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• The Family Check-Up Online (FCU-O) is a parenting program with telehealth coaching. • Parent participants faced challenges including mental illness and substance misuse. • Participants were primarily low income, and about one-third-resided in rural areas. • Findings offer preliminary support for the FCU-O among parents of young children. • The FCU-O improved parenting skills, parenting self-efficacy, and depressive symptoms. Online parenting interventions hold promise for increasing access to behavioral support for families with low income and who reside in rural areas. The current study evaluates the efficacy of a mobile app-based parenting support program, the Family Check-Up Online (FCU-O) with telehealth coaching support, for parents of children 1.5-5 years old at risk of experiencing parenting challenges. We tested effects of the FCU-O on parent wellbeing (parenting self-efficacy and symptoms of depression and anxiety) and parent-reported parenting skills (support for positive behavior, limit-setting, and proactive parenting) at the 3-month follow-up in a randomized controlled trial (FCU-O versus control). We also tested relationships between parents' baseline characteristics and their engagement with the app and telehealth coaching. Eligibility criteria included endorsing depressive symptoms or current or past substance misuse. Participants (N = 356) were predominantly White (72%) and low-income, with 43% of families residing in a rural area. Approximately one-third-of participants reported clinically significant symptoms of anxiety or depression and one-third-endorsed a lifetime history of opioid misuse. Intent to treat analyses tested effects of the FCU-O on parent wellbeing and parenting skills. The FCU-O was associated with improvements to parents' support for positive behavior, limit-setting, and proactive parenting skills, as well as parenting self-efficacy and depressive symptoms. Parents' initial symptoms of depression and anxiety significantly predicted greater telehealth coach engagement; low levels of initial self-reported skills positive behavior support and limit-setting significantly predicted greater app engagement. Results provide support for the FCU-O as a preventive parenting intervention for parents experiencing mental health challenges, with implications for reducing barriers to accessing parenting support for underserved families. [ABSTRACT FROM AUTHOR]

The relation between various types of plant-based diets and cancer risk is still unclear. We examined the association of the overall plant-based diet index (PDI) and healthy (hPDI) and unhealthy plant-based diet indices (uPDI) with the risk of selected digestive cancers. We used data from a network of hospital-based case–control studies including 942 oral/pharyngeal, 304 esophageal, 230 stomach, 1953 colorectal, and 326 pancreatic cancer cases. We calculated PDI, hPDI, and uPDI from a validated food frequency questionnaire. We used multivariable logistic regression models to estimate the odds ratios (OR) of selected digestive cancers across the three indices (in quintiles, Q, or tertiles, T, and in continuous). The PDI was significantly inversely associated with oral/pharyngeal (OR Q5 vs Q1 =0.63, 95% confidence interval, CI, 0.47–0.84) and esophageal cancer risk (OR T3 vs T1 =0.47, 95% CI 0.31–0.72). The inverse associations appeared stronger for the hPDI (oral cavity/pharynx: OR Q5 vs Q1 =0.52; 95% CI 0.39–0.70; esophagus: OR T3 vs T1 =0.59, 95% CI 0.39–0.91; stomach: OR T3 vs T1 =0.42, 95% CI 0.27–0.67; colorectum: OR Q5 vs Q1 =0.69; 95% CI 0.57–0.84; pancreas: OR T3 vs T1 =0.60; 95% CI 0.41–0.89). In contrast, the uPDI was directly associated with the risk of oral/pharyngeal (OR Q5 vs Q1 =1.43, 95% CI 1.06-1.94), colorectal (OR Q5 vs Q1 =2.28, 95% CI 1.86–2.81), and pancreatic cancer (OR T3 vs T1 =1.74, 95% CI 1.14–2.65). Esophageal and stomach cancer risks were non-significantly increased by 34% and 46% respectively in the highest uPDI quantile. A plant-based diet, especially a healthy plant-based diet, may reduce the risk of various digestive cancers, whereas an unhealthy plant-based diet may increase the risk. The quality of plant-based diets is important for digestive cancer risk evaluation and prevention. [ABSTRACT FROM AUTHOR]

• Despite high burden, significantly less is known about non-fatal drowning. • Using data linkage, cases of non-fatal drowning from the pre-hospital setting were analysed. • For every one drowning fatality, 15 non-fatal drownings were attended by ambulance. • Despite lower fatalities, drowning burden among adolescents and females is revealed when analysing non-fatal drowning data. • Results indicate a need to widen primary prevention efforts across population groups. Introduction : Drowning is a preventable cause of mortality, with 279 unintentional drowning deaths per year in Australia. Despite larger estimated numbers, less is known about nonfatal drowning compared to fatalities. This study aimed to examine the burden of fatal and nonfatal drowning in the Australian state of New South Wales using pre-hospital case capture. Methods: A cross-sectional analysis of individuals attended by an ambulance in NSW for drowning between 2010 and 2021 was conducted. Ambulance data (paper-based and electronic medical records) were linked to emergency department and death registry. Ratios of fatal to nonfatal drowning were constructed overall, by sex, age, and remoteness of incident and residential locations. Results: 3,973 ambulance-attended drowning patients were identified (an annual rate of 4.16/100,000 persons). Six percent (6.1%; n = 243) died within 30 days, 82.7% (n = 201) of which died on the day of incident, including at the scene. Mean survival time for those who died between 2 and 30 days was 4.6 days. The overall ratio of fatal to nonfatal incidents was 1:15. Ratios were highest for 10–19 year-olds (1:77), females (1:22), and in metropolitan incident (1:20) and residential (1:23) locations. Across the study drowning declined by 14 incidents and 0.18 fatalities per year. Discussion: Temporal trends indicate declining drowning incidents and fatalities. However, this study highlights significant numbers of nonfatal incidents among those traditionally seen as lower risk, such as adolescents and females, necessitating a widened focus on improving water safety among these groups. Conclusions: Nonfatal drowning results in significant, yet preventable health system burden in New South Wales. Practical Applications: This study highlights the importance of documenting the full burden of drowning, including health system impacts of a preventable cause of injury and death. Such data may be used to encourage further investment in primary prevention efforts. [ABSTRACT FROM AUTHOR]

In absence of national legislation, local governments may stimulate outdoor sports clubs to become smoke-free. However, it is unknown whether and to what extent such efforts are effective in encouraging sports clubs to adopt a smoke-free policy (SFP). The aim of this study was to assess the association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs. Retrospective, cross-sectional. Information on Dutch sports clubs (N = 3068) was linked to information on tobacco control policies of municipalities (i.e., "smoking prevention policies", "smoke-free environment policies", and "smoke-free sports policies") (N = 218). Multilevel logistic regression models examined the association between municipal tobacco control policies and the prevalence of SFPs among outdoor sports clubs, while controlling for sports clubs' characteristics. We found a positive, dose-response association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs. The odds of having an SFP in place was significantly higher for sports clubs in municipalities with moderate "smoking prevention policies" (OR = 1.85, 95%CI = 1.18–2.89), strong "smoke-free environment policies" (OR = 1.95, 95%CI = 1.19–3.20), and strong "smoke-free sports policies" (OR = 1.66, 95%CI = 1.02–2.24) compared to sports clubs in municipalities with no/weak policies. The results suggest that local tobacco control policies can increase the prevalence of SFPs among outdoor sports clubs. In order to create maximum effect, local policies need to be comprehensive and widely implemented. [ABSTRACT FROM AUTHOR]

Emergency medical services personnel are frequently subjected to strenuous physical tasks, such as lifting and moving patients, as well as working in awkward postures. These activities can result in a variety of debilitating injuries, including musculoskeletal disorders (MSDs). As a result, this systematic review and meta-analysis study aimed to examine the frequency of MSDs among emergency medical services personnel. Systematic review and meta-analysis. This systematic review and meta-analysis study was conducted based on the PRISMA guidelines. The protocol of this work is registered in PROSPERO with the code CRD42024506958. Searches were conducted without time limits in several databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar until February 12, 2024. The I2 index was used to assess heterogeneity, and random effects model was used for meta-analysis. Data were analyzed using STATA version 14. A total of 709 articles were obtained by initial search in the mentioned databases. Following a thorough screening and quality assessment, 27 articles were chosen for meta-analysis. The findings revealed that the overall prevalence of MSDs among emergency medical services personnel is 56.52% (95% CI: 35–78.04, I2 = 99.8%, P < 0.001) and the prevalence in different areas of the body are as follows: the low back (47.38%), upper back (35.15%), neck (31.19%), shoulder (30%), knee (27.07%), hand (20.70%), hip/thigh (19.48%), feet (19.11%), and elbow (17.36%). The prevalence of MSDs among emergency medical services personnel is very high. Considering the importance of the role of these employees and the specific risk factors of their jobs, it is recommended that periodic screening is prioritized. In addition, attention should be paid to the ergonomic evaluation of the work environment and the design of appropriate ergonomic interventions. [ABSTRACT FROM AUTHOR]

Intraoperative hypotension (IOH) is a common occurrence during anesthesia administration for various surgical procedures and is linked to postoperative adverse outcomes. Factors contributing to IOH include hypovolemia, vasodilation, and impaired contractility, often combined with patient comorbidities. Strategies for mitigating IOH have been developed and are continually being updated with new research and technological advancements. These strategies include personalized blood pressure thresholds, pharmacologic measures, and the use of predictive tools. However, the management of IOH also requires careful consideration of patient-specific comorbidities and the use of appropriate treatment options. [ABSTRACT FROM AUTHOR]

Precursors are evoked upstream of the Capgras' syndrome. Then, an analogy is suggested between the need for prognostic classification linked to the saturation of the asylum population at the dawn of the 20th century, and the current overflow of the psychiatric healthcare system. The contemporary situation justifies the search for information useful to mitigate ill mental health in at-risk adolescents. The article presents recent research reports on adolescents at-risk of emotional dysregulation, stemming from a longitudinal cohort database of European adolescents. The database analyses have revealed new brain and psychometric predictors of emotional dysregulation in adolescents. New early indicators were derived from easy-to-administer questionnaires, exploring emotions, affective symptoms and traits, sleep, early adversity and stress, puberty. Findings suggest that the physiology and stages of brain development could be taken into account for decisions regarding Mental Health. Studies on adolescent brain development have implications for public health, in terms of the age of protection for adolescents, and targeted prevention upstream of care. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is highly prevalent in the Australian community, ranking amongst the highest globally. The consequences of AF are significant. Stroke, dementia and heart failure risk are increased substantially, hospitalisations are amongst the highest for all cardiovascular causes, and Australians living with AF suffer from substantial symptoms that impact quality of life. Australian research has made a significant impact at the global level in advancing the care of patients living with AF. However, new strategies are required to reduce the growing incidence of AF and its associated healthcare demand. The Australian Cardiovascular Alliance (ACvA) has led the development of an arrhythmia clinical theme with the objective of tackling major research priorities to achieve a reduction in AF burden across Australia. In this summary, we highlight these research priorities with particular focus on the strengths of Australian research and the strategies needed to move forward in reducing incident AF and improving outcomes for those who live with this chronic condition. [ABSTRACT FROM AUTHOR]

Patients in the intensive care unit (ICU) are at a high risk of developing incontinence-associated dermatitis (IAD), the incidence and severity of which are positively related to pressure injuries, thus affecting nursing quality indicators. This quality improvement project aimed to decrease the severity and incidence of IAD, with a focus on enhancing awareness among nursing staff. This 36-month project was implemented via the Plan-Do-Study-Act (PDSA) model. and setting: Included staff members worked in the ICUs (central and emergency ICUs) at a Grade A tertiary hospital in Suzhou (South of Jiangsu), China. The quality improvement project included three main procedures: (1) formulating and implementing a modified prevention and treatment nursing protocol for early structured skin care with perineum ventilation, formulating a guidance sheet for incontinence nursing care; (2) organizing training and assessments of theories and skills, including three special sections on incontinence care training (theoretical knowledge, project process, video watching), skills training for nursing staff, and an incontinence nursing workshop to engage and evaluate all staff; (3) annual analysis and discussion of nursing quality control. Following project completion, there was a decrease in the overall incidence of IAD. Moreover, ICU nurses may attach more importance/awareness to IAD. This project successfully reduced the incidence of IAD among ICU patients. • Reduced IAD in ICU : Significant decrease in dermatitis incidence. • Nursing Training Enhanced : Specialized incontinence care workshops held. • PDSA Model Success : Improved nursing quality indicators over 36 months. • New Skin Care Protocol : Early care with perineum ventilation implemented. • Continuous Quality Control : Annual reviews to boost incontinence care. [ABSTRACT FROM AUTHOR]

This research is a descriptive and cross-sectional study aimed at examining the use of three different scales to assess the risk of pressure injury (PI) in surgical patients. This study was conducted between February 1 and July 1, 2022. The study included patients who had planned surgery in general surgery clinic. The sample size was 388 patients. Patients who agreed to participate in the study were asked to fill out the " Introductory Information Form " and perform a risk assessment using the Braden, Munro and 3S Scales. The statistics program IBM SPSS Statistics 25.0 packaged software was used in the analyses of data. It is evident that the relationship between the scales and the diagnosis of PI, as well as the strength of this relationship, are statistically significant (p < 0.05). The Munro Scale exhibited the highest value of Phi value and validity coefficient c, indicating a stronger association with the diagnosis of PI, thus suggesting its greater effectiveness in discrimination. According to the validity coefficients found, it can be stated that the correct classification percentages for Munro, Braden, and 3S Scales were 91 %, 71 %, and 66 %, respectively. The findings of this study indicate that both the Braden, Munro, and 3S Scales can be used for PI risk assessment in surgical patients, but the Munro Scale exhibits superior predictive validity compared to the Braden and 3S Scales in terms of overall sensitivity and specificity. • The risk of PI in surgical patients should be assessed with a valid and reliable risk assessment tool. • There is no clear evidence regarding which PI risk assessment tool should be used in surgical patients. • Munro and 3S Scale are among the PI risk assessment tools in surgical patients. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine family caregivers' level of knowledge on pressure injury (PI) prevention. This study used a cross-sectional and descriptive design. Data were collected between February and May 2023. The population of the study consisted of family caregivers providing care to patients who were at risk of developing pressure injuries and who were planned to be discharged from the inpatient wards of the hospital. A total of 105 family caregivers participated in the study. Of all the patients, 61.9 % (n = 65) were female and their average age was 68.96 years (SD = 18.07). While 30.48 % (n = 32) of the patients were bedridden due to Cerebrovascular Accident, 28.57 % (n = 30) were bedridden due to old age, and 28.57 % (n = 30) had PI. Of all the caregivers, 71.43 % (n = 75) were female, and their average age was 47.11 years (SD = 14.85). While 97.14 % (n = 96) of the caregivers had not received any training on PI before, 90.48 % (n = 95) had not provided care to a patient with PI before. Family caregivers scored an average of 22.25 (SD = 6.96) points out of 40 on the Pressure Injury Prevention Knowledge Test (PIPKT). A significant difference was detected between the knowledge test scores and education level and income level (P = 0.006; P = 0.002). Family caregivers were found to need information about PI prevention. It is recommended to develop content on PI prevention in the guidelines for family caregivers. • Family caregivers need education on preventing pressure bases. • Education should be planned in line with the education level and needs of the caregiver family member, and should start at the time of discharge and continue afterwards. [ABSTRACT FROM AUTHOR]

Many contemporary designs solely prioritize the therapeutic function of footwear, neglecting other crucial social and environmental considerations. The study aimed to explore challenges to therapeutic footwear usage for foot ulcer prevention. A qualitative critical ethnography design was used in this study. Fourteen participants were recruited at the local hospital in Baise City, China. Data were collected through in-depth interview. A thematic analysis approach was conducted for data analyzing. This study identified two themes: (1) workplace and physical condition, (2) diverse cultural practice. It was worth noting that slipper as a convenient and cheap wearing choice, decreased the usage of therapeutic footwear. The emerging activity of modern square dancing resulted in more requirements for its design. And the symbolic meaning of hard working in barefoot was also challengeable to therapeutic footwear utilization to some extent. Therapeutic footwear intervention design should not only focus on the therapeutic functionality, but also consider about individuals' demands towards working environment and physical status, and particular insights regarding culture and social background. We expected these findings could be evidence for improving therapeutic footwear usage in the future. • The use of special shoes for medical purposes is affected by one's work environment. • Your own physical health affects the way you take care of your feet. • People's willingness to use medical shoes is connected to their personal habits. • The cultural environment can pose challenges to using medical footwear. [ABSTRACT FROM AUTHOR]

Explore attitudes and practices of Australian professionals using ankle taping or bracing for the management and prevention of lateral ankle sprains. Cross-sectional study. Anonymous online survey. Australian healthcare or athletic workers, registered with an official governing body, involved in the management and/or prevention of lateral ankle sprains. Quantitative data was collected from 20 close-ended questions. Qualitative data from 14 open-ended questions were categorized into topics using inductive thematic analysis. Data was analysed using descriptive statistics and presented in figures and tabular format. A total 160 respondents answered the survey; the majority were podiatrists (42.5%), physiotherapists (23%), or sports/athletic trainers (13.8%). Ankle supports were overwhelmingly recommended and considered to be effective in the management (95% and 89% bracing and taping, respectively) and prevention (96% and 92% bracing and taping, respectively) of lateral ankle sprains. For management, semi-rigid brace with straps (26%) and figure eight taping technique (42%) were the most frequently used. For prevention, the most commonly used were soft brace with straps (30%) and the figure eight taping technique (37%). Australian professionals expressed a positive attitude towards using ankle supports in the management and prevention of lateral ankle sprains. • Ankle supports are recommended to manage and prevent lateral ankle sprains. • Contrast in current practice and guidelines for support type and duration of use. • Patient personal preference is an important factor for ankle support selection. [ABSTRACT FROM AUTHOR]

It is impossible to fully understand why the United States has consistently failed to protect its citizens from firearm violence until one understands some of the key discrepancies that exist at the center of the firearm policy debate. Differences in language, data categorization, and research related to firearms and their impacts in the United States contribute to confusion and debate between firearm policy advocates and opponents, ultimately stalling progress toward some common goals. As frontline health professionals, emergency nurses must be aware of these nuances in order to be informed advocates for the safety of their patients and their communities. Emergency nurses can use the information from this article to help inform screening and education related to firearm safety and injury prevention. They can also use this information to inform nursing research as well as local and national advocacy efforts related to firearm injuries and deaths. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) may affect up to 40% of patients post-operatively depending on the type of operation. They are a burden both for the patient and the healthcare system due to the valuable resources they consume, with each colorectal SSI costing the National Health Service (NHS) on average £10,523 per patient. SSIs can be classified as superficial, deep and/or organ/space, and there are many modifiable and non-modifiable risk factors. There has been recent published guidance on SSI prevention by a number of international organizations including the World Health Organization (WHO) in 2016, the Centers for Disease Control and Prevention (CDC) in 2017 and the National Institute for Health and Care Excellence (NICE) in 2020. [ABSTRACT FROM AUTHOR]

Effective prevention could protect the health of the workforce, save human capital loss, and maintain employee productivity as well as economic growth. Using real-world data of patients with end-stage kidney disease (ESKD) and lung cancer, we multiplied their lifetime survival functions with employment ratios and working salaries to estimate the lifetime employment durations and earnings. They were compared with corresponding age-, sex-, and calendar year-matched referents to assess the differences in loss of lifetime employment duration and earnings. From 2000 to 2017, 83,358 patients with end-stage kidney disease (ESKD) were associated with 32–66% lifetime productivity losses. Similarly, we collected 24,904 incident cases of lung adenocarcinoma during 2011–2018 and estimated the potential savings in human capital due to early detection. Based on the evolving trends of ESKD incidence rates in Taiwan, we calculated the lifetime human capital losses of ESKD patients in GDP (gross domestic product) percentages during 2000–2020. The aggregate lifetime productivity losses of ESKD in terms of GDP% varied between 0.000398% and 0.01% for male patients and between 0.0001% and 0.009% for female patients. The younger the patients, the bigger the losses in GDP%. Similarly, early detection of lung adenocarcinoma saved lives and productivity to some extent. Successful prevention of catastrophic illnesses at early stages would save the lifetime employment duration and productivity of the workforce. Future reform on the NHI could consider closer coordination between public health and healthcare organizations, focusing on effective prevention of diseases and complications to save productivity loss. [ABSTRACT FROM AUTHOR]

Curative technologies improve patient's survival and/or quality of life but increase financial burdens. Effective prevention benefits all three. We summarize estimation methods and provide examples of how much money is spent per quality-adjusted life year (QALY) or life year (LY) on treating a catastrophic illness under a lifetime horizon and how many QALYs/LYs and lifetime medical costs (LMC) could be potentially saved by prevention. We established cohorts by interlinkages of Taiwan's nation-wide databases including National Health Insurance. We developed methods to estimate lifetime survival functions, which were multiplied with the medical costs and/or quality of life and summed up to estimate LMC, quality-adjusted life expectancy (QALE) and lifetime average cost per QALY/LY for catastrophic illnesses. By comparing with the age-, sex-, and calendar year-matched referents simulated from vital statistics, we obtained the loss-of-QALE and loss-of-life expectancy (LE). The lifetime cost-effectiveness ratios of ventilator-dependent comatose patients, dialysis, spinal cord injury, major trauma, and cancers were US$ 96,800, 16,200–20,000, 5500–5,900, 3400–3,600, and 2900–11,900 per QALY or LY, respectively. The successful prevention of lung, liver, oral, esophagus, stomach, nasopharynx, or ovary cancer would potentially save US$ 28,000–97,000 and > 10 QALYs; whereas those for end-stage kidney disease, stroke, spinal injury, or major trauma would be US$ 55,000–300,000 and 10–14 QALYs. Loss-of-QALE and loss-of-LE were less confounded indicators for comparing the lifetime health benefits of different technologies estimated from real-world data. Integration of prevention with treatment for resources allocation seems feasible and would improve equity and efficiency. [ABSTRACT FROM AUTHOR]

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. 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.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. 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.)

As e-scooters have become common modes of transportations in urban environments, riding e-scooters has become a common mechanism of injury. This study examines the relationship between when riders are using these devices (i.e. day of week, and time of the day) and injury incidence based on data from a large U.S. city. This study is a retrospective cohort study of patients in the trauma registry at a level one trauma center. Registry data were combined with a publicly available dataset of all e-scooter trips that occurred during the study period. Frequency of injuries and trips were analyzed using ANOVA. Poisson regressions were conducted to calculate incidence rate ratios associated with injury incidence by day of the week and time of day. A total of 194 injured e-scooter patients were admitted to the trauma center during the study period. Patients were injured most often on Fridays (21%) and most often presented between 18:00–23:59 (38%). E- Scooter riders in general, most often rode on Saturdays (20%) and between 12:00–17:59 (44%). There was no significant relationship between day of week and injury. Riders in the early morning (IRR = 16.7, p <.001 95% CI: 10.5, 26.6), afternoon (IRR = 2.0, p =.01 95% CI: 1.2, 3.4), and evening (IRR = 3.7, p <.001 95% CI: 2.3, 6.2) had significant increased injury incidence compared to morning riders. E -Scooter injury incidence varies by the time of day. The time of day in which a person rides an e-scooter can have a significant impact on the likelihood that the person will sustain an injury. [ABSTRACT FROM AUTHOR]

Risk factor modification may decrease the risk of cardiovascular disease (CVD). Whether risk factor modification can mitigate the effect of hyperuricemia on CVD is unclear. This study aimed to investigate the risk of CVD among individuals with hyperuricemia, according to risk factors on target, compared with controls without hyperuricemia. This prospective study included 91,722 participants free of CVD at baseline (2006–2007) of the Kailuan study. Individuals with hyperuricemia were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking, physical activity, healthy diet, guideline-recommended levels of body mass index, blood pressure, fasting blood glucose, and total cholesterol). During a median follow-up of 13.00 years, 671 out of 6740 individuals (9.96%) with hyperuricemia and 6301 out of 84,982 control subjects (7.41%) had incident CVD. Compared with control subjects without hyperuricemia, individuals with hyperuricemia who had 4 or 5 to 7 risk factors on target had no significant excess CVD risk, the hazard ratio (HR) (95% confidence internal [CI]) was 0.93 (0.79–1.10) and 0.88 (0.71–1.10), respectively. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors on target, the HR of CVD associated with per additional risk factor within target range was 0.82 (95% CI, 0.77–0.87). Similar results were yielded for CVD subtypes. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors within target. [Display omitted] • The excess risk of CVD was progressively lower in hyperuricemia with more risk factors within target range. • Hyperuricemia with 5 to 7 risk factors within target had a similar or even lower risk of CVD as non-hyperuricemia. • These findings emphasized the importance of hyperuricemia control and risk factor modification in the prevention of CVD. [ABSTRACT FROM AUTHOR]

Kitesurfing is a popular activity among recreational athletes in Germany, and the number of athletes is constantly increasing. The objective of this study was to examine the influence of athletic experience and equipment choice on the frequency of kitesurfing injuries in Germany. Sixty-six athletes completed a standardized questionnaire at the beginning and end of a summer season. Baseline parameters, injury patterns and the use of safety equipment were recorded. Injuries were categorized as proposed by Brukner and Khan, and their severity and relationship with the previously mentioned parameters were analyzed. Nineteen of the participants (29%) reported a total of 24 injuries during the season, resulting in 230 h per injury and 4.3 injuries per 1000 h of kitesurfing. Eleven bone lesions, 10 skin lesions and 3 ligamentous injuries were observed. Experienced athletes were less frequently injured (p = 0.010). The use of a kite release system did not lower the frequency of injuries (p = 0.558). Both the frequency and severity of kitesurfing injuries were relatively low in our study. None of the examined materials had an influence on the frequency of injuries, but experienced athletes were less frequently injured. [ABSTRACT FROM AUTHOR]

• The largest series of pediatric cases of immediate hypersensitivity related to chlorhexidine, mostly represented by anaphylaxis (grades II–IV), confirmed by allergy tests and diagnosed in France. • In the setting of domestic use and misuse of chlorhexidine at home. • Hypothesis of sensitization, increases in case numbers, context of recurrence, and measures to prevent immediate allergies to chlorhexidine. Immediate allergic reactions to chlorhexidine have been clearly identified in numerous countries, generating governmental warnings worldwide. The aim of our study was to characterize (i) these allergies, which are less reported in pediatric populations, and (ii) the patient-at-risk profile so as to suggest preventive measures. In association with the allergy department and the regional pharmacovigilance center in Rennes University Hospital, France, a multicenter retrospective, descriptive, and observational study was conducted using data from the national pharmacovigilance database for the period of January 1, 2010 to June 30, 2020. Immediate allergies to chlorhexidine cases based on a clinical history compatible with an immunoglobulin E (IgE)-mediated reaction, along with positive allergic testing, were analyzed. Of the 478 cases identified, 17 pediatric cases of immediate allergic reaction to chlorhexidine (13 cases of grades II–IV anaphylaxis) were retained for the analysis. For 58.8 % of these cases, a history of a previous more moderate reaction to the substance was identified. The reactions occurred most frequently in cases of domestic misuse (88.2 %, n = 15/17) of chlorhexidine to dress a wound. Recurrence was reported for two cases, later leading to severe reactions at each new exposure to the allergen, suggesting an aggravation mechanism. The number of pediatric cases of immediate allergies to chlorhexidine has possibly been underestimated on account of insufficient knowledge of the allergy and in view of its common usage. Information on the method of caring for wounds among children and on the risk of allergic sensitization as well as exploring any unusual reaction to chlorhexidine application could reduce the number of allergic reactions. [ABSTRACT FROM AUTHOR]

• Bone strength is impaired in most NMDs. • Bone strength needs to be addressed and treated in NMDs. • Time to initiate bone health monitoring, indication and type of therapy, and duration of clinical follow-up are not defined for most NMDs. • Longitudinal skeletal phenotyping is key to understand the individual's bone health trajectory. • Bisphosphonates seem efficacious as first-line therapy in bone fragility treatment in NMDs. The 274th ENMC workshop for optimizing bone strength in neuromuscular disorders (NMDs) was held on January 19–21, 2024. The group of participants included experts in the fields of bone health and neuromuscular medicine along with the patient voice. Bone strength represents a crucial aspect of the management of pediatric and adult patients with NMDs. Bone strength may be compromised due to different pathophysiologic mechanisms, including disrupted bone–muscle "cross-talk", loss of biomechanical loading, nutritional insufficiency, inadequate weight-bearing physical activity, muscle weakness and/or immobility, and drug treatment. While for Duchenne muscular dystrophy recommendations for evaluation and treatment of bone strength have been published, evidence on bone strength in other hereditary and acquired NMDs is scarce. Enhanced knowledge is needed to understand the development and maintenance of bone strength in patients with NMDs. This workshop aimed to develop a strategy to improve bone strength and thus prevent fractures in patients with NMDs. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. Information is needed on vaccination protocols used by veterinarians and dairy producers to prevent and control infections in dairy herds. This observational study described farm's vaccination standard operating procedures (SOP) developed by veterinarians in collaboration with dairy producers in Québec. Data pertaining to vaccination protocols and dairy producer practices were collected as part of the biosecurity component of the National Mandatory Quality Assurance Certification Program (proAction). Generalized statistical mixed-effects models were used to assess associations between dairy herd characteristics and the vaccination SOP, encompassing various vaccination types. These included any vaccination, core vaccines only (bovine respiratory syncytial virus, infectious bovine rhinotracheitis herpesvirus, parainfluenza virus type 3, bovine viral diarrhea virus type 1 and type 2), and vaccination against diarrhea, mastitis, or clostridial diseases. These models accounted for random variations related to clustering by veterinarians and veterinary clinics. Furthermore, the variance of the outcome was partitioned into producer, veterinarian, and veterinary clinic levels to explore the proportion of the total variance attributable to each group. A total of 3,759 standardized vaccination procedures completed between 2018 and 2021 were analyzed. At least one vaccination target was included in the vaccination SOP in 90% of the dairy herds. The most frequently included vaccine in the SOP was core vaccines, comprising 88%, followed by mastitis (22%), neonatal diarrhea (18%), and clostridial disease vaccines (15%). The vaccination SOP, particularly core, mastitis, and diarrhea vaccinations, mainly varied due to the veterinarian's characteristics, followed by the clinic's characteristics. In contrast, the decision to included clostridial vaccination primarily varied with the veterinary clinic (76%). Organic producers generally included fewer vaccinations in their SOP, including core vaccines, than conventional producers. In addition, producers who were providing access to pasture had fewer vaccination SOP for vaccination against mastitis and neonatal diarrhea but more vaccination SOP for clostridial vaccination. [ABSTRACT FROM AUTHOR]

We reviewed the proper evaluation process, diagnostic work-up, and treatment procedures for patients with urolithiasis to prevent the recurrence of stone formation. It is essential to determine the type of stone and conduct specific blood and urine analyses to inform the course of treatment for patients. The aim of this review was to define patients who are at high risk of recurrence of urolithiasis, to delineate diagnostic and therapeutic algorithms for each type of stone, and to clarify general guidelines and recommendations for prevention of recurrence. A professional research librarian carried out literature searches for all sections of the urolithiasis guidelines, covering the timeframe between 1976 and June 2023. For every patient with urolithiasis, an attempt should be made to analyse the stone. Patients should be given general instructions on how to prevent recurrence, including adequate fluid and calcium intake, and low consumption of sodium and protein. Identifying and correcting the causative factors is a cornerstone in preventing the recurrence of urolithiasis. Diagnostic and therapeutic algorithms by stone composition are available. Every patient should undergo baseline metabolic screening, while patients with calcium stones, who are at high risk of relapse and complications, should undergo extensive metabolic screening with two 24-h urine collections and should receive targeted therapy. Patients with uric acid, infection, or cystine stones are at high risk of relapse. All patients at high risk of recurrence should be closely monitored, especially those not complying with therapy in the long term. Metabolic stone evaluation and patient follow-up are highly recommended to prevent urolithiasis recurrence. [ABSTRACT FROM AUTHOR]

This manuscript offers an in-depth comparative examination of the effectiveness of higher-dose (double standard-dose and high-dose) influenza vaccines in contrast to a single standard-dose vaccine when it comes to alleviating major cardiovascular events. Meta-Analysis. To conduct this study, an exhaustive search was carried out in the medical English literature using databases such as PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL until 10 April 2024. The evaluation of associations was achieved through the calculation of pooled relative risks (RRs) accompanied by their corresponding 95% confidence intervals (CIs). A meticulous analysis encompassed a comprehensive cohort of 68,713 patients. Among these participants, 34,430 individuals were randomly assigned to receive a higher-dose influenza vaccination, whereas 34,283 received the standard influenza vaccination. Contrary to initial expectations, a higher-dose influenza vaccine did not manifest elevated efficacy compared to the standard-dose vaccine in terms of mitigating major cardiovascular events. The computed pooled RR stood at 1.0, accompanied by a 95% CI ranging from 0.93 to 1.10. While this systematic review and meta-analysis did not find a statistically significant advantage of higher-dose influenza vaccines over a single standard-dose vaccine in preventing major cardiovascular events, the observed trend towards risk reduction warrants continued investigation. These findings contribute to the ongoing dialogue surrounding vaccination strategies and their implications for cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) accounts for nearly a third of musculoskeletal disorders in ballet dancers. LBP has a significant short- and long-term impact on dancers' performance, career, income, identity and overall health. However, the literature provides little specific guidance for the prevention and management of low back pain in ballet dancers. Against this background, this review presents those considerations and highlights gaps in the literature that warrant future research. We examined 15 bibliographical databases from February to June 2022. Recommendations for prevention and treatment formulated in the current literature omit elements of key importance for classical dancers and do little to distinguish the issues they face from those facing other athletes. The management of LBP in classical dancers needs to take proper account of the biopsychosocial and environmental landscapes in which they work. Building trustful relationships, shared decision-making and exploration of dancers' beliefs are key pillars of LBP care. The current literature does not fully explore these issues and fails to provide dance-specific screening tools. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. 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.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. 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.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. 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.)

The epidemiology data and global burden of diabetic foot disease underscores the need for effective prevention strategies, which requires an early diagnosis. Patient-reported outcome measures are instruments based on a simple format, which favours their application. Currently, there is an absence of instruments with a broad enough scope to capture the diverse aspects involved in diabetic foot disease. To develop a questionnaire for the assessment of patients with diabetic foot disease and carry out an analysis of its validity and reliability. The study was developed in two stages. Stage 1: the Delphi Panel was composed of 22 experts. The questionnaire is made up of 25 questions selected, after three rounds, from an initial sample of 68 questions. Stage 2: A validation study was performed. With a sample of 273 subjects, an exploratory factor analysis and an analysis of internal consistency, items response, and validity were carried out using the Diabetes Quality of Life, SF-12v2, Foot Function Index and EuroQol EQ5D questionnaires. Measurements of error and sensitivity to change were also analyzed. A 25-item questionnaire (DiaFootQ) was developed. It comprised two dimensions: 1) lifestyle and function; and 2) footwear and foot self-care. Sample (n=273) mean age was 69.77 years (±11.08). The internal consistency of DiafootQ was α=0.916, and item response values were ICC=0.862–0.998. External validity correlation levels ranged from r=0.386 to r=0.888. DiaFootQ was developed. Integrating the main aspects involved in diabetic foot disease could help to detect more accurately the risk or severity of these patients. DiaFootQ is a well-structured, valid, and reliable tool whose use should be promoted in clinical and research settings. • The DiaFootQ is a new instrument for the assessment and monitoring of patients with diabetic foot disease. • A thorough Delphi method was used for the DiaFootQ development. • DiaFootQ is highly innovative since it provides reports from the multiple aspects of diabetic foot disease. • The DiaFootQ proved to have adequate face, content, internal and external validity. [ABSTRACT FROM AUTHOR]

Previous findings from a clinical trial demonstrated noninferiority of Leukocyte- and platelet-rich fibrin (L-PRF) compared to commercially available fibrin sealants in preventing postoperative cerebrospinal fluid leakage, necessitating intervention. This cost-effectiveness evaluation aims to assess the value-for-money of both techniques for dural closure in supratentorial and infratentorial surgeries. Cost-effectiveness was estimated from a health care payer's perspective alongside a randomized clinical trial comprising 328 patients. The analysis focused on clinical and health-related quality of life outcomes, as well as direct medical costs including inpatient costs, imaging and laboratory costs, and outpatient follow up costs up to twelve weeks after surgery. Clinical and health-related quality of life data showed no significant differences between L-PRF (EuroQol five dimensions questionnaire 0.75 ± 0.25, 36-item Short Form Survey 63.93% ± 20.42) and control (EuroQol five dimensions questionnaire 0.72 ± 0.22, 36-item Short Form Survey 60.93% ± 20.78) groups. Pharmaceutical expenses during initial hospitalization were significantly lower in the L-PRF group (€190.4, interquartile range 149.9) than in the control group (€394.4, interquartile range 364.3), while other cost categories did not show any significant differences, resulting in an average cost advantage of €204 per patient favoring L-PRF. This study demonstrates L-PRF as a cost-effective alternative for commercially available fibrin sealants in dural closure. Implementing L-PRF can lead to substantial cost savings, particularly considering the frequency of these procedures. [ABSTRACT FROM AUTHOR]

The prodromal phase of schizophrenia provides an optimal opportunity to mitigate the profound functional disability that is often associated with fully expressed psychosis. Considerable evidence supports the importance of neurocognition in the development of interpersonal (social) and academic (role) skills. Further findings from adolescents and young adults at clinical high risk for developing psychosis (CHR P) suggest that treatment for functioning might be most effective when targeting early and specific neurocognitive deficits. The current study addresses this critical intervention issue by examining the potential of neurocognitive deficits at intake for predicting social and role functioning over time in CHR-P youth. The study included 345 CHR-P participants from the second phase of the North American Prodrome Longitudinal Study (NAPLS2) with baseline neurocognition and 2-year follow-up data on social and role functioning. Slower baseline processing speed consistently predicted poor social functioning over time, while attention deficits predicted poor role functioning at baseline and follow-up. In addition, the impact of processing speed and attention impairments on social and role functioning, respectively, persisted even when adjusting the regression models for attenuated positive, negative, and disorganized symptoms, and transition status. The current study demonstrates for, arguably the first time, that processing speed and attention are strongly predictive of social and role functioning over time, respectively, above and beyond the impact of symptoms and those CHR-P individuals that develop psychosis over the course of the study. These findings imply that early neurocognition is a critical treatment target linked to the developmental trajectory of social and role functioning. [ABSTRACT FROM AUTHOR]

Access to parenthood is not always easy, and various difficulties can sometimes emerge. Often underdiagnosed, these peri- and post-partum disorders have a major impact on the quality of early interactions. Prevention and fast care are fundamental. In Nancy, France, a mobile perinatal psychiatry team (EMPPer) was created in September 2021 with the aim of "reaching out" to these vulnerable populations with care access difficulties. A clinical case combining precariousness, migration, maternal psychopathological disorders, baby's psycho-affective and psychomotor development trouble is exposed. This article aims to present the multidisciplinary network intervention of EMPPer. [ABSTRACT FROM AUTHOR]