Search

Objective: The aim of the present cross-sectional study was to compare the interocclusal contact records obtained by three different digital methods (intra- and extraoral digital scanners and T-Scan III system) with the conventional method (articulating paper). Materials and methods: Twenty-five healthy volunteers were selected. As a control group, maximum intercuspation occlusal contacts were registered and photographed from the patients with an 8 µm articulating paper. Then, intraoral conventional elastomer impressions were taken and after obtaining the corresponding plaster models of every patient they were scanned with an extraoral scanner (Zfx Evolution, Zimmer Biomet Dental) (group 1). Moreover, digital impressions were made with an intraoral scanner (Trios Color POD, Phibo, 3Shape) and contacts were also registered (group 2). Finally, T-Scan III records were made and stored for further analysis (group 3). Two previously calibrated examiners independently evaluated the interocclusal contacts from every group. Data was analyzed by using Kappa index test and Pearson's chi-square test. Diagnostic tests and ROC curve were also performed. Results: Kappa interoperator index was 70.6% (better agreement). In Kappa intraoperator index, the best value was obtained in the intraoral scanner group (moderate agreement) and the worst with T-Scan III group (low agreement). ROC curve showed highest values in the intraoral scanner group (0.817) and lowest values in the T-Scan III group (0.613). Conclusion: Results suggest greater reliability to record occlusal contacts with the intraoral scanner. Clinical relevance: Intraoral scanners seem to be reliable in registering intermaxillary occlusal contacts when compared with the current gold standard. [ABSTRACT FROM AUTHOR]

This systematic review aims to give an overview of the diversity of research areas related to human biometeorology in Brazil. The main focus of this paper addresses research trends, represented by published papers with national and international authorship, main contributions and shortcomings, as well as challenges and prospects of research in this area of study. An extensive literature search was conducted in the Scopus, Web of Science, and Science Direct databases so as to identify relevant publication output up to July 2021 related to the research area. The screening resulted in 96 studies chosen for full-text reading. Overall, results indicated a reduced amount of articles on the subject matter published internationally, with noticeable gaps in research in some regions of the country, such as the Amazon region and in the Brazilian Midwest region. Research gaps in relevant areas have been identified with limited output in the climate dimensions of tourism, vector-borne diseases, mortality and morbidity in urban centers. Such gaps should further encourage researchers to engage in research focused on those areas. [ABSTRACT FROM AUTHOR]

Introduction: Smartphone applications (apps) for pharmacovigilance present an opportunity for integration as cost-effective healthcare service intervention into basic healthcare services in low-resource settings. This study aimed to (i) evaluate the implementation of the Med Safety app in Burkina Faso, and (ii) compare the characteristics of the reports sent by the Med Safety app with those sent on paper form. Methods: The study had two components: (i) a cross-sectional online survey assessing the Med Safety app, and (ii) a retrospective analysis comparing the characteristics of the Med Safety reports with those of the paper form, received by the National Pharmacovigilance Centre of Burkina Faso (CNVPS), from January 1, 2021 to December 31, 2022. We evaluated the success of the implementation of the Med Safety intervention using measures of acceptability, usefulness and feasibility. This assessment involved a set of 14 items rated on a 4-point Likert scale. Acceptability, feasibility, and usefulness were determined based on achieving a total score higher than the mean. Subsequently, we computed the proportion of participants whose overall score for all items exceeded the mean. Continuous and categorical variables were compared using the Wilcoxon rank-sum test and the Chi2 test, respectively. The significance level of the statistical test was set at 5%. Results: The survey participation rate was 51.9% (160/308). Half of the respondents were in the 35-44 age group (50.6%), and participants were predominantly male (71.9%). The Med Safety app was acceptable, feasible, and useful to 58.1% of respondents. The most useful features of the app were "reporting" (53.1%), "news" (13.6%) and "watch list" (12.4%). During the period, a total of 1,472 reports were received, including 357 (24.3%) through Med Safety and 1,115 (75.7%) through the paper form. The reports of adverse events following immunization received at the CNVPS numbered 974 (66.2%), these were related to COVID-19 vaccines, with 256 (26.3%) through the Med Safety and 718 (73.7%) through the paper form. The median time to submit the reports to the CNVPS was 159 (IQR 59–187) days for the Med Safety and 166 (IQR 107–281) days for the paper form (p < 0.001). Conclusion: In Burkina Faso, the Med Safety was found to be acceptable, useful, and feasible by users surveyed. In addition, and compared to the paper form, the app reduces the time to submit a report, and with increase in use, the reporting timeframe could be further improved. [ABSTRACT FROM AUTHOR]

This is the second in a series of studies assessing the usability and reliability of a novel voice-based delivery system of mental health screening assessments. The previous study demonstrated the reliability and patient preference of a voice-based format of the Patient Health Questionnaire 9 (PHQ 9) for measuring major depression compared to a traditional paper format. Through this study, we further examined the Amazon Alexa tool in the administration of the General Anxiety Disorder 7 (GAD 7). With a replicated methodology to the first study, 40 newly administered patients completed the GAD 7 in one format at their first session and the alternate format at their follow up. Results from the new in clinic population replicated the findings observed in the first PHQ 9 study: GAD 7 assessment scores for the Alexa and paper version showed a high degree of reliability (α = 0.77), patients showed higher overall positive attitudes for the voice-based GAD 7 format, and subscales for attractiveness, stimulation, and novelty were significantly higher for the voiced-based format. Results also demonstrated 42 (84%) of the 50 patients who completed the voice-based format responded as being willing to use the device from home. With new recommendations of universal screening of anxiety disorders for patients below the age of 65 and rapid changes in virtual mental healthcare, convenient screenings are more important than ever. We believe this novel clinical assessment tool has the potential to improve patient behavioral healthcare while mitigating the workload of healthcare professionals. [ABSTRACT FROM AUTHOR]

Security of medical images over an unsecured channel is a challenging task, and for this, several methods have been designed recently. The present paper is also in the same direction, and is an attempt to improve the security of the existing methods. In this paper, a cryptosystem is proposed, which performs encryption and decryption in the CBC (Cipher Block Chaining) mode of operation, and attains the confusion-diffusion properties using the PSN (Permutation-Substitution Network) of cryptography. The permutation is performed by a composite operation, consisting of rotation (via special orthogonal group), reflection, flipping, and pixel-wise shuffling, while substitution is performed by a composite operation of multiplication and multiplicative inverse over Galois field. The Archimedes' constant is utilized for constructing Initialization Vector (IV) to be used in the CBC mode of encryption (and decryption). The proposed approach is able to encrypt monochrome (8-bit, 10-bit, 12-bit, and 16-bit), palette color, and 24-bit color medical images, simultaneously into noisy-like images from the human visual as well as the statistical point of view. The designed approach is empirically assessed via several statistical and security evaluation metrics, such as key sensitivity, chi-squared test, number of pixel change rate, avalanche effect, poker test, peak signal-to-noise ratio, etc. The results of these metrics support the objectives of our proposed approach. Moreover, a thorough comparison is also made with the recent state-of-the-art existing methods. [ABSTRACT FROM AUTHOR]

The growth of Internet and the services provided by it has been growing exponentially in the past few decades. With such growth, there is also an ever-increasing threat to the security of networks. Several efficient countermeasures have been placed to deal with these threats in the network, such as the intrusion detection system (IDS). This paper proposes an ensemble learning-based method for building an intrusion detection model. The model proposed in this paper has relatively better overall performance than its individual classifiers. This ensemble model is constructed using lightweight machine learning models, i.e., Gaussian naive Bayes, logistic regression and decision tree as the base classifier and stochastic gradient descent as the meta-classifier. The performance of this proposed model and the individual classifiers used to build the ensemble model is trained and evaluated using three datasets, namely, KDD Cup 1999, UNSW-NB15 and CIC-IDS2017. The performance is evaluated for binary class as well as multiclass classifications. The proposed method also incorporates the usage of a feature selection method called Chi-square test to select only the most relevant features. The empirical results definitively prove that using an ensemble classifier can be immensely helpful in the field of intrusion detection system with unbalanced datasets where misclassifications can be costly. [ABSTRACT FROM AUTHOR]

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

Time series forecasting is an important application of many statistical methods. When it is appropriate to assume that the data may be projected towards the future based on the past history of the dataset, a preliminary examination is usually required to ensure that the data sequence is autocorrelated. This is a quite obvious assumption that has to be made and can be the object of a formal test of hypotheses. The most widely used test is the portmanteau test, i.e., a sum of the squared standardized autocorrelations up to an appropriate maximum lag (the truncation point). The choice of the truncation point is not obvious and may be data-driven exploiting supplementary information, e.g. the largest autocorrelation and the lag where such maximum is found. In this paper, we propose a portmanteau test with a truncation point equal to the lag of the largest (absolute value) estimated autocorrelation. Theoretical and simulation-based comparisons based on size and power are performed with competing portmanteau tests, and encouraging results are obtained. [ABSTRACT FROM AUTHOR]

The paper is a study of risk assessment posed by trees in selected urban woodlands (urban forests) of Warsaw. Two groups of trees were analysed and compared: exhibiting signs of maturity and ageing (hollow-bearing trees with open or hidden cavities and/or caries) and with no signs of decay. 373 individual trees growing near routes frequently or continuously used for recreational purposes were examined using Roloff's vitality classification, and tree risk assessment method, complemented by instrumental studies: a resistance resistograph, pulling tests, and sonic tomography (SoT). The collected data was analysed using the Chi-square test. The results indicate that it is not possible to conclude unequivocally that the presence of hollows in aged trees significantly increases the risk of falling. According to the safety factor results from the SoT and pulling tests, no correlation was demonstrated between the presence of hollow trees and an increase in risk class. The highest proportion of hollow trees (89.42%) was in the low risk group for trunk fracture and uprooting. The results also indicate the coherence of the diagnostic methods to be necessary for providing sufficient information to assess the statics and, ultimately, as our study showed, the protection of hollow trees. [ABSTRACT FROM AUTHOR]

At present, there are no brief, freely-available, informant-report measures that evaluate key challenging behaviors relevant to youth with autism spectrum disorder (ASD) or other developmental disabilities (DD). This paper describes the development, refinement, and initial psychometric evaluation of a new 18-item measure, the Open-Source Challenging Behavior Scale (OS-CBS). In a large sample (n = 2004, 169 with ASD, ages 2–17), results of psychometric analyses indicated a clear factor structure (property destruction, aggression, elopement, conduct problems, and self-injury and a general factor with high loadings from all items) based on exploratory structural equation modeling, good scale reliability (α =.66–.83 for subscales, α =.91 total scale), measurement invariance across demographics, and good construct validity. The OS-CBS is a psychometrically-sound instrument for screening and monitoring intervention progress. [ABSTRACT FROM AUTHOR]

Structural equation models are used to model the relationships between latent constructs and observable behaviors such as survey responses. Researchers are often interested in testing nested models to determine whether additional constraints that create a more parsimonious model are also supported by the data. A popular statistical tool for nested model comparison is the chi-square difference test. However, there is some evidence that this test performs suboptimally when the unrestricted model is misspecified. In this paper, we examine the type I error rate of the difference test within the context of single-group confirmatory factor analyses when the less restricted model is misspecified but the constraints imposed by the restricted model are correct. Using empirical simulations and analytic approximations, we find that the chi-square difference test is robust to many but not all forms of realistically sized misspecification in the unrestricted model. [ABSTRACT FROM AUTHOR]

Corporal punishment (e.g., spanking) remains a highly debated yet common form of discipline in the United States. A body of research exists investigating the prevalence and effects of corporal punishment; however, less attention has been devoted to factors influencing individual perceptions of corporal punishment. The current study explores college students' perceptions of corporal punishment with a specific focus on students' experiences with physical discipline and factors that may influence students' intentions to use physical discipline with their own children. Relying on a convenience sampling methodology, the current research is based on a sample of 318 students, who participated in a pen-and-paper survey. Findings reveal that most students experienced corporal punishment (86.8%) and roughly three-quarters intend to use physical discipline with their children. Moreover, positive attitudes towards physical forms of punishment were positively associated with intentions to use corporal punishment (OR = 1.494; ***p < 0.001). Despite most participants reporting experiences with corporal punishment and intending to use physical discipline with their children, many felt better disciplinary methods were available. Given that attitudes were correlated with intention to use, educational programs and curricular endeavors to inform individuals of the negative impact of corporal punishment, as well as alternative non-physical discipline strategies are recommended as ways to reduce reliance on physical forms of discipline. Highlights: Most college students sampled reported personal experience with physical discipline as children (86.8%). Most college students intend to use corporal punishment (75.2%) as a discipline strategy with their children. Most participants (71%) believed there were better ways to punish a child than using corporal punishment. Attitudes towards corporal punishment were the only variables associated with intention to use physical discipline in multivariate models. [ABSTRACT FROM AUTHOR]

Promoting Farmer Managed Natural Regeneration (FMNR) aims to increase the productive capacities of farmer households. Under FMNR, farmers select and manage natural regeneration on farmlands and keep them under production. While FMNR contributes to the wealth of farming communities, its contribution to household food security has rarely been researched. We, therefore, used a mixed-methods approach to address the research gap by measuring FMNR's contribution to food security among farmer households in the Talensi district of Ghana. We adopted the Household Dietary Diversity Score (HDDS) and Food Consumption Score (FCS) to estimate food security status among 243 FMNR farmer households and 243 non-FMNR farmer households. Also, we performed a Chi-square test of independence to compare the frequency of each food group (present vs not present) between FMNR adopters and non-FMNR adopters to establish the relationship between adopting FMNR and consuming the FCS and HDDS food groups. Our results reveal that FMNR farmer households are more food secure than non-FMNR farmer households. The HHDS of the FMNR farmer households was 9.6, which is higher than the target value of 9.1. Conversely, the HHDS of the non-FMNR farmer households was 4.3, which is lower than the target value of 9.1. Up to 86% and 37% of the FMNR farmer households and non-FMNR farmer households fell within acceptable FCS; 15% and 17% of FMNR farmer households and non-FMNR farmer households fell within borderline FCS. While none of the FMNR farmer households fell within poor FCS, 46% of non-FMNR farmer households fell within poor FCS. Adopting FMNR is significantly related to consuming all food groups promoted and benefiting from FMNR practices. The paper recommends enabling farmers in semi-arid environments to practice and invest in FMNR for long-term returns to food security. [ABSTRACT FROM AUTHOR]

Dating apps are now used by the majority of MSM to meet sexual and romantic partners. While research has demonstrated an association between app use and greater number of sex partners and STIs, dating apps also pose an opportunity for intervention. By advocating for new and improved sexual health features on dating apps, Building Healthy Online Communities (BHOC) aims to increase communication about sexual health on the apps. As a follow-up to our previous paper assessing the uptake of sexual health-related profile options on dating apps through Emory's annual survey of 10,000 MSM in the US, BHOC and Emory partnered to explore the change in uptake over time, again through their annual survey. Among survey participants in 2021, 85% reported using dating apps to meet a partner in the past year, and among this group, 93% reported awareness of sexual health features, up from 77% in 2018 (p < 0.0001). 71% of app users who were aware of features in 2021 reported using one or more sexual health feature, up from 61% in 2018 (p < 0.0001). BHOC will continue to advocate for increased uptake of these features, especially among subgroups with lower levels of uptake. [ABSTRACT FROM AUTHOR]

Background: To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. Methods: A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. Results: 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. Conclusions: For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to have youth participate in the design and implementation of a research project set within a child rights framework to better understand high schoolers' perceptions of safety in their school and community. Results: Between June 2020 and March 2021, a team of East Harlem, New York high school students, participated as co-researchers to modify the United Nations Children's Fund Child Friendly Cities Initiative Survey to suit their needs. Due to the COVID-19 pandemic, the final survey was conducted through an online remote classes system during advisory school classes, accompanied by brief focused group discussions. The novel process of conducting an interactive qualitative and quantitative virtual survey during a pandemic via youth participatory action research is outlined in this paper. Conclusions: Our results demonstrate that youth participatory action research can be utilized as part of a child rights framework approach to assess the views of youth regarding community safety and violence prevention. [ABSTRACT FROM AUTHOR]

Purpose: Identify aspects of quality of life (QoL) important to Australian informal carers and explore how well the Adult Social Care Outcomes Toolkit for Carers, Care-related Quality of Life instrument and Carer Experience Scale capture these aspects in the Australian context. Methods: Online questionnaires were completed by Australian informal carers. Socio-demographics, open-ended questions: positive/negative aspects of caring and QoL aspects missing from the instruments, and ranking of the instrument domains was used to explore the content of the instruments. Instruments were scored using preference-weighted value sets (reported in another paper). Content analysis was used to analyse the open-ended responses. Chi-squared test looked at differences in domain importance. Descriptive analyses summarised all other information. Results: Eight themes were identified: Behaviour-mood of the care recipient, Caring responsibilities, Finances, Health, Own life, Perception of carers, Relationship with care recipient and Support. Many aspects of carer QoL mentioned as missing in the instruments appeared covered by the domains, of which all were reported as important. The highest ranked domain was relationship with the care recipient. The influence of the care recipient specific support, behaviour/mood and health on carer QoL appear absent in all instruments. Conclusion: The content of the three instruments appears relevant in an Australian setting. The influence of care recipient's health and well-being on carer QoL should be considered, along with spillover effects. A content and/or face validity analysis is required to confirm differences in item interpretation in Australian informal carers. [ABSTRACT FROM AUTHOR]

Tobacco use is the leading cause of death in the United States and youth prevention is key to reducing tobacco use. American Indian/Alaska Native (AI/AN) individuals have a higher prevalence of tobacco use compared to other populations. This paper aims to evaluate the prevalence of tobacco products among youth within the Cherokee Nation reservation. Data from the 2019 Cherokee Nation Youth Risk Behavior Survey (YRBS) was used to analyze the prevalence of tobacco use (cigarettes, smokeless tobacco, electronic cigarettes, cigars, and ≥ 2 products) among students within Cherokee Nation. Weighted frequency and percentages were obtained for variables and 95% confidence intervals were computed using Taylor linearization variance estimators. Binary associations between variables were examined using the Rao-Scott Chi-square test. There were 1475 high students who participated in the 2019 Cherokee Nation YRBS. Males were more likely to report the use of smokeless tobacco and ≥ 2 products than females. Twelfth graders had a higher prevalence of reported e-cigarette use compared to lower grades. AI/AN students had a higher prevalence of current use of cigarettes and ≥ 2 products compared to other groups. The use of marijuana and alcohol was positively associated with the use of all tobacco products. Depression was also positively associated with the use of all products excluding smokeless tobacco. Grade, age, depression, and current use of other tobacco products, marijuana, and alcohol were associated with greater electronic cigarette intensity levels. Using the results, tribal and local organizations can promote evidence-based interventions that focus on reducing tobacco use among youth. [ABSTRACT FROM AUTHOR]

Research to date has shown that HIV infection is a highly stressful experience for individuals, and one of the key adaptive resources after such painful experiences may be forgiveness. The aim of the present study was to examine the associations between dispositional forgiveness (assessed using Mullet's Forgivingness Questionnaire and Toussaint's Forgiveness Scale), perceived stress (single-item measure of stress symptoms), health perception (EuroQol visual analogue version of the scale) and life satisfaction (Satisfaction With Life Scale) in people living with HIV (PLWH) in France. Paper surveys were completed by 222 PLWH aged 18–78 (57% male). Multiple regression analysis revealed that sensitivity to circumstances, unconditional forgiveness, self-forgiveness, and forgiveness of others were significant predictors of health and happiness. Mediation analysis showed that these relationships are completely mediated by perceived stress. The present findings suggest that forgiveness and perceived stress may be important variables for healing in PLWH. Interventions designed to improve forgiveness and self-forgiveness may result in improved health and life satisfaction in PLWH. [ABSTRACT FROM AUTHOR]

A great deal of economic problems are related to detecting the stability of time series data, where the main interest is in the unit root test. In this paper, we consider the unit root testing problem with errors being long-memory processes with the GARCH structure. A new test statistic is developed by using the random weighted bootstrap method. It turns out that the proposed statistic has a chi-squared distribution asymptotically regardless of the process being stationary or nonstationary, and with or without an intercept term. The simulation results show that the statistic has a desired finite sample performance in terms of both size and power. A real data application is also given relying on the inflation rate data of 17 countries. [ABSTRACT FROM AUTHOR]

Introduction: This research paper investigates whether robotic total knee replacement (TKR) reduces bone resection compared to conventional TKR. While TKR is a successful procedure, revision surgery remains a challenge with up to 8.3% of all knee replacement procedures requiring revisions. Materials and methods: The study retrospectively analyzed the tibial polyethylene inserts used and bone cuts made in 157 primary TKRs performed by a single surgeon. The results show that 93.3% of robotic TKRs used the base size tibial polyethylene of 9 mm, and the average distal femoral cut was 7.4 mm and the average tibial cut was 6.4 mm, with the minimum being 3 mm. Conclusion: The study suggests that robotic TKR reduces bone resection compared to conventional TKR. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate disparities in urine drug testing (UDT) during perinatal care at a single academic medical center. This retrospective cohort study included patients who had a live birth and received prenatal care at our institution between 10/1/2015 and 9/30/2020. The primary outcomes were maternal UDT during pregnancy (UDTPN) and UDT only at delivery (UDTDEL). Secondary outcomes included the number of UDTs (UDTNUM) and the association between a positive UDT test result and race/ethnicity. Mixed model logistic regression and negative binomial regression with clustering based on prenatal care locations were used to control for confounders. Of 6,240 live births, 2,265 (36.3%) and 167 (2.7%) received UDTPN and UDTDEL, respectively. Black (OR 2.09, 95% CI 1.54–2.84) and individuals of Other races (OR 1.64, 95% CI 1.03–2.64) had greater odds of UDTPN compared to non-Hispanic White individuals. Black (beta = 1.12, p < 0.001) and Hispanic individuals (beta = 0.78, p < 0.001) also had a positive relationship with UDTNUM. Compared to individuals with non-Medicaid insurance, those insured by Medicaid had greater odds of UDTPN (OR 1.66, 95% CI 1.11–2.49) and had a positive relationship with UDTNUM (beta = 0.89, p < 0.001). No significant associations were found for UDTDEL and race/ethnicity. Despite receiving more UDT, Black individuals were not more likely to have a positive test result compared to non-Hispanic White individuals (OR 0.95, 95% CI 0.72–1.25). Our findings demonstrate persistent disparities in substance use testing during the perinatal period. Significance: What is already known on this subject?: Prior literature has shown evidence of racial disparities in urine drug testing during pregnancy-related hospital admissions and at delivery. What this study adds?: This paper found that disparities in urine drug testing also exist during the prenatal care period at an urban academic institution. We also found a positive relationship between the number of tests received and being of Black or Hispanic race/ethnicity. Future research should investigate health care system-related interventions to mitigate disparities in urine drug testing. [ABSTRACT FROM AUTHOR]

Caregiver-adolescent sexual health communication can reduce sexual risk attitudes and behaviors, but less is known about caregiver-adolescent sexual health communication in Uganda. Using a risk-focused approach, this paper seeks to characterize caregiver-adolescent sexual health communication and associated individual and family-based attributes, and associations with adolescents' sexual risk attitudes. We used latent class analyses to derive typologies (classes) of sexual health communication and assess their relationships with respondents' socio-demographic characteristics and sexual risk-taking attitudes. We derived three latent classes of sexual risk communication characterized as avoidant (class 1; 48%), functional (class 2; 22.2%) and comprehensive (class 3; 29.8%), each representing varying levels of frequency and type of content covered in the caregiver-adolescent sexual health communication. Primary caregiver's sex and respondents' comfort talking to their caregiver were significantly associated with membership in the functional class (RRR = 1.52; 95% CI: 1.05–2.19; p < 0.05) and comprehensive class (RRR = 1.68; 95% CI: 1.13–2.49; p < 0.05). Caregivers and their adolescents are attempting to engage in conversations related to sexual health, but many caregivers tend to shy away from potentially embarrassing topics such as sex. The wide variations in type and content of covered in caregiver-adolescent sexual health communications may compromise adolescents' sexual health knowledge, putting them at risk for poor sexual health outcomes. Given the cultural taboos around caregiver-adolescent communications on sex related topics, family interventions to address to strengthen caregiver-adolescent communication on sexual health are required. Highlights: Study findings revealed three latent caregiver-adolescent sexual health classes, dominated by avoidant communication. Caregiver gender and adolescents' comfort enhanced caregiver-adolescent sexual health communication. Interventions must tackle cultural norms and taboos for better caregiver-adolescent sexual health communication. [ABSTRACT FROM AUTHOR]

Background: Frailty has been associated with increased postoperative mortality and morbidity; however, the use of the modified frailty index (mFI-11) to assess patients undergoing surgery for diverticular disease has not been widely assessed. This paper aims to examine frailty, evaluated by mFI-11, to assess postoperative morbidity and mortality among patients undergoing operative intervention for colonic diverticular disease. Methods: We used data from the Healthcare Cost and Utilization Project National Inpatient Sample (October 1, 2015–December 31, 2019). ICD-10-CM codes were utilized to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. mFI-11 items were adapted to correspond with ICD-10-CM codes. Patients were stratified into robust (mFI < 0.27) and frail (mFI ≥ 0.27) groups. Primary outcomes were in-hospital postoperative morbidity and mortality. Secondary outcomes included system-specific postoperative complications, length of stay (LOS), total admission cost, and discharge disposition. Multivariable regression models were fit. Results: Of the 26,826 patients, there were 24,194 patients with mFI-11 < 0.27 (i.e., robust) and 2,632 patients with mFI-11 ≥ 0.27 (i.e., frail). Adjusted analysis showed significant increases in postoperative mortality (aOR 2.16, 95% CI 1.38–3.38, p = 0.001) and overall postoperative morbidity (aOR 1.84, 95% CI 1.65–2.06, p < 0.001). LOS was higher in the frail group (MD 1.78 days, 95% CI 1.46–2.11, p < 0.001) as well as total cost (MD $25,495.19, 95% CI $19,851.63-$31,138.75, p < 0.001). Conclusion: In the elective setting, a high mFI-11 (i.e., presence of the variables comprising the index) could alert clinicians to the possibility of implementing preoperative optimization strategies. In the emergent setting, a high mFI-11 may help guide prognostication for these vulnerable patients. [ABSTRACT FROM AUTHOR]

Purpose: Since the 1960s, federal and state governments and private-sector companies have used supplier diversity initiatives to ensure their supply chains include businesses owned by traditionally economically disadvantaged or underrepresented groups. Originally concentrated on racial and ethnic minority groups, programs have expanded to include businesses owned by women, veterans, LGBTQ+ individuals, and, in some cases, people with disabilities. This study investigates the extent to which disability is included in supplier diversity initiatives of Fortune 500 companies. Methods: This paper uses a novel data set created by the authors with information on supplier diversity initiatives and Disability, Equity, and Inclusion (DEI) statements in Fortune 500 companies extracted from public sources. This information is combined with data from Compustat, a corporate financial database published by Standard and Poor's and additional variables from other sources. Results: 75% of the Fortune 500 companies have supplier diversity programs that express a commitment to diversity yet only 49% of those with such programs include disability-owned businesses (38% of all Fortune 500 companies). Among the largest 100 companies, 89% had supplier diversity programs that included disability, almost 6 times the rate Ball et al. reported in 2005. This study finds disability inclusion varies significantly by company size, industry, and whether the company is a government contractor. Conclusion: Despite the growth in disability inclusion, the absence of disability as a diversity category in regulations mandating supplier diversity initiatives for government contractors impacts disability inclusion. If we want to align our supplier diversity programs with the Americans with Disabilities Act, the first step is to address the issue in the Small Business Administration and federal contracting requirements. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) involves the cutting of the external female genital organs for non-medical purposes. It is a widespread public health problem in Nigeria as it affects the health of women and girls. The views of women about FGM are widely researched and known; however, very little empirical research has been conducted to understand the views of men. Aim: This study therefore sought to examine men's views with regard to the continuation of FGM and its associated factors in a rural Igbo community in Nigeria. Subject and Method: This paper reports the results of a survey of 215 men aged 18 and above living in Isuikwuato Local Government Area, Uturu in Nigeria. Bivariate and binary logistic regression were performed on 215 completed and returned questionnaires (86% response rate) using the Statistical Package for Social Science. This is the first study to investigate Nigerian Igbo men's views of FGM. Results: Descriptive statistics revealed that almost two-thirds of the sample (63.7%) thought FGM should be discontinued. Logistic regression found that owning a television and/or a radio and holding a Christian faith significantly predicted favouring the discontinuation of FGM. Conclusion: This study provides evidence to suggest that some Nigerian Igbo men's attitudes about FGM appear to be generally less than favourable. The major implication of these findings is that policy makers must place greater emphasis on addressing the economic and social development of rural areas in Nigeria if the harmful practice of FGM is to be reduced. [ABSTRACT FROM AUTHOR]

In order to improve the computational efficiency of testing the hypothesis about the distributions of random variables, the paper proposes a modified testing procedure. This procedure is based on determining the maximum estimation discrepancy for the distribution functions of the compared random variables, followed by the calculation and analysis of confidence intervals for the determined distribution function values. The hypothesis about the identity of distributions is confirmed if obtained confidence intervals overlap at a given level of significance. According to the results of computational experiments, the Kolmogorov–Smirnov and Pearson's chi-squared tests were compared using the following formulas for sampling the intervals of random variables: Sturgess' rule, Heinhold–Gaede formula, and that of the modified method. Pairwise combinations of the following distributions of random variables are considered: uniform, normal, lognormal, and power- law. It is shown that the modified procedure can be generalized to the case of testing hypotheses about the distributions of multidimensional random variables. In contrast to Pearson's chi-squared test, the proposed modified procedure helps to bypass the problem associated with converting the range of random variables into multidimensional intervals. [ABSTRACT FROM AUTHOR]

Software Defined Networking (SDN) is a network paradigm with the separation of the control plane from the data plane. Centralized management of the network and dynamic programming ability are the advantages of this separation. However, SDN suffers from security threats like DDoS attacks. In this paper, we propose an early detection and mitigation model to detect the DDoS attacks caused by the TCP SYN flood. This model uses the programming ability of SDN to collect features from network traffic at the centralized controller. For that, we implement the proposed model as a module in the POX controller. Our model extracts the header features: MAC addresses and TCP flags to construct the list of number of half-open connections per each host in the network within a given time period. The extended chi-square goodness of fit test serves as a basis for the detection method in our model. We calculate the χ 2 value for the list of half-open connections and from this p _ value is derived. When p _ value drops below the threshold value, the attack is detected. We also mitigate the attack by blocking the attack traffic from the attackers' within the network using source MAC addresses. The experiments results show that the model is successful in TCP SYN flood detection and mitigation at the source end, i.e. attack-originating network. We compare our model with existing literature and show improvement over attack detection and discuss the advantages of the proposed model over the existing schemes in the literature. [ABSTRACT FROM AUTHOR]

Violence, abuse and neglect constitute major threats to children's health and wellbeing globally. However, until recently, relatively little systematic attention has been paid to the role of faith communities in shaping the protective environment for children. This paper describes the development of a measure to capture child-protective disposition amongst faith communities through field studies with faith leaders and their spouses in Senegal, Uganda and Guatemala. Identifying common factors related to child care and protection practices, orientation to child rights and approaches to discipline, the measure potentially serves to both inform and evaluate interventions seeking to engage with the beliefs and behaviours of faith communities to support children's health and wellbeing. [ABSTRACT FROM AUTHOR]

The changes in pro-environmental behaviour, whether people become more environmentally friendly or not, have been analysed very scarcely. Therefore, the aim of this paper was to analyse the changes in pro-environmental behaviour and its determinants in Lithuania as a transition European Union country comparing years 2011 and 2020. Applying Chi-Square and t test statistics, the results showed a significant increase in performance of pro-environmental behaviour in 2020. Waste sorting and purchase of environmentally friendly goods increased the most, meanwhile water and energy saving behaviour increased the least. Applying the value-belief-norm theory and leaner regression analysis, we analysed whether the same determinants influenced pro-environmental behaviour in 2011 and 2020. The results revealed that the impact of determinants differed. In 2020, the main factor of pro-environmental behaviour was the perception of environmental problems but not self-transcendence values dimension. Furthermore, self-enhancement values and awareness of behavioural consequences negatively influenced pro-environmental behaviour in 2020. Analysing the changes in these factors, an insignificant difference was observed in self-enhancement values. The changes in other factors were significant, particularly the changes in the level of environmental responsibility was the biggest. Therefore, implementation of environmental education and information programmes and various environmentally friendly public initiatives positively contributed to the enhancement of environmental awareness and pro-environmental behaviour. [ABSTRACT FROM AUTHOR]

Protection of information (data/images) is crucial in the colossal and ever-expanding domain of digital transfer. Cryptography is one of the well-known admired solutions to preserve images' confidentiality over highly unreliable and unrestricted public media. Researchers propose numerous techniques to accomplish the ever-growing need for security. In continuation, this paper aims to develop a robust image encryption scheme that accomplishes the task of protection by employing a series of specially designed substitution box, permutation box and diffusion box by taking encryption keys as input which is consequently generated from a Generative Adversarial Network (GAN), an unsupervised deep learning algorithm trained on the Logistic Maps. The substitution box performs byte-level substitution using two different schemes, and the other two perform encryption at both bit-level and byte-level, which helps it withstand a wide range of attacks. A dataset with 789 standard images is taken for experimentation, partitioned into three sets according to size (128, 256, and 512). The projected scheme outperforms state-of-the-art methods with better performance since the trained generator passed the comprehensive tests; it also withstands most of the probable attacks available in the literature. GAN was subjected to the chi-square test, runs test, and NIST test suite to check the randomness of the Pseudo-Random Number Generator. The projected algorithm offers promising visual, statistical, robustness, and quantitative analysis results. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that the trauma population has needs for rehabilitation services that are best provided in a continuous and coordinated way. The discharge destination after acute care is the second step to ensuring quality of care. There is a lack of knowledge regarding the factors associated with the discharge destination for the overall trauma population. This paper aims to identify sociodemographic, geographical, and injury-related factors associated with discharge destination following acute care at trauma centers for patients with moderate-to-severe traumatic injuries. Methods: A multicenter, population-based, prospective study was conducted with patients of all ages with traumatic injury [New Injury Severity Score (NISS) > 9] admitted within 72 h after the injury to regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Results: In total, 601 patients were included; a majority (76%) sustained severe injuries, and 22% were discharged directly to specialized rehabilitation. Children were primarily discharged home, and most of the patients ≥ 65 years to their local hospital. Depending on the centrality of their residence [Norwegian Centrality Index (NCI) 1–6, where 1 is most central], we found that patients residing in NCI 3–4 and 5–6 areas sustained more severe injuries than patients residing in NCI 1–2 areas. An increase in the NISS, number of injuries, or a spinal injury with an Abbreviated Injury Scale (AIS) ≥ 3 was associated with discharge to local hospitals and specialized rehabilitation than to home. Patients with an AIS ≥ 3 head injury (RRR 6.1, 95% Confidence interval 2.80–13.38) were significantly more likely to be discharged to specialized rehabilitation than patients with a less severe head injury. Age < 18 years was negatively associated with discharge to a local hospital, while NCI 3–4, preinjury comorbidity, and increased severity of injuries in the lower extremities were positively associated. Conclusions: Two-thirds of the patients sustained severe traumatic injury, and 22% were discharged directly to specialized rehabilitation. Age, centrality of the residence, preinjury comorbidity, injury severity, length of hospital stay, and the number and specific types of injuries were factors that had the greatest influence on discharge destination. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9–11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. Objective: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. Methods: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0–10 m), speed (15–40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. Results: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73–1.08, moderate) and speed (p < 0.05; g = 0.40–0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03–1.81). Conclusions: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration. [ABSTRACT FROM AUTHOR]

Despite the abundance of literature highlighting poor sleep quality among medical students and its detrimental impact on their mental well-being and academic performance, no study has been conducted to investigate the sleep quality of undergraduate medical students in Rwanda to date. Therefore, this study sought to determine the magnitude of sleep quality of undergraduate medical students in Rwanda and to compare the scores of seven components of sleep quality across classes. This cross-sectional study was conducted among 290 undergraduate medical students aged 18–35 years (mean = 24, SD = 2.9) randomly recruited countrywide from 1st November 2021 to 1st March 2022. The questionnaire was self-administered with 2 sections: characteristics of medical students, and Pittsburgh Sleep Quality Index (PSQI). The Pearson Chi-square test was used to test whether the categories of seven components of sleep quality differ between classes, then ANOVA followed by the post hoc test was used to test if the seven components and global score of Pittsburgh Sleep Quality Index differ between classes. The results revealed that the global PSQI mean score was 7.73 (SD = 2.83), with fifth-year medical students reporting the highest PSQI mean score (M = 8.44, SD = 2.77), followed by first-year (M = 8.15, SD = 3.31). One-way ANOVA showed that the global PSQI score (F = 2.76, p = 0.028), subjective sleep quality (F = 3.35, p = 0.011), habitual sleep efficiency (F = 10.20, p < 0.001), and daytime dysfunction (F = 3.60, p = 0.007) were significantly different across classes. Notably, the post hoc test revealed significant scores differences in the global PSQI score between class II and V (p = 0.026), in subjective sleep quality between class I and II (p = 0.043), and between class I and IV (p = 0.016); habitual sleep efficiency between class V and all other classes (p < 0.001); and daytime dysfunction between class III and IV (p = 0.023). This paper concludes by arguing that poor sleep quality is highly prevalent among medical students in Rwanda, with final and first-year students reporting the poorest sleep quality. There were significant differences across classes in the global PSQI, subjective sleep quality, habitual sleep efficiency, and daytime dysfunction. Intervention approaches such as sleep education, behavioral changes, and relaxing techniques are recommended to address contributing factors and ultimately maximize the academic goals of Rwandan medical students. [ABSTRACT FROM AUTHOR]

Background: Certified training courses in all-terrain vehicle (ATV) operation are recommended, but little has been published regarding how they affect riding behaviors. Our objectives were to determine adolescents' ATV riding exposures, crashes and injuries, and the association of completing certified ATV training on riding behaviors. Methods: Respondents completed an anonymous paper survey at 30 school districts approximately one year after participating in the Safety Tips for ATV Riders (STARs) program. Survey data were compiled using Qualtrics™. Frequency, chi-square, Fisher's exact test, and logistic regression analyses were performed using SAS, V.9.4. Results: 4,891 students completed the survey from Fall 2012–Fall 2019. Respondents were 10–18 years old, and similar numbers of participants were male and female. Fifty-nine percent lived in town, 18% on a farm, and 22% in the country but not on farm. Forty-two percent reported their families owned an ATV. Seventy-seven percent had ridden an ATV, 40% of whom reported riding at least weekly. The vast majority (94%) used ATVs for recreation and 49% used them for work purposes. In the previous year, 22% of riders reported having been in a crash, with 7% of crash victims requiring medical attention for injuries. Greater crash likelihood was seen in males, recreational riders, more frequent riders, competitive racers and those who had ridden with passengers or on roads. Only 8% of riders had completed certified ATV safety training (note, STARs is not a certification program). Those whose families owned ATVs, more frequent riders, and public park users had greater likelihoods of course completion. Relative to their peers, respondents who completed a certification course had higher proportions that always/almost always wore helmets (39% vs. 20%, p < 0.0001) and lower proportions that never/almost never wore helmets (29% vs 58%, p < 0.0001), had ridden with passengers (63% vs. 96%, p < 0.0001), and had driven on public roads (41% vs 50%, p = 0.0065). Conclusions: ATV safety training certification among Iowa adolescents in the study was infrequent but those that received training reported higher helmet use, less riding with passengers, and less driving on public roads. These data suggest completing safety training certification may promote safer riding behaviors among youth. [ABSTRACT FROM AUTHOR]

This paper examines the mental health of service providers working with Syrian refugees. Using the Professional Quality of Life framework, we hypothesize greater stress/less support from the work, person, client environment is associated with symptoms of STS, depression, and anxiety. We surveyed a sample of 104 service providers throughout Istanbul late 2018. Multivariable logistic regression examined associations between work (organizational support, caseload, supervision), person (perceived social support), client environment (trauma disclosure, percent Syrian refugees) on STS, depression, and anxiety. We found rates of moderate-to-severe STS to be 27.88%; depression 40.38%; and anxiety 29.81%. Our hypothesis was partially supported. Lower organizational support was associated with moderate-to-severe STS (aOR 0.91, 95% CI 0.84, 0.99) while lower social support with anxiety (aOR 0.89, 95% CI 0.81, 0.99). Caseload, supervision, trauma disclosure, percent refugees did not show significant associations. Organizations working with Syrian refugees may benefit from enhancing organizational support and promoting social support for staff. [ABSTRACT FROM AUTHOR]

In this paper, MTL, an approach for visualization-based pedagogy, is analyzed and contextualized in both Cognitive Load Theory (CLT) and Dual Coding Theory (DCT). Through MTL, lectures, tutorials, laboratory sessions and individual study in learning and teaching programming are all carried out using two cognitive channels; verbal and non-verbal. RAM diagrams together with animations are used to visualize (represent the images of) codes, while text and voice are used for verbal presentations. A class experiment was carried out to evaluate the impact of using MTL together with animations in teaching programming. The chi-square test results revealed that, students' performance on one question (question 1) was significantly (p < 0.0001) higher for the experimental group (23.53%) as compared to the control group (1.89%). Similarly, the results of the chi-square test revealed that, students' performance on another question (question 2) was significantly (p < 0.0001) higher for the experimental group (23.53%) as compared to the control group (1.14%). It is concluded that the MTL approach enhances comprehension since it allows the use of two cognitive channels, which, in turn, reduces cognitive load. [ABSTRACT FROM AUTHOR]

This paper is devoted to investigate the implications of Einstein-Aether and modified Hořava–Lifshitz theories of gravity to the formation of light elements in the early universe named as big bang nucleosynthesis. We choose different models from these theories for a detailed investigation of big bang nucleosynthesis epoch and compare it with the observational bounds. That is, we compare the deviation of freeze-out temperature T f with the Λ CDM paradigm and use observational bounds on Δ T f T f to inspect constraints on the involved free parameters of these models. We apply Chi-square test on the Hubble parameter H in each model to analyze the compatibility of model parameters with the observations and find consistent results. We find that chosen models of Einstein-Aether gravity and modified Hořava–Lifshitz gravity can satisfy big bang nucleosynthesis constraints and thus constitute a viable cosmology since they can be source for dark energy sector and late-time accelerated expansion. [ABSTRACT FROM AUTHOR]

A large body of research has documented an immigrant mortality advantage. However, we still do not know enough about how interactions between the characteristics of origin and destinations countries shape variabilities in immigrants' experiences and health. In this paper, we examine the effects of ethno-cultural similarities and differences between the country of origin and the country of destination on immigrants' longevity. We use meta-regression methods to examine data on 78 origin and 16 destination countries (1092 risk estimates from 69 studies). In contrast to expectations from approaches that focus on immigration/acculturation stress, we found that a shared official linguistic family, moving to a country where one is not likely to be considered a visible minority, and more integrative immigration policies actually reduce or even eliminate the immigrant mortality advantage. We discuss potential explanations for these findings and argue that selection mechanisms provide a better account. [ABSTRACT FROM AUTHOR]

Aim: Owing to the COVID-19 pandemic, many companies shifted to telework, with few insights into its implementation, organisational conditions or the role of workplace health promotion and management. This study focused on a multifactorial investigation of conditions in companies which implemented and evaluated telework during the first lockdown in 2020 as well as on their future intentions to facilitate teleworking under health-promoting working conditions. Subject and methods: The research hypotheses relate to an extended technology acceptance model. In a mixed-methods design, expert interviews were fed into the development of an online questionnaire. Out of 1858 contacted companies representing a broad range of Austrian businesses, 192 responses (general management, workplace health managers, etc.) were analysed using descriptive and multivariate statistics. Results: The degree of implementation and claim to teleworking increased significantly during the first lockdown and did not return to pre-pandemic levels afterwards. Changes depended on preparation and experience: evaluation of teleworking and willingness to continue offering teleworking were conditional on preparation and the degree of implementation. Prerequisites for future intentions to implement health-promoting teleworking included readiness, general willingness and existing workplace health promotion/management structures. Conclusion: This paper demonstrates the potential of health-promoting organisational cultures for development processes – particularly in times of crisis. Anchoring health-focused structures in companies helps to create health-promoting frameworks. Health-promoting teleworking can be developed from workplace health promotion/management using established approaches. It is essential to build on in-house capacities and competencies to develop awareness for a holistic culture for health-promoting (tele)work and to encourage deliberations about potential measures. [ABSTRACT FROM AUTHOR]

This paper reports the results of a randomized controlled trial (RCT) to assess the efficacy of Nexus, a telehealth delivered intervention that combines Couples' HIV counseling and testing (CHTC) with home-based HIV-testing, examining the impact of the intervention on the couples' formation and adherence to safer sexual agreements. Between 2016 and 2018, 424 couples were recruited online from the U.S and randomized to the intervention arm (a telehealth delivered CHTC session with two home HIV-testing kits) or a control arm (two home HIV-testing kits), with study assessments at baseline, 3 and 6 months. Outcomes were the formation and adherence to safer sexual agreements, dyadic discordance in sexual agreements, breakage of sexual agreements, and perceptions of PrEP. Couples in the intervention arm had significantly greater odds of reporting a safer sexual agreement (3 months OR 1.87, p-value 0.005, and 6 months OR 1.84, p-value 0.007), lower odds of reporting discordant sexual agreements at 6 months (OR 0.62, p-value 0.048), and a significantly lower odds of reporting breaking their sexual agreement (3 months OR 0.51, p-value 0.035, and 6 months OR 0.23, p-value 0.000). By 6 months, couples in the intervention arm were less likely to say PrEP was beneficial to one (RRR 0.33, P = 0.000) or both of them (RRR 0.29, P = 0.000) than being beneficial to neither of the partners. The high levels of acceptability and efficacy of the intervention demonstrate strong potential for the scale-up of this efficacious intervention that is delivered through a low-cost telehealth platform. [ABSTRACT FROM AUTHOR]

In this paper, the problem of testing the hypothesis of linear combination of k-sample means of high-dimensional data is investigated under a low-dimensional factor model. We propose a new test and derive that the asymptotic distribution of the test statistic is a weighted distribution of independent chi-squared distribution of 1 degree of freedom under the null hypothesis and mild conditions. We provide numerical studies on both sizes and powers to illustrate performance of the proposed test. [ABSTRACT FROM AUTHOR]

The ability to do inquiry does not necessarily translate to understandings about scientific inquiry or the processes by which scientific knowledge is generated. The study reported in this paper focuses on what students know about scientific inquiry and what impact school science may have on this knowledge. We investigated grade 12 physical and life sciences students' understandings about eight core aspects of the nature of scientific inquiry (NOSI) at a diversity of high schools in South Africa. Data were collected in two phases. In phase 1, the Views About Scientific Inquiry (VASI) questionnaire was administered to 203 grade 12 students from six schools across different socio-economic spectra (township, former model c and independent schools). Phase 2 constituted follow-up semi-structured interviews with 20% of the questionnaire respondents (n = 41). The findings revealed that grade 12 students held mostly naïve and mixed understandings about the NOSI. Though observed differences indicated that students at elite independent schools held more informed views than students at suburban and township schools, chi-square test of association (X2) for different school types showed a statistically significant difference in students' understandings only for one NOSI aspect. This finding was regarded as being insignificant to make claims of differences in students' NOSI understandings for the different school types. The implications of these findings and future directions for research are also discussed. [ABSTRACT FROM AUTHOR]

Introduction: Smoking during pregnancy can affect infant birthweight. We tested whether an intervention that promoted scheduled gradual reduction improved birth outcomes among pregnant women who smoked. We also examined race differences in birth outcomes. Methods: We conducted a 2-arm randomized controlled trial where pregnant women who smoked received either SMS text-delivered scheduled gradual smoking reduction (SGR) program plus support texts or support messages only throughout their pregnancy. The outcomes for this paper were birth outcomes including birth weight and gestational age obtained from chart review. Analyses were conducted using chi-square and t-tests in SAS. Results: We approached 2201 pregnant women with smoking history. Of the 314 women recruited into the study, 290 completed a medical release form (92%). We did not find any significant differences in birth outcomes by arm or race. The majority of participants reduced smoking by the 80%. Women who reduced more than 50% of their baseline cigarettes per day had a birth weight increase of 335 g compared to those that did not (p = 0.05). The presence of alcohol/drug use in prenatal visit notes was associated with low infant birth weight (p = 0.05). Discussion: The scheduled gradual reduction intervention did not improve birth outcomes. Additional research is needed to help improve birth outcomes for pregnant women who engage in tobacco and illicit substance use. Clinical Trial #: NCT01995097 [ABSTRACT FROM AUTHOR]

Introduction: Though text messages are increasingly used in health promotion, the current understanding of text message-based interventions to increase screening mammography in low-income African American women is limited. This study aimed to assess the feasibility and acceptability of a text message-based intervention to increase screening mammography in low-income African American women. Materials and Methods: A 15-item, self-administered, paper-based survey on cell phone ownership, text messaging practices and preferences for future breast health information was administered to 120 female patients at an urban family medicine office. Descriptive analyses and demographic correlates of text messaging practices and preferences were examined. Results and Discussion: The majority of respondents (95%) were cell phone owners of whom 81% reported texting. Prior receipt of a text message from a doctor's office was reported by 51% of cell phone owners. Mammography appointment reminders were the most desired content for future breast health text messages. Age (≥ 70 years old) was found to have a significant negative relationship with text messaging practices and perceptions. Implications: The use of text messages to promote mammography was found to be acceptable in this patient population. In addition to age, variables such as the frequency, timing and subject content of text messages also influence their acceptability. [ABSTRACT FROM AUTHOR]

Introduction: Regulatory bodies recommend that outcome measures used in Alzheimer's disease (AD) clinical trials capture clinically meaningful changes for the trial participant. However, commonly used outcome measures do not reflect the individual's views on what matters to them individually. The aim of the electronic Person-Specific Outcome Measure (ePSOM) programme is to better understand what outcomes matter to patients in early Alzheimer's disease. Methods: As part of the ePSOM programme, we designed and ran an online study to understand what matters to individuals when developing new treatments for AD. The ePSOM survey ran Aug 2019–Dec 2019 (UK) and collected primarily free text responses which were analysed using Natural Language Processing (NLP) techniques. In this paper, we focus our analyses on individuals who reported having a neurodegenerative disease diagnosis (primarily Mild Cognitive Impairment (MCI) or AD), reporting the most frequent and most important brain health priorities for this group. Due to a small sample size, the Diagnosis group was analysed as a whole. Finally, we compared the Diagnosis group to an age and gender matched control group using chi-squared tests to look for any differences between the Diagnosis and control groups' priorities. Results: The survey was completed by 5808 respondents, of whom 167 (2.9%) (women n = 91, men n = 69, other n = 7) had received one of our pre-defined neurodegenerative disease diagnosis: most commonly MCI n = 52, 1.1% (mean age 69.42, SD = 10.8); or Alzheimer's disease n = 48, 1.0% (mean age 71.24, SD = 9.79). Several thematic clusters were significantly more important for the target diagnostic group, e.g.: Expressing opinions; and less important, e.g., Cognitive Games. Conclusion: We conclude there are a range of outcomes which individuals consider important and what potential new treatments should help maintain or improve, suggesting that outcomes that matter shift along the preclinical, prodromal and overt dementia continuum. This has important implications for the development of outcome measures in long term prevention studies that last several years where participants may pass through different stages of disease. In the final stage of our project, we will design an electronic outcomes app which will employ the methodology tested in the large-scale survey to capture what matters to individuals about their brain health at an individual level. [ABSTRACT FROM AUTHOR]

Objectives: Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to examine the prevalence and predictors of symptoms of PMADS among Black women. Methods: Black women completed a paper survey between August 2019 and October 2019. Binomial logistic regression was employed to examine predictors of PMAD symptoms. Results: The prevalence of symptoms of PMADs was 56%. A higher proportion of women with PMADs had experienced depression (16% vs. 32%, p = 0.006); physical (18% vs. 31%, p = 0.030), emotional (35% vs. 61%, p = 0.000), or sexual abuse (12% vs. 29%, p = 0.002); and symptoms of depression or anxiety before pregnancy (18% vs. 46%, p = 0.000). After adjusting for socio-demographics in multivariate analysis, experiencing symptoms of depression or anxiety before pregnancy (adjusted odds ratio [aOR] = 3.445, p = 0.001) was positively associated with experiencing symptoms of PMADs, whereas higher levels of self-esteem (aOR = 0.837, p = 0.000) were negatively associated with experiencing symptoms of perinatal mood and anxiety disorders. Conclusions for Practice: The prevalence of PMAD symptoms among this sample of Black women was alarmingly high. Women who experienced PMADs were more likely to report adverse childhood experiences (e.g., physical, emotional, and/or sexual abuse). By understanding the prevalence of PMADs and the factors associated with these disorders, healthcare professionals can improve diagnosis and treatment rates among this understudied and underserved population. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper was to investigate online health information seeking and health literacy among non-medical college students in Egypt and the differences between the two genders. Subjects and methods: A cross-sectional descriptive design was used to collect data from 600 students through a self-administered questionnaire. Results: Most of the students searched for health information on the internet (82.3%). 90.3% of them used their mobile phones and 97.8% sought data via Google. Skin and hair problems was the most searched for topic (83.3%), followed by reproductive health (79.7%). Students perceived that rapid and easy access to information were the main advantages of health information seeking online (98.5% and 95.5%, respectively), while the lack of reliability and scarcity of information in the Arabic language were the main disadvantages (78.2% and 60.5%, respectively). Only 31.2% of the sample achieved an adequate literacy level. Females in our sample had a higher frequency of online health information seeking and a higher level of health literacy. They also had a higher percentage of searching for health data on YouTube and seeking nutrition information. On the other hand, males used online health applications more frequently and were more interested in physical fitness and smoking. Females perceived the high cost as the main disadvantage of online health information seeking, while males were more concerned about the reliability of information. Health literacy was positively related to female gender and frequency of online health information seeking. Conclusion: Using the internet to deliver health information according to each gender's preferences and concerns can encourage students to search for health information online and, therefore, raise their health literacy level. [ABSTRACT FROM AUTHOR]