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This paper focuses on an innovative approach to preparing children and young people, with Spina Bifida, to move from child-centered to adult-oriented healthcare systems. Reflecting on our role in delivering a national nurse led service, we set to identify and critique international transition tools in use for this population. Specifically, we aimed to identify the core capabilities and indicators of progression to successful transition, so that holistic interventions could be planned to match the needs of individuals and their carers. There were two phases to the study, initially focusing on a systematic literature review on transition tools and the specific items that these tools captured, including skills, abilities and behaviors. Phase two culminated in the articulation of a segmented and incremental "road map", aligned with facets deemed essential for a successful healthcare transition. The reporting of the literature review (phase one) followed the PRISMA guidelines and shaped the qualitative element of the study (phase two) through the use of semi-structured interviews and thematic analysis. The search strategy yielded 11 studies, which were then manually searched for other relevant literature, adding a further 14 articles. The review analyzed 7 specific tools for spina bifida and 8 generic tools, which were deemed appropriate for this group of patients. A comprehensive list of core capabilities was then articulated and framed to fit a progression timeline. Specific interventions were formulated to explore ways to co-produce resources that could enhance and support a planned transition to adult-focused services. Our proposed mapping of capabilities and progression could shape other transition programs, where nurses work collaboratively with young people, carers and other members of a team. More work is needed to further explore and embed the framework that, as we did, could be digitized and shared with all stakeholders involved in the transition process. [ABSTRACT FROM AUTHOR]

Rabies is a fatal zoonotic disease affecting all mammalian species. It is caused by the rabies virus and is prevalent worldwide. Horses are not commonly infected with rabies but their vaccination is recommended due to the potential zoonotic risk. This study aimed to evaluate the duration of immunity following rabies vaccination in horses. A total of 126 serum samples were collected from 93 horses, vaccinated 6 to 91 months before sampling. Rabies-virus-neutralizing antibody (RVNA) levels were evaluated using the Rabies Fluorescent Focus Inhibition Test (RFFIT). A protective RVNA titer of above 0.5 IU/mL was found in 112 (88.9%) of the samples and 84 (90.3%) of the horses. Antibody titers declined over time (rho = −0.271, p = 0.002); however, there was no significant difference in antibody titers or the prevalence of unprotected horses between the time intervals following vaccination. Purebred horses had lower antibody titers (p = 0.024). The response to booster vaccination was inspected in ten horses, and increased antibody titers were found in eight of them. The results of this study demonstrate the prolonged persistence of protective immunity in horses following rabies vaccination, in some cases, for up to eight years. Therefore, the current annual vaccination strategy should be re-evaluated. A rate of 9.7% of poor responders should be considered from an epidemiological perspective in order to minimize the risk of emergence of the disease. [ABSTRACT FROM AUTHOR]

This JAMA Insights reviews the health effects of vaping among youth in the US and current recommendations for screening and treatment. [ABSTRACT FROM AUTHOR]

Purpose: Youth with chronic medical conditions are vulnerable to unique alcohol-related health consequences, yet there are few prevention strategies targeting this group. Youth with chronicmedical conditions parents' beliefs and provision of alcohol-related guidance have not yet been explored, which limits the development of effective family-based interventions. Methods: We evaluated baseline surveys of youth with chronic medical conditions and their parents (n = 268 dyads) enrolled in a randomized controlled trial of a psychoeducational intervention to reduce alcohol use by youth with chronic medical conditions. Surveys evaluated youth alcohol use, parent beliefs about their child's alcohol use, and parental provision of alcohol guidance, including disease-related and disease-independent (ie, "drinking and driving") topics. Paired bivariate tests (2, Fisher exact) were used to measure associations between youth with chronic medical conditions alcohol use and parent alcohol-related beliefs and provision of alcohol-related guidance. Results: In this study of 268 parent-youth dyads, many parents did not provide guidance on disease-specific topics, such as mixing alcohol with medications (47.8%) or risk of flares (37.6%). Furthermore, youth with chronicmedical conditionswhose parents had expectant beliefs about alcohol use (ie, alcohol use is "inevitable" or "OK with supervision") were more likely to report alcohol use (all P values <0.05). Discussion: These findings suggest parent beliefs may influence youth with chronic medical conditions alcohol use. Proactive, disease-specific education from medical providers to parents of youth with chronic medical conditions may help to reduce adverse consequences of alcohol use in these vulnerable youth. [ABSTRACT FROM AUTHOR]

Abstract: The directors of the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism have proposed new efforts to enable earlier identification and intervention for harmful substance use and its consequences. As editors of The ASAM Principles of Addiction Medicine, we fully support this goal. The word "preaddiction" has been suggested as a diagnostic label to describe individuals who would be targeted for early intervention. In this commentary, we offer that "unhealthy substance use" would be a better descriptor than "preaddiction" and review several potential barriers to be addressed in order to maximize the impact of introducing this new paradigm., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 American Society of Addiction Medicine.)