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Introduction/Objectives: Social determinants of health (SDoH) screening and intervention in pediatric primary care depends upon caregiver disclosure of adverse household or social conditions and thus may be influenced by perceived bias or stigma. This paper examines to what extent parents' experience of their child's medical home is associated with their perceptions of a practice-based social needs intervention. Methods: We conducted a cohort study of data reported by 73 parents of children obtaining care in a medical home with an embedded SDoH navigation program. Using survey data collected in October 2021 and October 2022, we calculated descriptive statistics and non-parametric bivariate analyses of the association between engagement with the SDoH navigation program and parent-reported social needs, stress, and perception of care quality as measured by the Person-Centered Primary Care Measure (PCPCM). Results: Initial ratings of care quality were high (mean baseline PCPCM score = 3.63) and remained high on second interview (mean change in PCPCM score = −0.04, 95%CI −0.16, 0.09, P =.58) despite significant reductions in parents' ratings of access to care over time. Parents reported substantial stress, unmet social needs, and unmet healthcare needs, with 41 families (56%) ever using the practice-based SDoH program, including 16 (22%) who were new users in 2022. There was no association observed between PCPCM score and parent stress, unmet social needs, or use of SDoH services. Conclusions: Parents' perceptions of care delivered in their child's medical home appears to be stable on repeat measurement, and independent of family context or interactions with social needs navigation services offered in the practice. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) can involve patterns of physical, sexual and emotional abuse. Women typically experience physical IPV in combination with emotional IPV, while emotional IPV is often experienced in the absence of other types of IPV. There is very little known about women's experiences of these different types of IPV over time. The primary aim of this paper is to describe patterns in women's individual experiences of physical and/or emotional IPV across the first 10 years of motherhood. Data were drawn from a prospective pregnancy cohort of 1507 first-time mothers in Melbourne, Australia. Emotional, physical, and combined physical and emotional IPV were reported in the first, fourth and tenth year of motherhood using the Composite Abuse Scale. The overall prevalence of each type of IPV remained consistent across the three time-points, with emotional IPV alone being the most prevalent. There was substantial variability in women's experiences of IPV over time and there was no common progression from one type of IPV to another. Women were more likely to report IPV at more than one time-point if they experienced combined physical and emotional IPV, while for women who reported emotional or physical IPV alone this was more likely to be at a single time-point. A number of socio-demographic characteristics in early pregnancy were associated with a higher risk of reporting IPV at all three time-points, including being unemployed (RRR = 3.6; 95% CI: 2.1, 6.2) and being aged 18–24 years (RRR = 3.1; 95% CI: 1.8, 5.4). Knowledge of the variability and persistence of IPV in the first 10 years of motherhood, and factors associated with these experiences, can help tailor effective health and social service responses. [ABSTRACT FROM AUTHOR]

This study aims to examine changes in body image (BI) over time and factors related to BI among patients with prostate cancer who receive hormone therapy (HT). A cross-sectional design and longitudinal design were utilized. Patients with prostate cancer who received HT were recruited from the urology outpatient departments in two hospitals in Taiwan between August 2017 and December 2020. Cross-sectional data were collected from 177 patients who had started HT for prostate cancer. Longitudinal data were collected from 34 newly diagnosed patients before receiving HT and at 1, 3, 6, and 12 months after HT. The variables measured included hormonal symptoms and distress, self-efficacy, and BI. The results showed that BI dissatisfaction ranged from 6.1% to 17.2%. Hormonal symptoms and distress (e.g. lack of vitality) were correlated with BI dissatisfaction. Education on the side effects of HT and coping strategies can be provided to patients to prevent BI dissatisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Holistic rehabilitation approaches addressing the numerous complex challenges in young persons with acquired brain injury are required. The purpose of this study was to describe and evaluate the holistic person-centered youth mentoring intervention program, which is based on occupational therapy. Methods: Prospectively collected data were extracted from a national clinical quality database (n = 59). Proportions of young persons receiving different aspects of support and proportions rating the intervention as meaningful were calculated. One-year changes in occupation, work ability, and social interactions were calculated. Results: The young persons most frequently received support for energy management (75%) and structuring of everyday life (61%). Seventy-three percent rated the intervention as meaningful. One year post-inclusion, occupation and work ability had increased by 35% and 58%, respectively, and it had declined by 10% and 26%, respectively. The 1-year increase and decrease in social interactions were less clear (15% and 25%, respectively). One-year changes did not differ between those who entered the program early or late after injury indicating the potential beneficial effect of the program. Conclusion: The findings could indicate that the program has a unique value in supporting young persons with acquired brain injury to create a meaningful everyday life through occupation, work ability, and social interaction. [ABSTRACT FROM AUTHOR]

The present study aimed to test if perceived pubertal timing was related to marijuana and alcohol use through deviant peer affiliation. Additionally, we examined if the deviant peer pathway was moderated by impulsiveness, gender, or both. Data were collected from 342 youth, most of whom had a family history of substance use disorder. Youth completed assessments every six months from age 13 to 16. For girls only, longitudinal analyses revealed that perceived pubertal timing was indirectly related to substance use through higher levels of deviant peer affiliation. This pathway was moderated by impulsiveness such that the association between perceived pubertal timing and deviant peer affiliation was only present for girls with average to high levels of impulsiveness. These findings elucidate a developmental pathway from perceived pubertal timing to substance use through deviant peer affiliation for high-risk girls, although low levels of impulsiveness were protective. [ABSTRACT FROM AUTHOR]

Background: To assess the risk of depression in patients with chronic rhinosinusitis (CRS) in a tertiary care center and the effect of treatment on depression scores. Methods: This prospective cohort study was conducted at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, between November 2021 and June 2022 and included adult patients (≥14 years) with CRS. The validated Arabic or English Sinonasal Outcome Test (SNOT-22) and Patient Health Questionnaire-9 (PHQ-9) were used before treatment and 3 to 6 months after surgery and maximal medical treatment. PHQ-9 scores were compared at baseline and follow-up visits. The relationship between changes in SNOT-22 and PHQ-9 scores were assessed using Spearman's correlation and simple linear regression. Results: Overall, 38 participants with a mean ± SD age of 32.7 ± 12 years were enrolled. CRS with nasal polyps (55.26%) was the most frequently seen condition, followed by allergic fungal CRS (31.58%) and CRS without nasal polyps (13.16%). Six patients (15.7%) had PHQ-9 scores ≥10, indicating they had major depressive disorder. PHQ-9 and SNOT-22 scores improved significantly after treatment (3.7 ± 5.8 vs 6.5 ± 6.9 pretreatment, P =.001; 20.7 ± 20.5 vs 45.6 ± 28.9 pretreatment, P <.0001, respectively). Mean ± SD change in PHQ-9 and SNOT-22 scores was −2.7 ± 7 and −24.9 ± 29.8, respectively. SNOT-22 and PHQ-9 scores were positively correlated (r =.522, P <.001). PHQ-9 score change was significantly associated with SNOT-22 score change (β =.178, 95% confidence interval 0.12-0.23, P <.0001). Conclusion: CRS affects the quality of life and psychological well-being of patients. Patient-centered care with maximal medical and surgical treatment help overcome its deleterious consequences. [ABSTRACT FROM AUTHOR]

Introduction: Chronic non-cancer pain (CNCP) is a lifelong condition with radical consequences, calling for management involving patients' families. Interventions based on the family systems nursing framework by Wright and Leahey have proved beneficial in other populations but require investigation in a CNCP population. This trial assumed that family nursing conversations (FNCs) based on the family systems nursing framework would increase patients' and family members' self-efficacy concerning CNCP management. Objective: To investigate whether an intervention with FNCs as an add-on to the usual multidisciplinary treatment of CNCP would have an effect on patients' and family members' self-efficacy. Additionally, to investigate any impact on family function, health-related quality of life, anxiety, and depression. Methods: The trial applied a prospective non-blinded quasi-experimental design with two comparable groups of patients and family members: a historical control group (HCG) and an intervention group (IG). The intervention was executed by nurses employed at a multidisciplinary pain center in the Capital Region of Denmark. HCG data were collected before the nurses' intervention training. The primary outcome was self-efficacy. Secondary outcomes were family function, health-related quality of life, anxiety, and depression. Results: In total, 58 patients and 85 family members were included. The primary outcome, self-efficacy, detected no statistically significant between-group differences in mean change for patients, p =.990, or family members, p =.765. A statistically significant effect in favor of the IG was found in between-group differences in mean change in patients' behavioral family function, p =.034, and anxiety, p =.031. No statistically significant between-group differences were detected in family members' secondary outcomes. Conclusion: The intervention had no effect on patients' or family members' self-efficacy but a positive effect on patients' behavioral family function and anxiety. The intervention was deeply affected by the COVID-19 pandemic. Hence, any results should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Background: Despite advancements in surgical technique, failure of tendon healing remains a common problem after arthroscopic rotator cuff repair (ARCR). Purpose/Hypothesis: The purpose of this study was to examine the relationship between range of motion (ROM) recovery and healing after ARCR. It was hypothesized that an early loss of ROM would be associated with tendon healing. Study design: Case-control study; Level of evidence, 3. Methods: This was a retrospective comparative study of primary ARCR of isolated full-thickness supraspinatus (SSN) tendon tears. Cases were retrieved from a prospective rotator cuff repair database and divided into 2 groups based on healing (healed/nonhealed). A standardized clinical evaluation was performed before and at 6 weeks, 3 months, and 6 months after surgery. Collected data included passive and active ROM, visual analog scale for pain, and Constant score. Healing was assessed by ultrasound at 6 months. Results: Of 1397 eligible ARCRs, 1207 were included. The healing rate was 86.7%. Age was higher in the nonhealed group (57.8 ± 7.9 years vs 61.6 ± 8.8 years; P <.001). Patients with healed repairs had a larger decrease in passive anterior elevation (AE) from the preoperative to the 6-week postoperative visit (–31°± 28° vs −18°± 26°; P <.001), followed by a more substantial increase throughout the remaining follow-up period (32°± 23° vs 18°± 21°; P <.001). At 6 months postoperatively, there was no difference in AE between groups (159°± 17° vs 161°± 14°; P >.999). External rotation elbow at side (ER1) and internal rotation hand in the back (IR1) followed similar courses of recovery. Passive and active ROM had a strong positive correlation at each follow-up. Age (odds ratio [OR], 1.79; 95% CI, 1.45-2.23; P <.001) and 6-week passive AE (OR, 1.33; 95% CI, 1.20-1.48; P <.001) and ER1 (OR, 1.15; 95% CI, 1.03-1.29; P =.017) were predictors for nonhealing. Conclusion: Lower passive AE and ER1 at 6 weeks postoperatively and younger age are associated with healing after ARCR of isolated SSN tendon tears. At 6 months postoperatively, there were no differences in ROM, regardless of tendon healing. [ABSTRACT FROM AUTHOR]

Objective: To evaluate therapeutic footwear expectations and usability of individuals with diabetes and foot complications. Design: A prospective multicenter study was conducted on participants with a high risk of developing a diabetic foot ulcer. Setting: Participants were enrolled in 11 different specialized diabetic foot units in Spain between March 2022 and June 2023. Subjects: Patients with diabetes at moderate to high risk of foot ulceration receiving first therapeutic footwear prescription. Interventions: All the patients included in the research were prescribed with their first pair of therapeutic footwear. Main measures: Primary outcome measures were MOS-pre and MOS-post questionnaires evaluating use and usability of prescribed therapeutic footwear. Secondary outcome measures aimed to evaluate footwear clinical efficacy as ulceration rate and self-reported perceived walking distance per day. Results: The use of therapeutic footwear exceeded the patient's pre-provision prediction of their anticipated use in 94% of people (n = 126). Based on the visual analogic satisfaction scale, the median satisfaction of daily wearing their therapeutic footwear was 7 points, Interquartile Range (IQR) [5–8.25]. During the follow-up period, 39 participants (29.1%) experienced diabetic foot ulcer. Perceived walking distance participants reported an improvement in their perceived walking ability during various daily life activities. Conclusions: Diabetes patients at moderate to high risk of diabetic foot ulcer improved their perception of walking ability after therapeutic footwear prescription. Adherence to the therapeutic footwear prescription resulted in less ulcerations. [ABSTRACT FROM AUTHOR]

Drawing on data from a prospective pregnancy cohort (N = 1,507), this study examines the relationship between exposure to physical and emotional intimate partner violence (IPV) across the first 10 years of motherhood and women's mental and physical health. A measure of IPV (Composite Abuse Scale) was included at 1, 4, and 10 years postpartum. Past year and prior experiences of IPV were associated with mental and physical health issues at 10 years, both for mothers who had experienced combined IPV and emotional IPV alone. Awareness of the health issues associated with different types of IPV can assist in tailoring responses for women who experience IPV. [ABSTRACT FROM AUTHOR]

Background: The Aggressive Student Culture Scale (ASCS) is a survey designed to measure the extent to which New Zealand (NZ) students experience aggressive behaviours within the school environment. The aim of this study is to assess the psychometric properties of the ASCS in the multidisciplinary Growing Up in NZ longitudinal study. Methods: We used data from 4938 children from the Growing Up in NZ study to examine the psychometric properties of ASCS for 8-year-old children. Confirmatory factor analysis was conducted, and measurement invariance was tested across sex, ethnicity, and deprivation levels. Results: The ASCS tool comprises a single latent factor: aggressive student behaviour. The ASCS provides an adequate and satisfactory measure for student aggression experiences. Full measurement invariance was supported for child's sex, but only configural invariance was confirmed across ethnicity and area-level deprivation. Males reported higher levels of aggressive experiences than females. Conclusions: The one-factor model structure offers an excellent fit to our data with good internal consistency. Comparisons across sex are valid; however, direct comparisons across ethnicity and deprivation levels should be approached with caution. We recommend replication studies and encourage further research involving participants from different age groups to better understand the factor structure across diverse demographic variables. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors—including age, sex, and tear severity—have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial. Purpose: To investigate the influence of tear etiology (degenerative vs traumatic) on functional and structural outcomes in patients with supraspinatus tendon tears. Study Design: Cohort study; Level of evidence, 2. Methods: Patients undergoing ARCR from 19 centers were prospectively enrolled between June 2020 and November 2021. Full-thickness, nonmassive tears involving the supraspinatus tendon were included. Tears were classified as degenerative (chronic shoulder pain, no history of trauma) or traumatic (acute, traumatic onset, no previous shoulder pain). Range of motion, strength, the Subjective Shoulder Value, the Oxford Shoulder Score (OSS), and the Constant-Murley Score (CMS) were assessed before (baseline) and 6 and 12 months after ARCR. The Subjective Shoulder Value and the OSS were also determined at the 24-month follow-up. Repair integrity after 12 months was documented, as well as additional surgeries up to the 24-month follow-up. Tear groups were compared using mixed models adjusted for potential confounding effects. Results: From a cohort of 973 consecutive patients, 421 patients (degenerative tear, n = 230; traumatic tear, n = 191) met the inclusion criteria. The traumatic tear group had lower mean baseline OSS and CMS scores but significantly greater score changes 12 months after ARCR (OSS, 18 [SD, 8]; CMS, 34 [SD,18] vs degenerative: OSS, 15 [SD, 8]; CMS, 22 [SD, 15]) (P <.001) and significantly higher 12-month overall scores (OSS, 44 [SD, 5]; CMS, 79 [SD, 9] vs degenerative: OSS, 42 [SD, 7]; CMS, 76 [SD, 12]) (P ≤.006). At the 24-month follow-up, neither the OSS (degenerative, 44 [SD, 6]; traumatic, 45 [SD, 6]; P =.346) nor the rates of repair failure (degenerative, 14 [6.1%]; traumatic 12 [6.3%]; P =.934) and additional surgeries (7 [3%]; 7 [3.7%]; P =.723) differed between groups. Conclusion: Patients with degenerative and traumatic full-thickness supraspinatus tendon tears who had ARCR show satisfactory short-term functional results. Although patients with traumatic tears have lower baseline functional scores, they rehabilitate over time and show comparable clinical results 1 year after ARCR. Similarly, degenerative and traumatic rotator cuff tears show comparable structural outcomes, which suggests that degenerated tendons retain healing potential. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the physical and functional outcomes of the 'Ending Pyjama Paralysis' intervention in an inpatient geriatric rehabilitation unit. Design: Quasi-experimental mixed-methods design nested within the 'REStORing health of acutely unwell adulTs' (RESORT) prospective, observational, longitudinal cohort of geriatric rehabilitation inpatients study. Setting: Geriatric rehabilitation wards in a major metropolitan public hospital between June 2019 and March 2020. Intervention: The 'Ending Pyjama Paralysis' movement originated in the UK. Its aim was to encourage patients to 'Get up, Get dressed and Get moving' to reduce hospital-associated functional decline. However, the physical and functional benefits of this campaign have not yet been evaluated. The 'Ending Pyjama Paralysis' was adopted as an integrated intervention on two out of four geriatric rehabilitation wards. The two control wards received usual care. Main Measures: Physical measures included the Short Physical Performance Battery, and functional measures included the Katz Index of Independence in Activities of Daily Living and Lawton and Brody's Instrumental Activities of Daily Living, which were completed on admission and discharge. A linear mixed-effects model was used to analyse the results. Results: A total of 833 admissions were included in this study. Of these, 512 patients were in the control group, and 321 were in the intervention group. There were no significant differences in both physical and functional measures between the intervention and control groups. Conclusion: The 'Ending Pyjama Paralysis' campaign did not result in enhanced functional or physical benefits in geriatric rehabilitation inpatients in this setting when applied in addition to usual care. [ABSTRACT FROM AUTHOR]

Despite the abundance of literature, longitudinal studies evaluating the factors associated with domestic violence (DV) at different stages and over longer periods of women's lives are rare. We evaluated factors associated with physical and sexual DV during pregnancy, at 10-year, and 18-year follow-ups after pregnancy and within a 19-year period of life using a cohort of women (n = 1,126) who participated in the Maternal and Infant Nutrition Interventions, Matlab trial in rural Bangladesh. Data on women's experience of DV, social and economic characteristics, empowerment, and family condition were recorded in a similar manner during pregnancy and at 10- and 18-year follow-ups, using standard questionnaires. Multivariate logistic regression models and generalized estimating equations were used to evaluate factors associated with women's experience of physical and sexual violence at each discrete time point and over a period of 19 years, respectively. During pregnancy, women were more likely to experience violence if they were members of microcredit programs/non-governmental organizations (NGOs), living in an extended family and had lower wealth status. At the 10- and 18-year follow-ups, higher levels of decision-making and higher wealth status were protective against the experience of violence. At the 18-year follow-up, women with larger age differences from their husbands were less likely to experience violence, while membership in microcredit programs/NGOs was associated with higher odds of experiencing violence among women. Within a period of 19 years, a higher level of education, living in an extended family, higher decision-making level and higher wealth index were protective against the experience of violence, while membership in microcredit programs/NGOs was a risk factor. In conclusion, this study showed that correlates of violence might change at different time points in women's life. Thus, policies and programs should consider the stage of women's lives while planning interventions for addressing violence against women. [ABSTRACT FROM AUTHOR]

Peripheral arterial disease (PAD) is associated with cerebral and coronary artery disease. Symptomatic PAD affects about 5% of people over 55 years; many more have asymptomatic PAD. Early detection enables modification of arterial disease risk factors. Diagnostically, assessment of symptoms or signs can be unreliable; ankle brachial pressure index (ABPI) testing is time-consuming and few healthcare professionals are properly trained. This study assessed the diagnostic accuracy of multi-site photoplethysmography (MPPG), an alternative non-invasive test for PAD, in primary care. PAD patients identified from general practice registers were age- and sex-matched with controls. Participants were assessed using MPPG, ABPI and duplex ultrasound (DUS). Outcome measures were sensitivity and specificity of MPPG and ABPI (relative to DUS) and concordance. MPPG test results were available in 249 of 298 eligible participants from 16 practices between May 2015 and November 2016. DUS detected PAD in 101/249 (40.6%). MPPG sensitivity was 79.8% (95% confidence interval [CI] 69.9–87.6%), with specificity 71.9% (95% CI 63.7–79.2%). ABPI sensitivity was 80.2% (95% CI 70.8–87.6%), with specificity 88.6% (95% CI 82–93.5%). With comparable sensitivity to ABPI, MPPG is quick, automated and simpler to do than ABPI; it offers the potential for rapid and accessible PAD assessments in primary care. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a significant global public health problem that results in high social and economic costs to individuals and communities. Compared to women in the general population, women engaged in sex work (WESW) are more likely to experience physical, emotional, and sexual IPV. This study examines the correlates of IPV among young WESW with their intimate partners in Southern Uganda. We used baseline data from the Kyaterekera project, a 5 year NIH-funded longitudinal study aimed at reducing HIV risks among 542 WESW in Southern Uganda. To examine the factors associated with IPV, we fitted three separate multi-level Poisson regression models for physical, emotional, and sexual IPV, respectively. Average age was 31.4 years, and 54% of the women reported being victims of at least one form of IPV from their intimate partners. Model one assessed correlates of sexual IPV. Being married women (β =.71, 95% CI [0.24, 1.17]), divorced/separated/widowed (β =.52, [0.02, 1.02]), depressed (β =.04, [0.02, 0.05]), and having any sexually transmitted infections (STIs) (β =.58, [0.14, 1.01]) were associated with sexual IPV. Model two assessed correlates of physical IPV. Experience of childhood sexual abuse (β =.12, [0.04, 0.19]) was associated with an increase in physical IPV, and increasing age reduced its occurrence (β = −.02, [−0.04, −0.001]). Finally, model three assessed emotional IPV. Women with higher education (β =.49, [0.14, 0.85]) and symptoms of depression (β =.02, [0.001, 0.04]) had higher risks for emotional IPV. For WESW, IPV presents an additional potential pathway for HIV and STIs acquisition and transmission through a lack of negotiating power for safe sex. Efforts to reduce violence against WESW should be prioritized as a strategy for enhancing the well-being of WESW. [ABSTRACT FROM AUTHOR]

To explore associations between autism traits and family functioning over time, we studied longitudinal data of a mixed group of 168 clinically referred autistic and non-autistic children. Cross-lagged models showed a significant association between fewer autism traits at the diagnostic assessment and better family functioning 1 year later for the whole group, independently of children's internalizing or externalizing behavior. When splitting the group into autistic children (58%) and non-autistic children (42%) based on an autism diagnosis, this association was only significant in the subgroup of non-autistic children with autism traits. We hypothesized that the needs of families experiencing difficulty understanding and adjusting to their children with autism traits, but no clinical autism diagnosis, might be unmet without the training or support facilities offered to families with autistic children. Although further research is needed to explore this association, clinicians may also consider supporting families of non-autistic children with autism traits to prevent family functioning problems. Because high autism trait levels in non-autistic children may be of a different origin than autism, for example, other neurodevelopmental or mental health problems, family training or support should be tailored to the child's underlying difficulties. Little is known about family functioning over time when raising a child with autism traits, with or without a clinical autism diagnosis. Therefore, we asked caregivers—mostly parents—of a group of 168 children about the family functioning and the child's emotional and behavioral characteristics, as well as autistic traits, twice with about 1 year in between. For numerous reasons, the children were referred to youth mental health care centers, including child and adolescent psychiatric services. Care as usual was offered after the diagnostic assessment if a clinical diagnosis was the assessment outcome. Caregivers reported less problematic family functioning in children with fewer autism traits over time. The child's additional emotional or behavioral characteristics did not seem to influence this relation. Furthermore, we split the whole group into autistic children with a clinical autism diagnosis (58%) and non-autistic children with autism traits but without a clinical diagnosis (42%) to see whether we would find the same results in both groups. Surprisingly, the relation between family functioning and the level of a child's autism traits only held for the subgroup of non-autistic children with autism traits. Thus, raising children with autism traits without a clinical diagnosis may affect family functioning over time. We think that families might have difficulty understanding and adjusting to the autism traits of their children but are lacking the support that is exclusively offered to families of children with a clinical autism diagnosis. We must be cautious because we do not know whether there is a causal relation. Although further research is needed to explore and learn to understand this result, clinicians might consider offering support to families of children with subthreshold autism to prevent problems in family functioning. Because high autism trait levels in non-autistic children may be of a different origin than autism, for example, other neurodevelopmental or mental health problems, family training or support should be tailored to the child's underlying difficulties. [ABSTRACT FROM AUTHOR]

Background: Inferior return to sports (RTS) and functional outcomes have been reported in women after anterior cruciate ligament reconstruction (ACLR). Purpose/Hypothesis: The purpose was to evaluate the results of combined ACLR and anterolateral ligament reconstruction (ALLR) in young women with a high-grade pivot shift (grade ≥2). It was hypothesized that combined ACLR and ALLR would result in better RTS and rotational stability than isolated ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Two groups were retrospectively evaluated and compared. Group I (n = 39; mean age, 31.1 ± 5.7 years) underwent isolated ACLR using hamstring autografts; group C (n = 39; mean age, 30.4 ± 6.1 years) underwent combined ACLR and ALLR. Subjective outcome measures included the International Knee Documentation Committee subjective form, Lysholm, Tegner, and ACL–Return to Sport after Injury (ACL-RSI). Objective tests included a KT-2000 arthrometer stress test, a pivot-shift test, an isokinetic strength test, a Y-balance test, and a single-leg hop test. A postoperative questionnaire was administered to determine the rates and types of RTS, quality of sports performance, and reinjury and satisfaction rates. Subjective scores and clinical tests were performed at 2 years. Magnetic resonance imaging and second-look arthroscopy were conducted during the 1- and 2-year follow-ups, respectively. Results: The mean follow-up for groups I and C were 30.4 ± 3.9 and 29.3 ± 3.5 months, respectively (P =.194). Patients in group C had better anteroposterior (P =.001) and rotational (P =.005) stability and higher ACL-RSI scores (P =.025) than those in group I. Group C had higher composite and posteromedial reach scores on the Y-balance test than group I (P =.014 and P =.010, respectively). A total of 26 (66.7%) patients in group C and 17 (43.6%) in group I returned to their prior level of sports (P =.040). Rerupture of the ACL graft and contralateral ACL rupture occurred in 2 (5.1%) and 2 (5.1%) patients in group I, respectively, compared with no rerupture or contralateral ACL rupture in group C. Conclusion: Combined ACLR and ALLR in young women with a high-grade pivot shift was associated with better knee stability parameters, dynamic postural stability, and psychological readiness to RTS than isolated ACLR. [ABSTRACT FROM AUTHOR]

Objectives: Fenestrated endovascular repair (FEVAR) has become a widely used treatment option for complex abdominal aortic aneurysms (AAA) but long-term survival and quality of life (QoL) outcomes are scarce. This single center cohort study aims to evaluate both long-term survival and QoL after FEVAR. Methods: All juxtarenal and suprarenal AAA patients treated with FEVAR in a single-center between 2002 and 2016 were included. QoL scores, measured by the RAND 36-Item Short Form Survey (SF-36), were compared with baseline data of the SF-36 provided by RAND. Results: A total of 172 patients were included at a median follow-up of 5.9 years (IQR 3.0-8.8). Follow-up at 5 and 10 years post-FEVAR yielded survival rates of 59.9% and 18%, respectively. Younger patient age at surgery had a positive influence on 10-year survival and most patients died due to cardiovascular pathology. Emotional well-being was better in the research group as compared to baseline RAND SF-36 1.0 data (79.2 ± 12.4 vs 70.4 ± 22.0; P < 0.001). Physical functioning (50 (IQR 30–85) vs 70.6 ± 27.4; P = 0.007) and health change (51.6 ± 17.0 vs 59.1 ± 23.1; P = 0.020) were worse in the research group as compared to reference values. Conclusions: Long-term survival was 60% at 5-years follow-up, which is lower than reported in recent literature. An adjusted positive influence of younger age at surgery was found on long-term survival. This could have consequences for future treatment indication in complex AAA surgery but further large-scale validation is necessary. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

Background: Greater trochanteric pain syndrome (GTPS) is a common problem with an incidence of 1.8–5.6 per 1000 population. Physiotherapy, anti-inflammatories, corticosteroid injections and surgery have all been described in the management of GTPS, with limited, temporal success. Extracorporeal shockwave therapy (ESWT) has been proposed as a potential non-invasive management option for this difficult presentation. Method: We ran a prospective, 2-arm, single-blinded, randomised control trial comparing focused shockwave therapy (f-ESWT) to an ultrasound guided corticosteroid injection. Primary outcome measure was the visual analogue pain score. Secondary outcome measures included the Harris Hip Score (HHS) and Trendelenburg test for function; SF-36 for quality of life (QoL); and a Likert scale question for subjective assessment of symptom improvement. Results: 104 patients (10 males and 94 females), of mean age 61.5 years were recruited. 53 were randomised to receive ESWT and 51 to receive an image-guided injection. 11 patients were lost to follow-up. There were no significant differences in baseline scores between groups. At 3 months, pain, function and QoL scores had improved in both groups but were not statistically significant. The Trendelenburg test was significantly improved in the f-ESWT group with 80% patients being negative compared to 20% at baseline (p < 0.001). At 12 months, across all outcomes, the ESWT group had significantly improved scores compared to the injection group; VAS 37.1 versus 55.0 (p = 0.007, 95% confidence interval [CI], 6.3–30.8), HHS 69.7 versus 57.5 (p = 0.002, 95% CI, −20.0 to −4.6) and SF-36 52.4 versus 47.7 (p = 0.048, 95% CI, −9.31 to −0.04). The improvement in Trendelenburg test was maintained in the ESWT group, but the injection group had reverted to baseline (p < 0.001). Conclusions: We have shown f-ESWT is an effective treatment for patients with GTPS. We would advocate f-ESWT as an effective non-invasive treatment modality for this challenging patient population. Trial Registration No. ISRCTN8338223 [ABSTRACT FROM AUTHOR]

Objectives: This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse's memory. Methods: Longitudinal data from the Health and Retirement Study (2004–2016) were used (N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory. Results: Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives' depressive symptom trajectories was significantly associated with husbands' memory (p >.05), husbands' decreasing trajectory was linked to wives' better memory (β = 0.498, 95% CI = 0.106, 0.890). Discussion: Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses' memory. [ABSTRACT FROM AUTHOR]

The adverse physical, psychological, and mental health consequences associated with COVID-19 illness are well-documented. However, how specific symptoms change over time and how COVID-19 affects one's day-to-day activities of daily living (ADL), Quality of Life (QoL), sleep quality, and fatigue severity are not well described. This longitudinal and descriptive study examined the changes in COVID-19 symptoms, ADL, QoL, sleep quality, and fatigue severity within the first 20 days. A convenience sample (n = 41) of non-hospitalized SARS-CoV-2 positive patients were recruited and followed for 20 days. Participants completed self-report measures: COVID-19 symptoms, ADL, QoL, sleep quality, and fatigue severity at days: 1, 10, and 20 following a diagnosis. Findings revealed that symptoms decreased over 20 days (p <.001). In parallel with the decrease in symptoms, QoL and ADL improved over 20 days (p <.05). However, sleep quality and fatigue severity did not improve within 20 days (p >.05). Our findings contribute to the growing evidence that COVID-19 symptoms can linger, especially fatigue and sleep quality, that affect overall day-to-day functioning for at least 20 days after diagnosis. To mitigate the effect of COVID-19 on QOL and ADL, findings underscore the need for clinicians to work collaboratively with patients to develop a symptom management plan for a variety of symptoms including fatigue and sleep quality. Beginning to repurpose existing self-management strategies for the longer term COVID-19 symptoms could be beneficial and help to optimize patient outcomes. Future work should examine these variables over a longer timeframe and among different samples of non-hospitalized patients. [ABSTRACT FROM AUTHOR]

Gestational weight gain (GWG) outside recommended parameters can lead to pregnancy or birth complications. Avoidance coping may influence GWG. We examined the association of avoidance coping with GWG among a sample of 112 pregnant Black women in the Midwest. Participants completed avoidance coping questionnaires at three time points throughout pregnancy. Data were abstracted from medical records for BMI and GWG. Overall, 23.2% gained inadequate weight, 30.4% adequate weight, and 46.4% excess weight. Multinomial logistic regression models indicated associations between avoidance coping and GWG adjusted for covariates. Participants with higher avoidance coping scores at 22–29 weeks' gestation were more likely to experience excess weight gain (odds ratio [ OR ] = 1.19, 95% CI [1.02, 1.37]). Participants with higher avoidance coping scores at 30–36 weeks' gestation were less likely to experience excess weight gain, (OR = 0.82, 95% CI [0.72, 0.93]). The impact of higher avoidance coping on excess weight gain depends on the time period in pregnancy. [ABSTRACT FROM AUTHOR]

Background: The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. Objectives: To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. Participants and Setting: Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. Methods: Details of childhood maltreatment are from two sources; child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. Results: Childhood maltreatment whether measured by agency report or self-report predicts overall low life success; agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28); sexual abuse, OR = 2.85(2.05,3.96); emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. Conclusions: Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life. [ABSTRACT FROM AUTHOR]

Background: The initial graft tension applied during anterior cruciate ligament (ACL) graft fixation may promote posttraumatic osteoarthritis (PTOA). Purpose/Hypothesis: This study sought to assess the effect of initial graft tension and patient sex on PTOA outcomes at 10 to 12 years after ACL reconstruction (ACLR). The hypothesis was that there would be no group- or sex-based differences in outcomes. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients were randomized to receive ACLR with a low or high initial graft tension. Outcomes were evaluated at 10 to 12 years postoperatively and compared with a matched, uninjured control group. Outcomes included clinical assessments (anteroposterior [AP] knee laxity measurement, International Knee Documentation Committee [IKDC] examination score), a functional assessment (single-leg hop for distance), patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], 36-Item Short Form Health Survey, Tegner activity level, patient satisfaction), and PTOA imaging (Osteoarthritis Research Society International [OARSI] radiographic score and Whole-Organ Magnetic Resonance Imaging Score [WORMS]). Two-way mixed-model analyses of variance were used to evaluate differences in outcomes between tension groups and the control group and between female and male patients. Results: Both tension groups scored worse than the control group for the IKDC examination (P ≤.021), KOOS (Pain, Activities of Daily Living, Sport/Recreation, and Quality of Life subscales) (P ≤.049), and WORMS difference score (P ≤.042). The low-tension group scored worse than the control group for KOOS Symptoms (P =.016) and the OARSI difference score (P =.015). The index limb had worse scores than the contralateral limb within the high-tension group for AP laxity (P =.030) and hop deficit (P =.011). This result was also observed within both tension groups for the WORMS (P ≤.050) and within the low-tension group for the OARSI score (P =.001). Male patients had higher Tegner scores (mean ± SE) relative to female patients (male, 5.49 ± 1.88; female, 4.45 ± 1.65) and worse OARSI difference scores (male, 1.89 ± 5.38; female, 0.244 ± 0.668) (P =.007 and.034, respectively). However, no significant differences were detected between tension groups for any of the outcomes measured. Conclusion: Overall, ACLR failed to prevent PTOA regardless of initial graft tension. However, male patients treated with a low initial graft tension may be at greater risk for PTOA. These results do not support the hypothesis of no sex differences in outcomes at 10 to 12 years after ACLR. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and predictors of physical activity, sedentary behaviour and fatigue five years after total knee replacement surgery. Design: A longitudinal cohort study. Setting: Community-dwelling adults who had previously undergone total knee replacement. Methods: Five-year follow-up questionnaire data were obtained from participants previously enrolled in a randomised controlled trial examining rehabilitation after total knee replacement. Main study outcomes at one year did not differ between randomisation groups, hence data were pooled for the present longitudinal analysis. Before and one and five years after surgery, participants completed questionnaires (Active Australia Survey, WOMAC, SF12 v2, demographics and fatigue). Results: 272/422 community-dwelling adults (45–74 years) completed the questionnaires at five years. Excessive sedentary behaviour was evident in 91% of the cohort, predicted by excessive sedentary behaviour and lack of energy at one year. Inadequate physical activity at five years was evident for 59% of the cohort, predicted by higher fatigue and comorbidity scores pre-surgery and inadequate physical activity at one year. Just under half (47%) of the cohort experienced clinically-important fatigue at five years, predicted by clinically-important fatigue before and one year after surgery, lack of sleep before surgery and physical activity one year after surgery. Conclusion: Documenting physical activity, sedentary behaviour and fatigue before and one year after knee replacement is important to identify those at risk of longer-term inadequate physical activity, excessive sedentary behaviour and clinically-important fatigue. Interventions to maintain activity and reduce sedentary behaviour are needed to reap the potential health benefits of total knee replacement surgery. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is associated with adverse outcomes for both victims and perpetrators, though there is significant heterogeneity in manifestations of relationship violence. A growing amount of research has focused on elucidating predictors of clinical IPV—defined as severe violence involving institutional or medical intervention due to actual or potential injury—so as to better understand potential prevention and intervention targets. Early life adversity (ELA) is associated with IPV in adulthood, yet this literature focuses on discrete, retrospectively reported adversities (e.g., physical abuse and neglect) and has yet to consider clinical IPV as an outcome. Little is known about if and how broadly adverse early environments may confer risk for this specific form of relationship violence. We investigated associations between exposure to ELA prior to age five and clinical IPV victimization and perpetration by age 20 in a longitudinal, community-based sample of men and women in Australia (N = 588). Early life adversity was prospectively indexed by maternal reports of financial hardship, child chronic illness, maternal stressful life events, maternal depressive symptoms, parental discord, and parental separation. Youth interpersonal conflict life events at age 15—an interviewer-rated assessment of episodic stressors involving conflict across relationships in mid-adolescence—was tested as a potential mediator for both victims and perpetrators. Among women, ELA predicted IPV victimization and perpetration, and interpersonal conflict life events partially mediated the link between ELA and victimization, but not perpetration. Neither ELA nor interpersonal conflict life events predicted victimization or perpetration among men. Women exposed to ELA are at-risk for conflictual interpersonal relationships later in life, including violent intimate relationships, and deficits in conflict resolution skills may be one mechanism through which ELA leads to IPV victimization among this subgroup. Violence prevention and intervention efforts should target interpersonal skills, including conflict resolution, among women and girls exposed to adverse early environments. [ABSTRACT FROM AUTHOR]

Background: Training and game loads are potential risk factors of injury in junior elite ice hockey, but the association of training and game loads to injuries is unknown. Purpose: To investigate the association of chronic training and game loads to injury risk in junior male elite ice hockey players. Study Design: Cohort study; Level of evidence, 2. Methods: In this prospective cohort study, we monitored all health problems among 159 male junior ice hockey players (mean age, 16 years; range, 15-19 years) at sports-specific high schools during the 2018-2019 school year. Players reported their health problems every week using the Oslo Sports Trauma Research Center Overuse Questionnaire on Health Problems (OSTRC-H2). The number of training sessions and games was reported for 33 weeks. We calculated the previous 2-week difference in training/game loads as well as the cumulative training/game loads of the previous 2, 3, 4, and 6 weeks and explored potential associations between training/game loads and injury risk using mixed-effects logistic regression. Results: The players reported 133 acute injuries, 75 overuse injuries, and 162 illnesses in total, and an average of 8.8 (SD ±3.9) training sessions and 0.9 (SD ± 1.1) games per week. We found no association between the difference of the two previous weeks or the previous 2- 3- and 4-week cumulative, training or game load and acute injuries, nor the difference of the two previous weeks, or the previous 4- and 6-week cumulative, training or game load and overuse injuries (OR, ∼1.0; P >.05 in all models). Conclusion: In the current study of junior elite ice hockey players, there was no evidence of an association between cumulative exposure to training/game loads and injury risk. [ABSTRACT FROM AUTHOR]

The topic of school bullying has become an important issue over the world. Being in disadvantaged situations of fathers' absence, prior research suggested that left-behind children (LBC) with absent fathers in China are more vulnerable to get involved in school bullying (bullying or being bullied). In addition, fathers' absence brings much pressure to single stay-at-home mothers, leading to more maternal psychologically controlling parenting. Following a three-wave longitudinal design, this study aimed to examine the developmental relationship between maternal psychological control and father-absent LBC's bullying/victimization as well as its mechanism. A total of 348 father-absent LBC aged 7-11 years in China completed a battery of questionnaires at three-time points. The results indicated that there are reciprocal effects between maternal psychological control and father-absent LBC's bullying/victimization. Specifically, maternal psychological control at T1 predicted father-absent LBC's victimization at T2; children's victimization at T2 predicted maternal psychological control at T3; maternal psychological control predicted later children's bullying perpetration stably from T1 to T2 and from T2 to T3; children's bullying at T2 predicted maternal psychological control at T3. Two vicious circles happened in the above relationships. Current findings highlight the stronger effects of mothers' negative parenting on children's school bullying, which bring inspiration for future family education and school intervention. [ABSTRACT FROM AUTHOR]

Background: About 4 out of 10 fibromyalgia patients suffer from depression. The European Alliance of Associations for Rheumatology (EULAR) guidelines recommend using antidepressants to treat fibromyalgia. Objective: To determine predictors of improved outcomes following a multicomponent treatment program. Design: We designed this longitudinal treatment outcome study to evaluate the prevalence of depression symptoms in patients diagnosed with fibromyalgia at a tertiary care facility, and the impact of depression on functional outcomes after completing a multicomponent fibromyalgia treatment program. Setting: Tertiary care center. Patients: This study included 411 adult patients with fibromyalgia who completed a multicomponent treatment program for fibromyalgia. Expert physicians performed comprehensive evaluations following American College of Rheumatology (ACR) criteria to confirm fibromyalgia before referral to the program. Intervention: An intensive outpatient multicomponent treatment program consisting of 16 hours of cognitive behavioral strategies served as the intervention. Measurements: Functional status was assessed using the Fibromyalgia Impact Questionnaire Revised (FIQR). Depression was evaluated with the Center for Epidemiologic Study of Depression (CES-D) measure. Measures were administered prior to participation in the program and approximately 5 months following completion of the program. Results: The cohort had a high prevalence of depressive symptoms (73.2% had depression at admission). Higher depression scores at baseline predicted poorer outcomes following multi-component treatment. Effectively treated depression resulted in improved functioning at follow-up. Limitations: Findings limited to tertiary care center cohort of fibromyalgia patients. Patients did not undergo a structured clinical diagnostic interview to diagnose depression. Conclusions: The current data links depression to poorer outcomes in patients with fibromyalgia. Depression is an important modifiable factor in the management of fibromyalgia. Guidelines should reflect the importance of assessing and effectively treating depression at the time of diagnosis of fibromyalgia, to improve functional outcomes. Registration: Specific registry and specific study registration number—Institutional Review Board—(IRB# 19-000495). Funding Source: No funding. [ABSTRACT FROM AUTHOR]

Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April–May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to examine the various preoperative predictive factors of inferior turbinate surgery and to find possible factors that predict an optimal subjective response using 3 common surgical techniques—radiofrequency ablation (RFA), diode laser, and microdebrider-assisted inferior turbinoplasty (MAIT)—in a randomized, prospective study with a 1-year follow-up. Methods: The patients filled a visual analogue scale (VAS) questionnaire regarding the severity of nasal obstruction prior to and 1 year after surgery. A VAS score improvement of 3 points or more was chosen as an optimal subjective response. Univariate and multivariate regressions were used to evaluate the effect of the predictive factors. In total, 80 patients attended a 1-year control visit. Results: In the multivariate analysis, patients without anterior septal deviation had a statistically significantly higher odds ratio of a satisfactory subjective response compared to patients with anterior septal deviation (5.6; 95% CI: 1.4-23.1; P =.02). Patients treated with RFA had a statistically significantly higher odds ratio of an optimal subjective response compared to patients treated with MAIT (9.0; 95% CI: 1.5-54.2; P =.02). Conclusions: Anterior septal deviation seems to decrease the likelihood of an optimal subjective response to inferior turbinate surgery, which supports the consideration of concomitant septoplasty at least in clear cases to optimize the subjective response. Radiofrequency ablation had a significantly higher likelihood of an optimal subjective response compared to MAIT. Further investigations regarding the findings are needed. [ABSTRACT FROM AUTHOR]

Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention. [ABSTRACT FROM AUTHOR]

Background: Iliocaval stenting is widely used for treatment of symptomatic iliocaval obstruction. The aim of our study was to compare quality of life before and after iliocaval stenting. Method: Prospectively collected data using CIVIQ20 questionnaire, Venous Clinical Severity Score (rVCSS) and Villalta-Prandoni score (VP) of patients following iliocaval stenting for non-thrombotic and post-thrombotic venous obstruction were analysed. Result: One hundred and one limbs (87 patients) were stented between May 2017 and May 2019. Baseline CIVIQ20 median value was 50 (34–66); 1 month after surgery CIVIQ20 value was 36 (26–58) and the scores then remained steady for the rest of the first year. Both rVCSS and VP scores decrease by 3.09 (95% CI: 2.39, 3.89; p <.001) and 5.21 (95% CI: 4.14, 6.48; p <.001) units, respectively, throughout the first year. Conclusion: Quality of life of patients with iliocaval obstruction significantly improves after successful percutaneous reconstruction. Severity of symptoms measured by rVCSS and VP scores decreases. [ABSTRACT FROM AUTHOR]

Objective: To study the long-term effectiveness of case-management rehabilitation intervention on vocational reintegration of patients after myocardial infarction (MI). Design: Blinded simple randomization was used to construct an intervention and control groups that were followed up for two years. Subjects and setting: 151 patients, aged 50.3 ± 5.9 years, who experienced uncomplicated MI and were enrolled in a cardiac rehabilitation program were recruited. Interventions: included an early referral to an occupational physician, tailoring an occupational rehabilitation program, based on individual patient needs, coordination with relevant parties, psychosocial intervention, intensive follow-up sessions during a two-year follow-up. Main measures: Return to work within six months of hospitalization and maintenance of employment at one and two years of follow-up. Results: Return-to-work (RTW) rate in the intervention group was 89% and nearly all maintained employment at one year of follow-up (92%) and two years of follow-up (87%). Moreover, almost all of them returned to and maintained their previous jobs. The corresponding figures were: 98%, 94% and 98%, respectively. The figures for the RTW and employment maintenance for the control group were: 74%, 75%, and 72%, respectively. Only about 75%, in this group kept their previous job. The case-management intervention was associated with increased odds of maintaining employment at follow-up of one year (OR = 5.89, 95% CI 1.42–24.30) and two years (OR = 3.12, 95% CI 1.01–10.03). Conclusions: The extended case-management rehabilitation intervention had a substantial positive impact on both the RTW of MI patients and their maintenance of employment at one and two years of follow-up. Trial Registration: This trial is registered at US National Institutes of Health #NCT04934735. [ABSTRACT FROM AUTHOR]

The current study sought to examine whether parental phubbing was significantly related to adolescents' cyberbullying perpetration and if moral disengagement mediated this relationship. We further examined whether online disinhibition moderated the direct and indirect relationships between parental phubbing and adolescents' cyberbullying perpetration. The participants included 2,407 adolescents from seven middle schools in China who completed the questionnaires regarding their experience with parental phubbing, moral disengagement, cyberbullying perpetration, and online disinhibition. Results indicated that adolescents with a high level of parental phubbing were likely to cyberbully others. Moral disengagement significantly mediated the relationship between parental phubbing and adolescents' cyberbullying perpetration. Furthermore, online disinhibition moderated the indirect relationship between parental phubbing and adolescents' cyberbullying perpetration. Specifically, the paths from parental phubbing to moral disengagement and from moral disengagement to cyberbullying perpetration became strengthened when adolescents experienced high levels of online disinhibition. [ABSTRACT FROM AUTHOR]

Although childhood maltreatment has been shown to play an important role in adolescent cyberbullying perpetration, little is known about mediating and moderating mechanisms underlying this relationship. The current study investigated the mediating role of callous-unemotional (CU) traits in the association between childhood maltreatment and adolescent cyberbullying perpetration, as well as the moderating role of perceived social support. A total of 2,407 Chinese adolescents (aged 11–16 years, Mage = 12.75 years, SD = 0.58) completed the measures of childhood maltreatment, CU traits, cyberbullying perpetration, and perceived social support. The results showed that CU traits partially mediated the relationship between childhood maltreatment and adolescent cyberbullying perpetration. Furthermore, perceived social support moderated the relationship between childhood maltreatment and CU traits, as well as CU traits and cyberbullying perpetration. Specifically, childhood maltreatment had a greater impact on CU traits for adolescents with higher levels of perceived social support and the predictive function of CU traits on cyberbullying perpetration was stronger for adolescents with low levels of perceived social support. [ABSTRACT FROM AUTHOR]

We examine if psychological intimate partner violence (pIPV) is predicted by parental psychological control (PPC) via insecure attachment. Our results analyzing longitudinal data from the Child Development Project show that PPC perceived at age 16 predicts insecure attachment at age 18, which then predicts pIPV at age 24. Moreover, the paths with attachment anxiety are consistently significant while ones with attachment avoidance are not. Further, all the paths are significant regardless of the gender of the adolescents and parents, which indicates that PPC is detrimental regardless of the gender of the adolescents or parents. Lastly, PPC perceived at age 16 does not directly predict pIPV at age 24, which suggests that social learning theory of aggression (Bandura, 1978) may not explain the association from PPC to pIPV. Our results suggest that research and practice would benefit by considering PPC as an antecedent of pIPV via insecure attachment from adolescence to emerging adulthood. [ABSTRACT FROM AUTHOR]

Background: Long-term patient-reported outcome measures (PROMs), rates of return to sport, and revision risk after anterior cruciate ligament (ACL) reconstruction (ACLR) are not well understood. Purpose: To provide long-term follow-up of PROMs, return-to-sport rates, and revision rates after ACLR and to identify predictors for poor outcome. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 2042 patients were included in an institutional ACL registry (2009-2013) and longitudinally followed. PROMs were completed preoperatively and at all follow-up time points. Questions regarding return to sport and knee stability were completed at final follow-up. Predictors for poor outcome on the International Knee Documentation Committee (IKDC) score were estimated in a regression model incorporating risk factors such as patient characteristics, graft choice, and concomitant injuries. Revision rates and risk of subsequent non-ACL surgeries were calculated. Results: Autografts were used in 76% of the patients (patellar tendon, 62%; hamstring grafts, 38%). Allografts were used in 24% of patients. The questionnaires were returned by 1045 (51.2%) patients at a mean of 7.2 years (range, 5.0-9.8 years) after surgery. Improvements in IKDC score of >30 points were sustained for all patient categories. The strongest predictor for lesser improvement in IKDC score was a cartilage lesion >2 cm2 identified during surgery. Male sex and college education completion were associated with improved IKDC scores. Meniscal lesions did not predict change) in the IKDC score. A total of 69% of patients had returned to sport after 8.1 years (range, 6.7-9.8 years). The main reason for not returning to sport was fear of reinjury. The revision rate was 7.2% after 9 years (range, 8-11 years), 13% of patients needed subsequent ipsilateral non-ACL surgery, and 6% underwent contralateral ACLR. The absence of a meniscal tear, younger age, and male sex were predictors for revision. Graft choice did not predict PROM results or revision risk. Conclusion: Improvements in IKDC scores were sustained 7 years after ACLR. The strongest predictor for poor outcome was a cartilage lesion >2 cm2. Patients can expect a 70% return-to-sport rate and an 87% chance of their knee feeling stable during daily and athletic activities after 8 years. Young male patients have better PROM scores but a higher risk of revision. There is a 26% chance of subsequent knee surgery within 9 years, including a revision rate of 7%, subsequent non-ACL surgery to the operated knee in 13%, and a 6% chance of contralateral ACLR. [ABSTRACT FROM AUTHOR]

Early adolescents (aged 12-15) were observed during dyadic conflict discussions with their siblings (n = 23) and mothers (n = 32) in their homes. The verbal conflict behaviors and affect of family members were coded continuously. Sequential analyses identified temporal associations between individuals' affect and their own and their partners' verbal conflict behaviors. In addition, within-family and across-context similarities in behavior were examined. Results revealed that while many links between emotion and behavior were consistent with previous research (e.g., attack/assert when frowning/upset, withdraw/concede when sad), several differences emerged depending on the relationship (sibling vs. mother-adolescent) and position in the family (e.g., adolescent vs. mother). Furthermore, many within-family similarities were observed in responses to emotion, while adolescents showed few similarities in their behavior across contexts. Results are discussed in relation to the developmental context of early adolescence and family systems theory. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) can comprise physical, sexual, and emotional abuse, and is a widespread public health concern. Despite increasing recognition that women experience different types of IPV, the majority of research has focused on physical IPV. The present study aims to examine associations between different types of IPV (physical, emotional, physical, and emotional) and women's mental, physical, and sexual health by analyzing longitudinal data from a prospective pregnancy cohort of 1,507 first-time mothers in Melbourne, Australia. Questionnaires included validated measures of physical and mental health (Short Form Health Survey, Edinburgh Postnatal Depression Scale) and IPV (Composite Abuse Scale). Emotional IPV alone was the most commonly reported type of IPV (n = 128, 9.5%), followed by both physical and emotional IPV (n = 76, 5.7%), and then physical IPV alone (n = 30, 2.2%). Women reporting emotional IPV or physical and emotional IPV had increased odds of poor health compared with women reporting no IPV. Experience of physical and emotional IPV was most strongly associated with mental health issues, including depressive symptoms (adjusted odds ratio [OR] 4.6, 95% confidence interval [CI] = [2.9, 7.1]) and self-reported anxiety (adjusted OR 2.9, 95% CI = [1.9, 4.4]). Experience of emotional IPV alone was associated with poor mental health as well as physical factors, including poor general physical health (adjusted OR 1.9, 95% CI = [1.2, 3.1]), and pain during sex (adjusted OR 1.8, 95% CI = [1.2, 2.7]). Increased odds of poor body image were also observed for women reporting emotional IPV alone and physical and emotional IPV. These findings highlight the need for greater awareness of the diversity in women's experiences of IPV among health care providers. This includes understanding the prevalence of emotional IPV among new mothers, and the range of health problems that are more common for women experiencing IPV. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic. Methods: The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as “pre-pandemic” (N=128), between March 2020 and July 2020 as “early pandemic” (N=38), and between August 2020 and November 2021 as “later pandemic” (N=21). Average PIPES subscale scores were dichotomized into “higher” and “lower” groups (⩽median, >median) and logistic regression models were performed. Results: Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods.Conclusion: Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period. [ABSTRACT FROM AUTHOR]

Introduction: We examined factors influencing anemia outcomes in rural children following implementation of a prevention program. Method: Mixed methods study of children, parents, and clinicians utilized statistical modeling and content/ethnographic analysis. Retrospective chart abstraction evaluated treatments administered and measured hemoglobin in children aged 6 to 59 months (n = 161). Prospective interviews/questionnaires examined parent (n = 51) and clinician (n = 19) perceptions. Results: Anemia prevalence decreased by 21.2%. Predictors of increased hemoglobin were clinic visit number and age at first visit. Once anemia improved, children were likely to remain improved (P =.65). Despite favorable program perceptions, stakeholders emphasized ecological barriers, including social disadvantage and local practices. Discussion: Socioeconomic factors prevented guideline concordant behaviors. Persistent attention to intrapersonal, interpersonal, and community social determinants is a sine qua non for successfully managing the epidemic. The first step to provide culturally congruent care is to explicitly acknowledge that guideline-concordant behaviors are often complex. [ABSTRACT FROM AUTHOR]

Background: Globally, countries are rolling out Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quarantine policies and vaccination programs. Research studies are needed in helping understand the likelihood of acquired immunity to reinfection and identify priority groups for vaccination to inform them. This study aimed to assess period prevalence and longitudinal changes in antibody levels after SARS-CoV-2 infection in Qatari primary care settings. Methods: A cohort study design with 2 data collection phases was undertaken—Phase 1 (conducted in July 2020) and Phase 2 (conducted in October 2020). A stratified random sampling technique by age, gender and nationality was utilized to identify the study sample. The total sample size required for the study was estimated to be 2102. Participants were invited to an appointment where they were administered a questionnaire and provided samples for polymerase chain reaction and Immunoglobulin G immunoassay tests. Results: A total of 943 individuals participated in both Phase 1 and Phase 2. In this cohort, seroprevalence of SARS-CoV-2 was found to be 12% (N = 113) in Phase 1 and 17.2% (N = 162) in Phase 2. Of the 113 participants who were seropositive in Phase 1, 38.1% (CI 29.5-47.2%, N = 43) had a reduction, 54.9% (CI 45.7-63.8%, N = 62) had no change, and 7.1% (CI 3.4-12.9%, N = 8) had an increase in IgG titer in Phase 2. All (N = 18) participants aged 10 to 17 years retained their antibodies. The proportion of men who retained their antibodies was slightly higher compared to women—92.5% (N = 74) and 87.9% (N = 29) respectively. Similarly, symptomatic individuals (97.8%; N = 45) had a higher antibody retention compared with asymptomatic individuals (86.4%; N = 57). Conclusions: This study provides preliminary information on the longitudinal changes in antibody levels after SARS-CoV-2 infection. These findings will help inform quarantine policies and vaccination programs. [ABSTRACT FROM AUTHOR]

Background: Little is known about the burden of overuse injuries and illnesses in junior elite ice hockey. Purpose: To describe the prevalence and burden of all health problems in junior male elite ice hockey players in Norway during 1 school year. Study Design: Descriptive epidemiological study. Methods: A total of 206 junior male ice hockey players (mean age, 17 years; range, 15-20 years) attending specialized sports academy high schools in Norway reported all health problems, acute injuries, overuse injuries, and illnesses, weekly during the 2018-2019 school year (44 weeks). The players self-reported injuries and illnesses using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. Results: Of the players included, 25% (95% CI, 23%-27%) reported at least 1 health problem at any given time, while 16% (95% CI, 14%-17%) experienced health problems with a substantial negative effect on training and performance. Of the total burden of health problems, acute injuries accounted for 44%, overuse injuries 31%, and illnesses 25%. For acute injuries, the greatest burden was caused by injuries to the ankle, knee, and hand, whereas for overuse injuries the most burdensome location was the hip/groin and knee. Conclusion: This study documented that while acute injuries did represent the greatest problem among junior elite ice hockey players, overuse injuries, especially to the knee and hip/groin, also had a substantial effect. [ABSTRACT FROM AUTHOR]

Background: The influence of femoral torsion on clinically significant outcome improvement after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has not been well-studied. Purpose: To quantify femoral torsion in FAIS patients using magnetic resonance imaging (MRI) and explore the relationship between femoral torsion and clinically significant outcome improvement after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Included were patients who underwent hip arthroscopy for FAIS between January 2012 and August 2018 and had 2-year follow-up and preoperative MRI scans containing transcondylar slices of the knee. Participants were categorized as having severe retrotorsion (SR; <0°), normal torsion (NT; 0°-25°), and severe antetorsion (SA; >25°) as measured on MRI. Patient-reported outcomes (PROs) included the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Subscale, modified Harris Hip Score, 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain and satisfaction. Achievement of Patient Acceptable Symptom State (PASS) and substantial clinical benefit (SCB) were analyzed among cohorts. Results: Included were 183 patients (SR, n = 13; NT, n = 154; SA, n = 16) with a mean age, body mass index, and femoral torsion of 30.6 ± 12.1 years, 24.0 ± 4.4 kg/m2, and 12.55° ± 9.58°, respectively. The mean torsion was –4.5° ± 2.6° for the SR, 12.1° ± 6.8° for the NT, and 31.0° ± 3.6° for the SA group. There were between-group differences in the proportion of patients who achieved PASS and SCB on the iHOT-12, pain VAS, and any PRO (P <.05). Post hoc analysis indicated that the SA group achieved lower rates of PASS and SCB on the iHOT-12 and pain VAS, and lower rates of PASS on any PRO versus the SR group (P <.05); the SR group achieved higher rates of PASS and SCB on pain VAS scores versus the NT group (P =.003). Conclusion: The orientation and severity of femoral torsion during hip arthroscopy influenced the propensity for clinically significant outcome improvement. Specifically, patients with femoral retrotorsion and femoral antetorsion had higher and lower rates of clinically significant outcome improvement, respectively. [ABSTRACT FROM AUTHOR]

Background: The evidence in support of operative versus nonoperative management of rotator cuff tears (RCTs) is limited, based primarily on observational studies of lower scientific merit. Purpose: To (1) compare the efficacy of operative versus nonoperative management of full-thickness RCTs across time and (2) detect variables that predict success within each group. Study Design: Cohort study; Level of evidence, 2. Methods: We included patients with symptomatic full-thickness RCTs who were enrolled in an institutional shoulder registry. Patient enrollment began in 2009 and continued until early 2018. The following outcome measures were collected at baseline, then 6 months, 1 year, and annually up to 5 years postoperatively: Western Ontario Rotator Cuff Index (WORC), American Shoulder and Elbow Surgeons (ASES) score, Veterans RAND 12-Item Health Survey (VR-12) mental and physical component subscales (MCS and PCS, respectively), 100-point Single Assessment Numeric Evaluation (SANE) rating, and 100-point visual analog scale (VAS) for pain and for patient satisfaction. We performed regression models for all outcome variables across all 5 years of follow-up and included the following predictor variables: treatment type (operative vs nonoperative), sex, age, symptom duration, smoking status, diabetes status, injury side, and obesity status. Results: A total of 595 patients were included. Longitudinal mixed-effects regression revealed that patients who received operative treatment did better across time on all outcomes. Women (n = 242; 40.7%) did not fare as well as did men on the ASES, WORC, or VR-12 PCS. Older patients tended to improve less on the VR-12 PCS and more on the VR12-MCS. Patients with longer symptom duration at baseline had better scores across time on the ASES, WORC, VAS for pain, and SANE. Current or recent smokers and patients with diabetes tended to have lower scores on all measures across time. For changes in scores from baseline, patients in the operative group improved to a larger degree out to 3 years compared with those in the nonoperative group. Conclusion: Patients with RCTs tended to improve regardless of whether they received operative or nonoperative treatment, but patients who underwent operative treatment improved faster. There appear to be several predictors of improved and worsened outcomes for patients with RCTs undergoing operative or nonoperative treatment. [ABSTRACT FROM AUTHOR]

Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children's cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers' rating of their children's intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 (sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 (always intelligible). Children's speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence (P <.001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement. [ABSTRACT FROM AUTHOR]

Sexual harassment (SH) and sexual assault (SA) continue to be a focus of prevention efforts in the U.S. military because of the prevalence and potential to affect the health and readiness of service members. Limited research exists on the association of SH and SA with coping behaviors, such as physical activity, within the military. Data including self-reported SA, SH, and physical activity were obtained from the Millennium Cohort Study, a longitudinal cohort study designed to examine the impact of military service on the health and well-being of service members. A hierarchical regression approach was applied to examine the association between SH or SA and subsequent physical activity levels. Hierarchical regression showed that, among those self-reporting recent SA, the odds of medium-high (300-449 min/week) and high physical activity levels (≥450 min/week) were significantly increased. Although the magnitude of these associations was attenuated with an increasing amount of adjustment, the odds of high physical activity levels remained statistically significant in the fully adjusted model (medium-high: odds ratio [OR] = 1.72, 95% confidence interval [CI] = [1.08, 2.73]; high: OR = 1.58, 95% CI = [1.02, 2.44]). We observed statistically significant negative associations between recent SH and medium-high physical activity levels in adjusted models (OR = 0.70, 95% CI = [0.54, 0.91]). The current results demonstrate that SA is generally associated with increased levels of physical activity among military service members. Analyzing the relationship between sexual trauma and physical activity is valuable because of the high prevalence of SH and SA in the military, long-term health implications including physical and emotional well-being, and potential impact on military readiness. [ABSTRACT FROM AUTHOR]