses the impact of estimation methods for general and education-specific trends in alcohol-attributable mortality (AAM), and develops an alternative method that can be used when the data available for study is limited. Methods: We calculated yearly adult (30+) age-standardised and age-specific AAM rates by sex for the general population and by educational level (low, middle, high) in Finland and Turin (Italy) from 1972 to 2017. Furthermore the slope index of inequality and relative inequality index were computed by country and sex. We compared trends, levels, age distributions, and educational inequalities in AAM according to three existing estimation methods: (1) Underlying COD (UCOD), (2) Multiple COD (MCOD) method, and (3) the population attributable fractions (PAF)-method. An alternative method is developed based on the pros and cons of these methods and the outcomes of the comparison. Results: The UCOD and MCOD approaches revealed mainly increasing trends in AAM compared to the declining trends according to the PAF approach. These differences are more pronounced when examining AAM trends by educational groups, particularly for Finnish men. Until age 65, age patterns are similar for all methods, and levels nearly identical for MCOD and PAF in Finland. Our novel method assumes a similar trend and age pattern as observed in UCOD, but adjusts its level upwards so that it matches the level of the PAF approach for ages 30–64. Our new method yields levels in-between UCOD and PAF for Turin (Italy), and resembles the MCOD rates in Finland for females. Relative inequalities deviate for the PAF-method (lower levels) compared to other methods, whereas absolute inequalities are generally lower for UCOD than all three methods that combine wholly and partly AAM. Conclusions: The choice of method to estimate AAM affects not only levels, but also general and education-specific trends and inequalities. Our newly developed method constitutes a better alternative for multiple-country studies by educational level than the currently used UCOD-method when the data available for study is limited to underlying causes of death. [ABSTRACT FROM AUTHOR]

Fibromyalgia (FM) is a condition associated with chronic musculoskeletal pain, fatigue, joint rigidity, sleep interruption, depression and cerebral dysfunction. It is a complicated syndrome with not well-known pathogenesis and only clinical diagnosis at the present. Osteoporosis, however, is described as a skeletal disease, which main characteristics are: (1) reduced strength of the bone which is associated with the loss of skeletal mass and (2) micro-architectural deterioration of the bones, without clinical symptoms-except when fractures occur. In recent years, few studies have addressed the relation between fibromyalgia and osteoporosis. Most studies show that fibromyalgia may lead to an increased possibility of osteoporosis due to low levels of exercise because of the chronic pain. In addition, when Vitamin D levels are measured in patients with firbromyalgia syndrome it seems to be lower than general population. However, results of studies of the bone mineral density (BMD) of these patients are conflicted. In this short review article, we provide current knowledge on the relationship between fibromyalgia and osteoporosis, and in addition we discuss the association between fibromyalgia syndrome (FMS) and low bone mineral mass as shown in previously published papers including for systemic reviews and meta-analysis on these subjects. [ABSTRACT FROM AUTHOR]

This study investigates the gender disparities and cohort differences in the health trajectories of older Chinese adults. Drawn on a nationally representative dataset from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey, this paper uses a growth-curve model to identify the health trajectories of older adults in functional limitations, chronic diseases, depressive symptoms and cognitive skills. Older women are found to have slightly fewer functional limitations than older men at an earlier age; however, this gap is reversed later because of women's higher deterioration rate in physical function. Compared to men, older women have more chronic diseases at younger ages, but this trend is changed after age 90 years due to a faster decline rate in chronic diseases for women. The gender gap in the depressive symptom trajectories narrows with age, whereas the gap in the trajectories of cognitive skills widens. The cohort differences favouring later-born cohorts decrease with age in the trajectory of functional limitations. The latest cohort born in 1940 or after has the fastest increase in chronic diseases and depressive symptoms among all the cohorts. These results are further verified using the random-effect model and pooled ordinary least squares. Policymakers should promote gender equality and reduce cohort differences to achieve the national goal of "Healthy China". [ABSTRACT FROM AUTHOR]

In this paper, we contend that urban middle-class older Indians engaged in "serious leisure" as a way to reimagine and reconfigure the structure of everyday life during the pandemic-led epochal downtime. In particular, we heuristically show that leisure activity patterns and constraint negotiation strategies among older Indians followed conceptual semblances with the dominant leisure-based typology of Serious Leisure Perspective. By thematically analysing household surveys (n = 71), time-use diaries and in-depth interviews (n = 15) of middle to upper middle-class individuals (55–80 years), we show how both men and women distinguished between serious leisure that is marked by motivation, agency and perseverance with that of unstructured, routinized free-time (or causal leisure). Time-use diaries suggested that despite the changed realities of heightened domestic time available to both genders due to the pandemic, women recorded higher proportion of their daily hours in household management and caregiving. Although women were governed by moral-cultural self-descriptions in their engagement with leisure, it was often associated with an enhanced sense of self-actualisation, self-management and identity. Overall, we show how the social codes of age and gender were inextricably linked with the practice of leisure during the pandemic. [ABSTRACT FROM AUTHOR]

The aim of this work was to propose a preliminary local diagnostic reference levels (DRL) for pediatric interventional cardiology (PIC) procedures in Argentina, for different ranges of age and weight. This work has been conducted in the framework of the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency to ensuring that radiation exposures of pediatric patients are the minimum necessary during fluoroscopy-guided interventional procedures. The local DRL values presented in this paper by weight group and age group were 7.1 Gy·cm2 (<5 kg), 10.7 Gy·cm2 (5–15 kg), 18.0 Gy·cm2 (15–30 kg), 15.9 Gy·cm2 (30–50 kg), and 28.2 Gy·cm2 (50–80 kg) and 5.3 Gy·cm2 (<1), 11.2 Gy·cm2 (1 to 5<), 19.6 Gy·cm2 (5 to 10<), and 21.4 Gy·cm2 (10 to 16<), respectively. Our dose results are among the values found in other international studies; however, there is great potential for dose optimization. [ABSTRACT FROM AUTHOR]

Empathy is a key skill in the daily life of preschoolers, and it is important to understand how it evolves during this crucial period of development. This paper includes two studies. The first study, which had a cross-sectional design, examined affective, cognitive, and behavioral empathy in 354 children (aged from 3 to 6 years) through a performance-based measure and questionnaires completed by their mothers. Although girls tended to have better affective empathy than boys on the performance-based task, no difference was noted in the mothers' perceptions of their children's empathy. Empathy dimensions varied depending on the age of the children. The hierarchical cluster analyses of the cases identified differentiated subgroups of children, according to their empathic skills in the three dimensions. The second study, which was longitudinal, used the same measures and investigated the developmental trajectory of empathy in 69 preschoolers over one year. The results showed that each empathic dimension predicted itself one year later, but did not predict the two others. The implications for potential interventions are emphasized in this study. [ABSTRACT FROM AUTHOR]

Physiculus cynodon is a member of the Moridae family and possesses a ventral bioluminescent organ. Although it has been captured by commercial vessels for decades, our understanding of its biology and ecology remains fragmented. This paper provides data on the species' spatial and vertical distributions; age and growth; size, age, sex compositions; and sex ratio in the waters around the Emperor Seamounts and the northwestern Hawaiian Ridge. This information is based on the analysis of multi-year Russian data obtained from scientific surveys and observations on commercial fishing vessels. The northernmost capture of this species has been recorded at Nintoku Seamount. Additionally, this species was regularly encountered at depths ranging from 53 to 900 m on seamounts such as Lira (Annei), Koko, Milwaukee (Yuryaku and Kammu), Colahan, and C-H of the Emperor Seamounts and Hancock, Zapadnaya, and Academician Berg of the northwestern Hawaiian Ridge. Catch rates of P. cynodon gradually decreased in a southeastern direction. Notably, the relative abundance of this species in bottom trawl catches significantly surpasses that in pelagic catches. The age of the fish in the catch varied from 9 to 37 years, and its growth is described by the VBGF equation with the following coefficients: L∞ = 858.6, k = 0.030, t0 = 3.5. While the growth patterns for males and females were similar, it is worth mentioning that males rarely survive beyond the age of 25 years. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, focused protection strategies including selective lockdowns of the elderly were proposed as alternatives to general lockdowns. These selective restrictions would consist of isolating only those most at risk of COVID-19 hospitalization and subsequent use of healthcare resources. The proposal seems to have troubling implications, including the permissibility of selective lockdown on the basis of characteristics such as ethnicity, sex, disability, or BMI. Like age, these factors also correlated with an increased risk of hospitalization from COVID-19. In this paper, we argue that age has meaningful differences as a morally relevant characteristic in the justification for selective restrictions of liberty. Thus, it might justify selective freedom restrictions in a way in which other factors might not. We offer four moral domains that separate age from other proxies: empiricism, operationality, discrimination, and disparity. [ABSTRACT FROM AUTHOR]

Groundwater age or residence time is important for identifying flow and contaminant pathways through groundwater systems. Typically, groundwater age and age distributions are inferred via lumped parameter models based on measured age tracer concentrations. However, due to cost and time constraints, age tracers are usually only sampled at a small percentage of the wells in a catchment. This paper describes and compares two methods to increase the number of groundwater age data points and assist with validating age distributions inferred from lumped parameter models. Two machine learning techniques with different strengths were applied to develop two independent metamodels that each aim to establish relationships between the hydrochemical parameters and the modelled groundwater age distributions in one test catchment. Ensemble medians from the best model realisations per age distribution percentile were used for comparison with the results from traditional lumped parameter models based on age tracers. Results show that both metamodelling techniques predict age distributions from hydrochemistry with good correspondence to traditional lumped parameter model (LPM)-derived age distributions. Therefore, these techniques can be used to assist with the interpretation of lumped parameter models where age tracers have been sampled, and they can also be applied to predict groundwater age distributions for wells in a similar hydrogeological regime that have hydrochemistry data available but no age tracer data. [ABSTRACT FROM AUTHOR]

Purpose: COVID-19 has devastated the United States (U.S.). One of the more notably impacted areas is the South. Compared to the rest of the U.S., the South is characterized by increased rurality, lowered access to healthcare, older populations, and higher religiosity, all of which might predispose its residents to more detrimental effects of COVID-19, including COVID-related fatalities. As such, this paper provides important considerations for individuals engaging in work with Southern, rural Americans dealing with COVID-related grief and loss. Methods: A review of the literature addressing the impact of Southern legislature, rurality, cross-country factors, and faith on COVID-related grief among Southerners was conducted, with applicable considerations expressed. Conclusions: Care should be taken by providers working with rural, Southern residents to attend to tangible and intangible losses experienced as a result of COVID-19. These considerations can help inform work with rural Southerners dealing with grief during the pandemic. [ABSTRACT FROM AUTHOR]

Aim. The objective was to investigate the impact of structural empowerment and demographic factors on the psychological empowerment of nurses. Background. The empowerment of nurses plays a crucial role in improving patient care and achieving successful healthcare outcomes. When nurses feel empowered in their work environment, they tend to remain dedicated to their jobs and experience higher levels of job satisfaction and engagement. Methods. This cross-sectional study utilized a convenience sample of 287 nurses recruited from various hospital units, resulting in a response rate of 94.7%. Data were collected through a paper survey consisting of three sections: structural empowerment, psychological empowerment, and demographics. Results. The first hierarchical regression explains 57.0% variance in nurses' psychological empowerment (F = 78.52, p < 0.001). Age (β = 0.37, p < 0.01) and structural empowerment (β = 0.69, p < 0.001) have a positive influence on nurses' psychological empowerment. Conversely, having a bachelor's degree (β = −0.16, p < 0.01) had a negative impact psychological empowerment. The second hierarchical regression clarifies the specific aspects of structural empowerment that influences positively on nurses' psychological empowerment: access to opportunities (β = 0.13, p < 0.01), support (β = 0.13, p < 0.01), resources (β = 0.35, p < 0.001), and informal power (β = 0.12, p < 0.01). Conclusion. This study emphasizes the importance of considering demographic variables, such as age and education, in conjunction with structural empowerment to effectively enhance nurses' psychological empowerment. Implications for Nursing Management. Nursing managers should tailor their empowerment strategies based on the demographic characteristics of their nurses. It is essential to focus on providing nurses with access to opportunities, support, resources, and informal power. These insights provide valuable guidance for nursing managers to enhance nurses' psychological well-being, job satisfaction, and overall quality of life. Ultimately, this contributes to positive outcomes for patients, nursing staff, and healthcare organizations. [ABSTRACT FROM AUTHOR]

(1) Background: The paper focuses on the relationship between financial knowledge (FK) and holding private health insurance (PHI), and also focuses on the effect of age on the aforementioned relationship. (2) Method: The study was carried out on a sample of 8055 individuals taken from the 2016 Financial Competences Survey (the only one available), prepared by the Bank of Spain. Unlike previous studies that limited themselves to considering numeracy as a proxy for FK, in this study, two levels of FK—basic and advanced—are considered. (3) Results: The results indicate that a higher level of FK, specifically advanced FK, increases the probability of an individual holding PHI. Regarding age, it has been observed that the relationship between FK and PHI is only relevant in middle and older age, but not in younger and adults. Therefore, it is appropriate to differentiate between basic and advanced FK, and we confirm that age exerts a moderating effect on the influence of FK on PHI. (4) Conclusion: We conclude that FK—specifically, advanced FK for middle-aged and older people—is relevant to the likelihood of an individual holding PHI, which can improve health and financial wellbeing. [ABSTRACT FROM AUTHOR]

Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0–59 months old in 94 low‐ and middle‐income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age—presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months—presumably mostly due to further adverse exposures being less detrimental for older children, and catch‐up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch‐up growth may be achieved after age 2, screening around this time can be beneficial. Key message: Stunting prevalence was higher for older children until around age 28 months.The age with the highest stunting prevalence was fairly consistent across UNICEF regions.However, the stunting prevalence and gradient of the rise and fall in stunting prevalence across age varied between countries, living standards and sex.Programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence.Some catch‐up growth may be achieved after age 2, so screening around this time can be beneficial. [ABSTRACT FROM AUTHOR]

Growing healthcare costs have been accompanied by increased policymakers' interest in the efficiency of healthcare systems. Network formation by hospitals as a vehicle for consolidation and achieving economies of scale has emerged as an important topic of conversation among academics and practitioners. Within networks, consolidation of particular specialties or entire campuses is expected and encouraged to take place. This paper describes the main findings of an effort to build gravity-type models to describe patient choices in inpatient and daycare hospital facilities. It analyzes the distance decay effects as a function of car travel times and great-circle distance, and it offers a method for inclusion of university hospitals. Additionally, it reviews the impact of driving and transit accessibility on hospital attraction and reviews the differences in distance decay for patient age groups and hospitalization types. In the described application, the best models achieve a Mean Absolute Percentage Error of around 10% in non-metropolitan areas, and 14.5% across different region types. Results in metropolitan areas suggest that latent factors unrelated to proximity and size have a significant role in determining hospital choices. Furthermore, the effects of relative driving and transit accessibility are found to be small or non-existent. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Depression is a leading cause of disability worldwide that negatively impacts quality of life. Talk therapy such as cognitive behavioural therapy is an effective treatment for depression. The Internet is an important tool for mental healthcare delivery. Internet‐delivered or online talk therapy interventions are associated with lower costs and improved accessibility.Current reviews do not address the effectiveness of Internet‐delivered cognitive behavioural therapy (iCBT) on quality of life (QoL). What the paper adds to existing knowledge: Interventions for iCBT have better QoL improvements for individuals with greater depressive symptom severity, females, young adults and individuals with complex comorbid disorders. Support from a healthcare provider for iCBT interventions have better outcomes than self‐guided therapy interventions. Tailoring the iCBT intervention to the specialized needs of the population is beneficial. What are the implications for practice: There is potential to address treatment gaps for managing the care of individuals with depression. Utilizing iCBT promotes the integration of accessible mental healthcare in clinical settings.Healthcare providers can have a more comprehensive approach to delivering iCBT by considering adaptations relevant to the clinical population being treated. Introduction: Major depressive disorder (MDD) is a leading cause of disability resulting from social, psychological and biological factors affecting quality of life (QoL). Cognitive behavioural therapy (CBT) is an effective psychotherapy for MDD. Internet‐delivered CBT (iCBT) is associated with lower costs and improved accessibility. Aim: We aimed to examine the effectiveness of iCBT on QoL in adults with depression. Method: PubMed, Embase and PsycINFO were searched between 2010 and 2022. Inclusion criteria were experimental designs, adults ≥18 years old, depression diagnosis or valid self‐report measure, iCBT intervention; and QoL outcome. Exclusion criteria were studies without depression analysis and intellectual disabilities or psychosis. Results: Seventeen articles were included, with a negative correlation between depression severity and QoL. Sex, age and physical comorbidity positively influenced effectiveness. Depressive severity, dysfunctional attitude and negative thinking were predictors and moderators of QoL. Clinician support can impact social interactions and sense of belonging. Discussion: Internet‐delivered cognitive behavioural therapy is effective for improving QoL in adults with MDD. Severe depression, females, younger age and comorbid disorders were associated with greater QoL improvements. Implications for Practice: The findings suggest iCBT could address depression treatment gaps related to improving QoL. Utilizing iCBT potentially improves the care continuum for individuals with complex disorders. [ABSTRACT FROM AUTHOR]

In Nigeria, adolescents in urban slums are increasingly at risk of adverse sexual and reproductive health (SRH) outcomes. However, little is known about how individual factors predict parent-adolescent communication on SRH issues in a resource-poor urban setting in Ibadan. Thus, this study investigated individual factors associated with parent-adolescent communication on SRH issues in urban slums of Ibadan, southwest, Nigeria. This study is part of a larger project that explores the socio-ecological factors influencing parent-adolescent communication on SRH issues in selected slums in Ibadan, Nigeria. Within this broader framework, this paper relies on the quantitative data obtained in 10 selected slums. Interviewer-administered structured questionnaire [scripted on open data kits (ODK)] was utilized to collect data from a sample of 796 parent-adolescent dyads. Six SRH topics were investigated to describe the issues discussed. Analytical techniques utilized include; frequency counts, chi-square, and multinomial logistic regression. Parent-adolescent communication regarding SRH issues is not uncommon in urban slums of Ibadan but characterized by indirect communication, threat and warning. Parents and adolescents' age, gender, marital/relationship status, educational attainments and religion played influential role in parent-adolescent communication regarding SRH issues. These factors were identified to be significantly associated with the pattern of parent-adolescent discussion of SRH issues. Age-specific SRH education should be available to adolescents and parents need to be educated on appropriate SRH information and the best way to engage their adolescents on SRH issues. [ABSTRACT FROM AUTHOR]

Objective: This paper tests the hypothesis that increases in recorded dependency levels of permanent residential aged care clients are associated with reduced length of stay and higher turnover. A secondary objective is to compare the Aged Care Funding Instrument with its predecessor, the Resident Classification Scale, on a common schema. Methods: Administrative data for all Commonwealth-subsidised residential aged care services in Australia from 2008–09 to 2018–19 were obtained from the National Aged Care Data Clearinghouse. More than 750 000 episodes of permanent residential aged care were analysed. The categories from the two rating systems were mapped to a six-level schema, primarily based on the dollar value of the categories at the time of transition. Results: There was a strong trend towards higher dependency ratings across admissions, residents, and separations. However, contrary to expectation, measures of system activity showed a slowing of the system: length of stay increased and turnover decreased. Conclusions: The mapping of dependency rating schemes to a common rating enables the analysis of long-term trends in residential care dynamics. There is no evidence that the marked increases in reported dependency ratings led to accelerated system activity, consistent with an earlier study. This analysis forms a solid base for ongoing analysis of care appraisals in the context of a possible new rating scheme. It highlights the interplay between policy changes and provider behaviour, and the need for robust data to monitor care appraisals and system dynamics. What is known about the topic?: Residential aged care subsidies are determined by care needs in relation to assessed dependency levels, using the Aged Care Funding Instrument since 2008, and before that, the Resident Classification Scale. Between 2008–09 and 2018–19, there was considerable growth in residents classified at more dependent levels, and this would be expected to result in greater turnover in the system. What does this paper add?: This paper maps the rating schemes to a simplified, common rating that enables the analysis of long-term trends in residential care dynamics. It shows that the system is slowing, contrary to the trends expected if residents were more frail as the reported ratings imply. The paper examines possible explanations of these trends, and addresses policy implications. What are the implications for practitioners?: In the context of a potential new client-dependency classification, this study shows the importance of robust measures of the dynamics of the system—and the underlying data— vis - à - vis the means by which client dependency is assessed. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the prevalence of non-fatal overdose among people who use illicit opioids (PWUIOs) and determine the demographic and behavioral characteristics associated with non-fatal overdose among this population. Studies in English published before February 1, 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUIOs. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PICOs criteria. After a detailed assessment of over 13,845 papers, a total of 67 studies met the eligibility criteria. The findings showed a past-year pooled prevalence rate of non-fatal overdose among PWUIOs of 26% (95% CI, 23% −29%). Greater odds of non-fatal overdose among PWUIOs was associated with (i) being younger, (ii) being female, (iii) being homeless, (iv) individuals who received money, goods, or drugs in exchange for sex, (v) individuals who had witnessed somebody else have an overdose, (vi) individuals who had used public spaces as primary injection locations, (vii) individuals who reported polydrug use, (vii) use of non-injection methamphetamine, and (viii) high injecting frequency (more than two daily drug injections). Harm-reduction programs should consider the provision of education concerning overdose-related risk factors to the vulnerable and hard-to-reach PWUIOs. [ABSTRACT FROM AUTHOR]

Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor. In this paper, we analyse whether such an intervention could be cost-effective or even cost-saving for the respective health systems. We calculate the net value of the lifelong costs of cataract with and without surgery. This calculation includes direct costs (e.g., treatment, glasses, surgery) as well as indirect cost of the caregiver and the patient. We total all costs from the year of onset of cataract until death and discount the respective values to the year of onset. We define the surgery as cost-saving if the net-value of costs with surgery is lower than without surgery. If the cost per quality adjusted life year is lower than one gross national product per capita, we define the intervention as highly cost-effective. We find that the cost-effectiveness of cataract surgery depends on the age of onset of the disease and the age of surgery. If the surgery is performed with the beginning of severe impairment, even surgery of a 78-year-old patient is still cost-saving. Almost all possible constellations are highly cost-effective, only for the very old it is questionable whether the surgery should be performed. The simulations show that cataract surgery is one of the most cost-effective interventions. However, millions of people in low-income countries still have no chance to prevent or cure blindness due to limited resources. The findings of this paper clearly call for a stronger effort to reach poor and rural populations with this cost-effective service. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint).It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. What the paper adds to existing knowledge?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research.By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. What are the implications for practice?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice.There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments.Training programmes that focus on attitudinal change need to be more rigorously evaluated. Introduction: Attitudes are considered integral to mental health nursing practice. Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. [ABSTRACT FROM AUTHOR]

In clinical practice, many drug therapies are associated with prolongation of the QT interval. In literature, estimation of the risk of prescribing drug-induced QT prolongation is mainly executed by means of logistic regression; only one paper reported the use of machine learning techniques. In this paper, we compare the performance of both techniques on the same dataset. High risk for QT prolongation was defined as having a corrected QT interval (QTc) ≥ 450 ms or ≥ 470 ms for respectively male and female patients. Both conventional statistical methods (CSM) and machine learning techniques (MLT) were used. All algorithms were validated internally and with a hold-out dataset of respectively 512 and 102 drug-drug interactions with possible drug-induced QTc prolongation. MLT outperformed the best CSM in both internal and hold-out validation. Random forest and Adaboost classification performed best in the hold-out set with an equal harmonic mean of sensitivity and specificity (HMSS) of 81.2% and an equal accuracy of 82.4% in a hold-out dataset. Sensitivity and specificity were both high (respectively 75.6% and 87.7%). The most important features were baseline QTc value, C-reactive protein level, heart rate at baseline, age, calcium level, renal function, serum potassium level and the atrial fibrillation status. All CSM performed similarly with HMSS varying between 60.3% and 66.3%. The overall performance of logistic regression was 62.0%. MLT (bagging and boosting) outperform CSM in predicting drug-induced QTc prolongation. Additionally, 19.2% was gained in terms of performance by random forest and Adaboost classification compared to logistic regression (the most used technique in literature in estimating the risk for QTc prolongation). Future research should focus on testing the classification on fully external data, further exploring potential of other (new) machine and deep learning models and on generating data pipelines to automatically feed the data to the classifier used. [ABSTRACT FROM AUTHOR]

Water age is the time taken for water to travel through a distribution system and reach the consumer. Generally, there is a trade-off between water pressure and water age in a water distribution system—higher pressure results in higher flow velocity, which often means shorter traveling time for the water, while lower pressure leads to slower flow and thus higher water age. Low pressure is a desired objective in a distribution system, as it reduces the physical stress on its components and minimizes water losses in the event of a leak. Low water age is a desired objective as well, as increased age is regarded as having a low water quality. Therefore, the two objectives compete with one another. The problem of trying to minimize both water pressure and age is a common problem in water distribution systems' design and management. This paper introduces an algorithm for pressure reducing valves' (PRVs) placement for reducing water age in water distribution systems. The algorithm is based on graph-theory elements and uses EPANET 2.2 for simulation and analysis. The method is demonstrated on two small scale examples, and the results present relatively significant improvements in respect to water age. [ABSTRACT FROM AUTHOR]

Solute dynamics depend strongly on hydrologic flow paths and transit times within catchments. In this paper, we use a travel time tracking method to simulate stream salinity (as measured by electrical conductivity) in the Duck River catchment, NW Tasmania, Australia. The study couples storage selection function transit time modelling with two alternate approaches to model electrical conductivity (EC). The first approach assumes the catchment has a cyclic salt balance (i.e., rainfall source, stream flow sink) that is in dynamic equilibrium and evapoconcentration of salt is the only process changing concentration. The second approach assumes that the salinity of water in catchment storages is a function of water age in those stores, without explicitly simulating salt mass balance processes. The paper compares these alternate approaches in terms of EC simulation performance, simulated stream water age distributions, and simulated storage age distributions. A split sample calibration‐validation analysis was conducted using the 2008 and 2009 water years. Both EC simulation approaches reproduced stream EC variations very well under both calibration and validation. The simulations using the age‐related EC simulation approach produced less biased results and, consequently, higher model coefficient of efficiency for validation periods. This approach also produced more consistent model parameter estimates between periods. There were systematic differences in the resultant age distributions between models, particularly for the solute balance‐based simulations where parameters (catchment storage size) changed more between the two calibration periods. The effect of time varying versus static storage selection functions were compared, with clear evidence that time varying storage selection functions with parameters linked to catchment conditions (flow) are essential for adequate simulation of EC dynamics during flow events. [ABSTRACT FROM AUTHOR]

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index‐Service Prioritization Decision Analysis Tool (VI‐SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap‐around supportive housing to address poor health outcomes. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the study design and respondent characteristics (including non-response analyses) of the Danish Health and Wellbeing Surveys in 2015 and 2019 and a follow-up survey that was carried out during the COVID-19 pandemic in 2020. Methods: The Danish Health and Wellbeing Survey is the Danish part of the European Health Interview Survey (EHIS). The samples in 2015 (N =12,000) and 2019 (N =14,000) were both based on a simple random selection of individuals aged ⩾15 years from the Danish Civil Registration System. All individuals from the sample in 2019 who were still alive and living in Denmark were reinvited for a follow-up survey in 2020 (N =13,474). Data in all surveys were collected via self-administered questionnaires (web or paper based). The questionnaires in 2015 and 2019 included the EHIS model questionnaire as well as national questions, whereas the questionnaire in 2020 mainly focused on physical and mental health, employment and working lives, and health behaviour. Results: The overall response proportion declined slightly between 2015 (48.4%) and 2019 (47.4%) but went up to 49.8% in the follow-up survey in 2020. Unit non-response was associated with, for example, male sex, younger age, being unmarried and lower educational level but not with degree of urbanisation. In all, 5000 individuals completed the questionnaire in both 2019 and 2020. Conclusions: The results are in line with most previous research on non-response in health surveys. However, an association between degree of urbanisation and non-response has been suggested in previous studies. This association was not found in our study. [ABSTRACT FROM AUTHOR]

FET is to resuscitate the endometrium and transfer the embryo into the uterus after the endometrium is ready. The quality of transferred embryos is an important factor affecting the outcome of assisted reproductive technology. This paper aims to explore the feasibility of D4 frozen-thaw embryo transfer and analysis of related factors affecting the outcome of freeze-thaw embryo transfer. A retrospective analysis of the clinical data of 2925 patients who received frozen-thaw embryo transfer (FET) in the Department of Reproductive Medicine, General Hospital of Northern Theater Command from January 1, 2017 to July 31, 2019. Including the woman's age, body mass index (BMI), endometrial thickness on the day of transplantation, number of embryos to be transferred, and type of embryos to be transferred. A single factor, multivariate logistic regression and nomogram were used to analyze the influence of different factors on the clinical outcome of FET. Nanomedicines and related nanomedicines are rapidly developing and establishing their importance in embryo transfer. This paper uses nanomaterials to explore the feasibility of D4 frozen-thawed embryo transfer. The woman's age, endometrial thickness on the day of transplantation, BMI, the number of embryos transferred, and the type of embryos transferred all affect the outcome of FET. The pregnancy rate of the D5 and D4 transplantation groups was, respectively, higher than that of the D3 transplantation group, with statistically significant differences. In the FET cycle, the age of the woman, endometrial thickness on the day of transplantation, the number of embryos transferred, and the type of embryos transferred are all independent factors influencing the outcome of FET. D5 blastocyst is the easiest to get pregnant, and that has the best clinical outcome which is better than the D6 blastocyst group; D4 morula and D5 blastocyst FET have little difference in clinical pregnancy outcomes, but both of them are significantly better than D3 cell embryos, so D4 morula can be considered for transplantation in the FET cycle. In conclusion, whether it is a patient who has failed the fresh cycle transplantation or the whole embryo freezing cycle whose transplantation is canceled due to high hormone levels on the transplantation day, FET is required. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to indicate the current situation of the COVID-19 outbreak in India, the world's second-most populous country. India reported its first COVID-19 case in the southern province of Kerala in late January 2020. Since then, the outbreak has spread to other provinces and union territories, with the highest number of cases reported in Maharashtra province as of 24 May 2020. Design/methodology/approach: This paper presents the age- and gender-wise analysis of COVID-19 patients in Maharashtra province and the whole nation. Findings: It shows that 75% of them belong to the age group of 21–60 years and the age above 50 years has a very high fatality rate of 14.52% in Maharashtra. This analysis also shows that 76% of COVID-19 cases are in males in the nation. The data indicates that in the nation, 75.3% of the deaths are in the age group over 60 years and 86% of cases of death had diabetes-related comorbidity, hypertension, chronic kidney problems and heart problems. In India, the case-fatality rate, which estimates the proportion of deaths among identified confirmed cases, is 2.93% as of 24 May, which is significantly less than that many countries. Originality/value: To the best of the author's knowledge, this is the first attempt to indicate the current situation of the COVID-19 outbreak in India based on age and gender. [ABSTRACT FROM AUTHOR]

The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee aims to improve the use of drugs in older adults and develop new therapeutic approaches for the syndromes and diseases of old age through advocacy, education, and research. In the present paper, we propose strategies relevant to drug development and evaluation, spanning preclinical and the full range of clinical studies. Drugs for older adults need to consider not only age, but also other characteristics common in geriatric patients, such as multimorbidity, polypharmacy, falls, cognitive impairment, and frailty. The IUPHAR Geriatric Committee's position statement on 'Measurement of Frailty in Drug Development and Evaluation' is included, highlighting 12 key principles that cover the spectrum of translational research. We propose that where older adults are likely to be major users of a drug, that frailty is measured at baseline and as an outcome. Preclinical models that replicate the age, frailty, duration of exposure, comorbidities, and co‐medications of the proposed patients may improve translation. We highlight the potential application of recent technologies, such as physiologically based pharmacokinetic–pharmacodynamic modeling informed by frailty biology, and Artificial Intelligence, to inform personalized medicine for older patients. Considerations for the rapidly aging populations in low‐ and middle‐income countries related to health‐care and clinical trials are outlined. Involving older adults, their caregivers and health‐care providers in all phases of research should improve drug development, evaluation, and outcomes for older adults internationally. [ABSTRACT FROM AUTHOR]

This paper illuminates how teachers are influenced by age, gender and sexuality in teaching about sex and relationships. In this analysis grounded in feminist theory, age, gender and sexuality are considered to be enacted as doings. Six interviews with teachers working with sexuality education in K-12 schools in Sweden were chosen from of a larger body of material consisting of 21 interviews with professionals engaged in school-based sexuality education. The six interviewees were selected because they explicitly addressed how teachers' age, gender and/or sexuality come to matter in the classroom. Findings show how male and female teachers organise their teaching in relation to normative expectations of age, gender and sexuality. In sexuality education, the diverse life-courses of (hetero)sexual women offer a wide range of pedagogic possibilities for female teachers to address issues of sexuality, consent and relationships whereas male teachers are constrained to doing safe(r) forms of masculinity by directing attention away from their bodies and experiences. In understanding these results, I argue that the figure of the tant has been key in forming the pedagogic backdrop to Swedish sexuality education, hence embedding a normative 'who' in the 'how' to teach sexuality education. [ABSTRACT FROM AUTHOR]