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Urinary tract infections (UTIs) make up a significant proportion of the global burden of disease in vulnerable groups and tend to substantially impair the quality of life of those affected, making timely detection of UTIs a priority for public health. However, economic and societal barriers drastically reduce accessibility of traditional lab-based testing methods for critical patient groups in low-resource areas, negatively affecting their overall healthcare outcomes. As a result, cellulose-based materials such as paper and thread have garnered significant interest among researchers as substrates for so-called frugal analytical devices which leverage the material's portability and adaptability for facile and reproducible diagnoses of UTIs. Although the field may be only in its infancy, strategies aimed at commercial penetration can appreciably increase access to more healthcare options for at-risk people. In this review, we catalogue recent advances in devices that use cellulose-based materials as the primary housing or medium for UTI detection and chart out trends in the field. We also explore different modalities employed for detection, with particular emphasis on their ability to be ported onto discreet casings such as sanitary products. [ABSTRACT FROM AUTHOR]

Construct validity of novel tablet-based neurocognitive tests (in the NeuroScreen app) measuring processing speed, working memory, and executive functioning in adolescents and young adults (AYA) living with perinatally-acquired HIV (PHIV) and perinatal HIV-exposure without infection (PHEU) was examined. Sixty-two AYA (33 PHIV, 29 PHEU) were recruited from an ongoing longitudinal study (CASAH) in New York City. Medium to large and statistically significant correlations were found between NeuroScreen and gold standard, paper-and-pencil tests of processing speed, working memory, and executive functioning. Results provide partial support for NeuroScreen as an alternative to cumbersome paper-and-pencil tests for assessing neurocognition among HIV-affected AYA. [ABSTRACT FROM AUTHOR]

The discharge of older people from hospital at night is a topical and emotive issue that has recently gained media attention in New Zealand and the United Kingdom, including calls to prevent it occurring. With growing pressures on hospital capacity and ageing populations, normative aspects of hospital discharge are increasingly relevant. This paper therefore addresses the question: Should older people (say, over eighty years old) ever be discharged home from hospital during the night? Or given safety concerns, should regulation against the night-time discharge of older people be put in place? Employing a principlist lens to bioethics, this paper considers key principles or values involved, including discharge safety concerns, personal preference and consent, the risk of remaining in hospital, and broader considerations around discharge policy. These points act as a possible framework for further research and discussion of normative aspects of hospital discharge. Overall, this paper argues that while discharge safety concerns must be properly acknowledged and addressed, it can still sometimes be appropriate for an older person to leave hospital at night. The option of night-time discharge should therefore remain open to people of all ages. [ABSTRACT FROM AUTHOR]

Long COVID, also known as "post-acute sequelae of COVID-19," affects at least 65 million individuals worldwide with a wide spectrum of symptoms that may last weeks, months, or permanently. Its epidemiology and burden in Africa are unclear. This meta-analysis examines long-term COVID-19 effects in the WHO African Region. A systematic search in several databases was carried out up to 12 February 2023 including observational studies from African countries reporting the cumulative incidence of long COVID signs and symptoms. Only studies conducted in African countries were included. Several sensitivity and meta-regression analyses were performed. Among 1547 papers initially screened, 25 were included, consisting of 29,213 participants. The incidence of any long COVID symptomatology was 48.6% (95% CI 37.4–59.8) as psychiatric conditions were the most frequent, particularly post-traumatic stress disorder reaching a cumulative incidence of 25% (95% CI 21.1–30.4). Higher age (p = 0.027) and hospitalization (p = 0.05) were associated with a higher frequency of long COVID. Long COVID poses a significant burden in Africa, particularly concerning psychiatric conditions. The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients. High-quality studies addressing this condition in African setting are urgently needed. [ABSTRACT FROM AUTHOR]

Public health officials promoted COVID-19 vaccines to limit burdens placed on the U.S. healthcare system and end the pandemic. People in some closed religious communities refused to vaccinate and likely acquired temporary immunity through infection. This paper compares the death rates in Amish, Old Order Mennonites, and conservative Mennonite groups to a rate estimated for the U.S. population. Approximately two-thirds of the U.S. population was immunized against COVID-19, while few in the Amish/Mennonite community were. We find divergent patterns. Once vaccines became available, excess deaths declined in the general population and remained elevated among Amish and Mennonites. Vaccination campaigns must consider and value the cultural beliefs of closed religious communities to be effective. [ABSTRACT FROM AUTHOR]

This paper explores how Western medicine may not fully understand and address post-traumatic stress disorder (PTSD) and other trauma-induced illnesses in a culturally appropriate manner in marginalized communities and offers a theoretical framework to develop comprehensive, effective, and sustainable solutions that comprehensively address and treat the trauma on both a collective and individual level. Focused on Palestinians, this paper discusses the collective trauma Palestinians experienced and how it manifests in transgenerational effects on the body and mind that may be post-traumatic stress disorder (PTSD) or perhaps another distinct condition that is yet to be codified in the Western medical lexicon. It describes local alternatives to Western medical diagnostic tools like the "ease to disease" diagnostic scale and the sociopolitical context—in this case, the Palestinian fight for karamah, or dignity—from which such alternatives arise. Based on these findings, a novel theoretical framework, the comprehensive communal trauma intervention model (CCTIM), a truly transdisciplinary population-level model for treating mental health in vulnerable communities globally, is proposed. It articulates the need to address the root cause of collective trauma, make modifications to the healthcare system, and cultivate strategic equity-oriented and research-based partnerships. [ABSTRACT FROM AUTHOR]

This paper describes a case study of an Outreach and Drop-in Centre (ODIC) established under the National Action Plan for Drug Demand Reduction, Ministry of Social Justice and Empowerment, Government of India. In the quantitative part, data were gathered from the ODIC office documents and analysed using MS Excel. Linear regression analysis demonstrated a relationship between the number of in-centre clients and the number of Community Outreach Programmes (COPs). Similarly, this study examined the relationship between the number of networks established and the number of participants in COPs. Hence, two regression lines were derived accordingly. In addition, qualitative data collected through key informant interviews corroborated the quantitative results. This case study highlights the importance of networks and COPs in increasing the reach of ODIC and ensuring the quality of services. Finally, in partnership with other government agencies, this ODIC sets a model for engaging marginalised adolescents in reducing substance abuse. [ABSTRACT FROM AUTHOR]

Stress fractures likely have a 1–2% incidence in athletes in general. In runners, a more vulnerable population, incidence rates likely range between 3.2 and 21% with female runners having greater susceptibility. The incidence of femoral shaft stress fractures is less well known. New basic and translational science research may impact the way clinicians diagnose and treat femoral stress fractures. By using a fictitious case study, this paper applies bone science to suggest new approaches to evaluating and treating femoral shaft stress fractures in the running population. [ABSTRACT FROM AUTHOR]

The present project utilized a Learning Collaborative (LC) to disseminate the Behavioral Health Home Plus (BHHP) physical-behavioral health integration model to providers serving two behavioral health populations at risk for adverse health conditions: youth psychiatric residential treatment facilities (five sites) and adult opioid treatment providers (seven sites). Following the positive results of a randomized controlled trial utilizing an LC to implement two behavioral health home models in community mental health provider organizations serving adults with serious mental illness, Community Care Behavioral Health Organization facilitated integration of the models to scale health and wellness supports to additional behavioral health care delivery settings. This paper presents provider results focused on BHHP implementation training, LC implementation, physical health and wellness promotion within sites, and BHHP model sustainment plans. Provider self-reported data indicate that the LC approach is a successful tool for integrating and sustaining BHHP model components in routine care. [ABSTRACT FROM AUTHOR]

Hidden heterogeneity poses serious challenges to survival analysis because the observed (aggregate) and the unobservable (individual) hazard functions may differ markedly from each other. However, the recent discovery of the so-called "mortality plateau" (i.e., the approximately constant value when mortality levels off, at very old ages) has brought new insights and pushed researchers towards the use of the gamma-Gompertz mortality model. Among the assumptions of this model, two are particularly relevant here: the shape, not the level, of the individual hazard function is a constant and so is the rate of ageing, i.e., the relative increase in mortality risks as people get older. The latter, however, does not pass empirical tests: the rate of ageing seems to vary (albeit only slightly) by age, gender, birth cohort and country. In this paper, we propose a new model (EGG, or extended gamma-Gompertz) which overcomes this limitation by allowing the rate of ageing to increase gradually with age before converging to a constant value, as in Gompertz. While preserving all the fine theoretical and empirical properties of its simpler predecessor, the EGG model adapts better to empirical reality, i.e., in this paper, the mortality profile of the cohorts born between 1820 and 1899 in five countries with high-quality data. The advantages of this more refined mortality model are discussed. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that entrepreneurship does not pay enough to compensate people for the risk that it entails. It sometimes even shows an entrepreneurship discount. This paper shows that such a discount can arise if entrepreneurial skills and working skills are negatively correlated in the population of agents. The paper also shows that in an otherwise standard occupational choice setting, the entrepreneurship premium rises with entrepreneurial scarcity and falls with their span of control. Finally, liquidity constraints on startups raise the entrepreneurship premium by lowering the equilibrium wage. [ABSTRACT FROM AUTHOR]

Police officers are at risk of being exposed to multiple traumas throughout their careers. Compared to the general population, police officers are also at elevated risk for the development of post-traumatic stress disorder (PTSD), increased suicidal ideation, and increased substance use. Cognitive-behavioral interventions have proven empirical validity for the prevention and treatment of PTSD and complex trauma. However, the efficacy of these interventions in police officers has not been studied. This paper will provide the practitioner with an overview of the factors that contribute to the complexity of trauma exposure in police officers, describe trauma-focused cognitive behavioral therapy as an evidence-based treatment for this population, and illustrate how this treatment can be adapted to better fit the needs of police officers. Implications of these adaptations and suggestions for future areas of intervention research with law enforcement are also described. [ABSTRACT FROM AUTHOR]

Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first 'state of the art', identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations. [ABSTRACT FROM AUTHOR]

The relationship between problem gambling and homelessness is a little studied area in the gambling studies field. A recent study by Sharman et al. (J Gambl Stud, doi: 10.1007/s10899-014-9444-7, 2014) is the first quantitative study in Great Britain on this interesting and important topic. In this context, the study is to be commended and provides an empirical benchmark on which other studies can build. The study reported a problem gambling prevalence rate of 11.6% and is significantly higher than the problem gambling rate of the general population in Great Britain (which is <1%). However, given the political sensitivity surrounding the expansion of bookmakers in the UK, the study needs further contextualization otherwise the findings of such studies may be used by anti-gambling lobby groups to serve their own political agendas. While it is good that such an area has been empirically investigated in Great Britain, this paper briefly (1) places the issue of problem gambling among the homeless into the wider context of problems among the homeless more generally (particularly in relation to mental health problems and other addictive behaviors), (2) highlights some of the methodological problems and weaknesses of the study, and (3) notes a number of factual errors made in the paper. [ABSTRACT FROM AUTHOR]

Immigrant Latinas (IL) experiencing intimate partner violence (IPV) often experience barriers to accessing formal support systems due to immigration-related issues (e.g., fear of deportation, language proficiency, lack of family support in the U.S.). This paper contains a systematic review of peer-reviewed published articles within the past 25 years addressing IPV prevention and intervention programming designed for this vulnerable population. We examined specific group-format programs and curricula conducted at community-based agencies with social services across the country. Qualitative analysis of the 10 articles that met search criteria (i.e., programs must be culturally specific, designed to serve IL, conducted in group-format, focused on IPV intervention or prevention) generated information regarding the nature of group interventions addressing this issue and population. Several themes emerged upon completion of the qualitative review describing key characteristics of each intervention. All reviewed articles reported generally positive outcomes using a variety of methods. Studies using quantitative methods found statistically significant outcomes for constructs including depression, self-esteem, and knowledge of wellness. Professionals from diverse practice settings working with IL would likely benefit by developing intervention and prevention group-format programming to address this problem. [ABSTRACT FROM AUTHOR]

The 2015 UK Supreme Court judgment in Montgomery v Lanarkshire reinforces the importance of informed consent to medical treatment. This paper suggests that Montgomery recognises the challenge faced by vulnerable individuals in choosing between treatment options and making decisions with appreciation of information about material risks. The judgment endorses a form of weak paternalism to safeguard such persons, which is not disrespectful of the aggregate principles of the Mental Capacity Act 2005. But ethical practice requires professionals to tread carefully between weak and hard paternalism in the context of therapeutic interactions with vulnerable patients, while ensuring their awareness of material risks. [ABSTRACT FROM AUTHOR]

Forced marriages were criminalized in Spain in 2015, both as a specific form of coercion (offence against liberty) and as a type of human trafficking. However, the criminalisation was carried out with limited data on existing cases and without empirical research questioning whether forced marriages were taking place in Spain and what specific individuals were at risk. This paper presents the main findings of an empirical study aimed at detecting the existence of victims of forced marriage in this country and at describing the dynamics and characteristics of the processes which led to their victimisation. A total of 150 support organizations operating in Spain reported their knowledge of the extent and dynamics of forced marriages, revealing the existence of people forced to marry against their will, including some legal residents and even Spanish nationals. The research identifies at least 57 victims who have received assistance from support organizations. People most at risk were very young women, usually from North African, Sub Saharan African or Central Asian, as well as, to a lesser extent, Roma, and with a large percentage of Spanish nationals and legal residents. Mechanisms used to compel the victims are usually subtle, far from those more incisive active means required in the Spanish legislation. The results contribute to the debate on what is tolerable in today's globalized society and underscore the need to understand this reality before regulating it. [ABSTRACT FROM AUTHOR]

Despite significant progress in research on the treatment and prevention of psychological, behavioral, and health problems, the translation of this knowledge into population-wide benefit remains limited. This paper reviews the state of America's children and families, highlighting the influence of stressful contextual and social conditions on child and family well-being and the concentration of disadvantage in numerous neighborhoods and communities throughout the nation. It then briefly reviews the progress that has been made in pinpointing policies that can reduce stressful contextual conditions such as poverty, discrimination, and the marketing of unhealthful foods and substances. It also describes numerous family and school interventions that have proven benefit in preventing psychological and behavioral problems as diverse as tobacco, alcohol, and other drug use; depression; antisocial behavior; academic failure; obesity prevention; and early childbearing. We argue that progress in translating existing knowledge into widespread benefit will require a nationwide effort to intervene comprehensively in neighborhoods and communities of concentrated disadvantage. We present a strategic plan for how such an effort could be organized. The first step in this organizing would be the creation of a broad and diverse coalition of organizations concerned with advancing public health and well-being. Such a coalition could increase public support both for the policies needed to focus on these disadvantaged areas and the research needed to incrementally improve our ability to help these areas. [ABSTRACT FROM AUTHOR]

Aim: Long-term invasively ventilated patients exhibit exceptional and resource-intensive healthcare needs. However, major knowledge gaps in Germany complicate appropriate approaches to best address these demands. This paper evaluates available information on the patient group and their healthcare needs from German data sources and derives implications for healthcare planning and regulation by national/federal self-governing bodies, political decision-makers, and specialized providers. Methods: Based on the concept of needs, we addressed the normative dimension typically characterized by epidemiological data. Based on existing German health system data resources, an explorative approach was utilized to identify and characterize available databases providing information on the patient group and/or their healthcare. Results: To date, no available database provides information on the healthcare needs of this patient group. As of the reporting year 2017, the diagnosis-related groups (DRG) statistics will provide hospital-specific data on home invasive ventilation interventions, but the data do not provide information on long-term care. Claims data may be a promising source for cross-sectoral evaluation of healthcare needs but feature methodological challenges. These results call for efforts to address limited data eligibility, adopt a broader understanding of healthcare needs, and identify actions needed to evidence informed and needs-oriented healthcare. Conclusion: Future approaches on needs-oriented specialized healthcare should close the existing knowledge gap based on reliable data. In addition to normative information, they should consider subjective dimensions on a life course perspective and quantitative and qualitative service performance characteristics across multiple sectors and professions. [ABSTRACT FROM AUTHOR]

The Intervention with Microfinance for AIDS and Gender Equity (IMAGE) programme has been scaled up to three provinces in South Africa. This paper explores associations between women's engagement in the intervention, intimate partner violence (IPV) and factors associated with IPV and partner abuse. We enrolled women receiving group-based microfinance loans plus gender training into the scaled-up IMAGE cohort study (n = 860). We present cross-sectional analysis on participants' characteristics and intervention engagement and use multivariate logistic regression to explore associations. 17% of women reported lifetime (95% CI 15 to 20%) and 7% past year (95% CI 5 to 9%) IPV, 9% past-year economic (95% CI 7 to 11%) and 11% past-year emotional (95% CI 9 to 14%) abuse. Women under 35 years had higher levels of IPV and emotional abuse. 53% of women attended all the trainings, 83% continuously borrowed and 98% agreed the training had a major impact on their life. Attendance was associated with improved partner relationships (χ2p < 0.001), but not lower IPV risk. Odds of past-year IPV decreased the more types of support (e.g. advice) women received from group members (aOR 0.27, p < 0.001 among those reporting all support versus none or some). A similar pattern was seen for economic, but not emotional, abuse. The scaled-up IMAGE intervention is widely acceptable and may support improvements in partner relationships, but younger women need to be targeted. Group support appears to be a potentially important component of the intervention. [ABSTRACT FROM AUTHOR]

Background: While much attention has been given to the prediction of violent offending behaviour amongst people with psychotic disorders, less attention has been given to the fact that these same individuals are often the victims of violence. In this paper, we examine victimisation amongst participants in a prevalence study of psychosis, and describe demographic and clinical correlates of victimisation. METHOD The study was based on the Australian National Survey of Mental Health and Wellbeing--Low Prevalence (Psychotic) Disorders. The participants were asked if they had been a victim of violence in the previous year. The association between selected demographic and clinical variables and being a victim of violence was examined using logistic regression.Results: Of the 962 individuals with psychosis, 172 reported being a victim of violence in the past 12 months (17.9 %). The odds of being a victim were increased in those who: (a) were female, (b) were homeless, (c) had a lifetime history of substance abuse, (d) had been arrested in the previous 12 months, (e) had poorer social and occupational function, and (f) had higher scores on the disorganisation summary score.Conclusions: Clinicians should remain mindful that one out of every six individuals with a psychotic disorder reports being a victim of violence in the previous year. Models of care that address issues related to symptom relief, accommodation, and exposure to high-crime areas may reduce the rates of victimisation amongst those with psychotic disorders. [ABSTRACT FROM AUTHOR]

Purpose: The bond between mother and child is biological, genetic, spiritual, and unique. In times of intimate partner violence (IPV), mothering continues with efforts to protect and care for their children. The purpose of this project is to understand Indigenous mothering within the contexts of Indigenous identities, IPV, and rural, remote, and northern (RRN) places. Method: A secondary analysis of the Canadian Domestic Homicide Prevention for Vulnerable Populations Phase 3 Database revealed 16 cases identified as Indigenous mothers residing in RRN places. Grounded theory analyses explicated a preliminary theory of 'Colonial Pathways In, Indigenous Pathways Through' the social process of Indigenous mothering through IPV experiences in RRN places. Results: Indigenous mothering through IPV in RRN places is a responsive and embodied experience within a storied space, occurring through three pathways: Colonial pathways' into IPV; survival pathways during IPV; and recovery of cultural identity as providing an escape from IPV, expressed through themes of 1. comparative mothering, 2. continuous hypervigilance, protective nurturance, pursuit of safety, and 3. cultural recovery. Indigenous mothers demonstrates resilience in striving for safety while caring for their children within an IPV context. Conclusions: Indigenous mothering occurs even in the worst of times, such as during IPV. 'Colonial Pathways In, Indigenous Pathways Through' theory increases our understanding of Indigenous mothering in RRN places. Of significance is the occurrence of traumatic brain injury, pointing to the need for recognition that it is occurring and screening and treatment is required. Most of all, the study highlights the resilience, resistance, and resourcefulness of Indigenous mothers striving to keep themselves and their children safe. [ABSTRACT FROM AUTHOR]

The at-risk-of-poverty rate is one of the three indicators used for monitoring progress towards the Europe 2020 poverty and social exclusion reduction target. Timeliness of this indicator is critical for monitoring the effectiveness of policies. However, due to complicated nature of the European Union Statistics on Income and Living Conditions (EU-SILC) poverty risk estimates are published with a 2-3 years delay. This paper presents a method that can be used to estimate ('nowcast') the current at-risk-of-poverty rate for the European Union (EU) countries based on EU-SILC microdata from a previous period. The EU tax-benefit microsimulation model EUROMOD is used for this purpose in combination with up to date macro-level statistics. The method is validated by using EU-SILC data for 2007 incomes to estimate at-risk-of-poverty rates for 2008-2012 and to compare the predictions with actual EU-SILC and other external statistics. The method is tested on eight EU countries which are among those experiencing the most volatile economic conditions within the period: Estonia, Greece, Spain, Italy, Latvia, Lithuania, Portugal and Romania. [ABSTRACT FROM AUTHOR]

Demand for supportive housing outstrips availability in metropolitan regions around the country. Individuals who are homeless with serious mental illnesses, substance abuse, and other debilitating health conditions are often heavy users of publicly financed services and institutions, such as jails, emergency departments, psychiatric and medical hospitals, and sobering and detoxification services. King County, in collaboration with community partners, has developed a regional system for coordinating and prioritizing access to this limited resource based on utilization of publicly financed services/institutions and/or vulnerability. In this paper, the model, key implementation steps, preliminary results, and lessons learned are described. [ABSTRACT FROM AUTHOR]

Refugees and asylum seekers may experience challenges related to pre-arrival experiences, structural disadvantage after migration and during resettlement requiring the need for special protection when participating in research. The aim was to review if and how people with refugee and asylum seeker backgrounds have had their need for special protection addressed in national and international research ethics guidelines. A systematic search of grey literature was undertaken. The search yielded 2187 documents of which fourteen met the inclusion criteria. Few guidelines addressed specific ethical considerations for vulnerable groups much less people with refugee and asylum seeker backgrounds. One guideline explicitly addressed vulnerability for refugees and asylums seekers. To ensure members of ethics committees and researchers consider the potential challenges of conducting research with these groups, guidelines may need to be supplemented with a refugee and asylum seeker specific research ethics framework. Such a framework may be necessary to optimally protect people with refugee and asylum seeker backgrounds in research. [ABSTRACT FROM AUTHOR]

ims: This paper elaborates on the determinants of society 'at risk', children and youth at risk and risk behaviours of children and youth. Subjects and methods: A review of an existing literature and conducted studies on children and youth at risk and risk behaviours of children and youth has been carried out. Using the results of a number of studies in Croatia and abroad, particularly those of longitudinal character, this paper presents a review of the problems of those children and youth that are deemed to be at risk of developing risk behaviours. The term 'young people at risk' represents people who exhibit behaviours, points of view or faults that are considered indicative of subsequent behavioural problems. Results: When analyzing the results of epidemiological and other studies in both Croatia and abroad, epidemiological studies on internalized and externalized disorders of children and youth are becoming more frequent and continuous. Among internalized issues, anxiety, depressive disorders, suicides and wider mental health problems of children and youth are analysed and highlighted more and more often. Among externalised disorders, violent behaviour, criminal activity, juvenile offences, alcohol consumption, drug abuse and risky sexual behaviours are a part of the epidemiological studies presented in a paper. Conclusion: To implement effective prevention strategies, it is crucial to understand and epidemiologically follow risks to which children and youth are exposed to and to provide appropriate interventions according to the level of risk faced by each individual. [ABSTRACT FROM AUTHOR]

The 'meningitis belt' is a region in sub-Saharan Africa where annual outbreaks of meningitis occur, with epidemics observed cyclically. While we know that meningitis is heavily dependent on seasonal trends, the exact pathways for contracting the disease are not fully understood and warrant further investigation. Most previous approaches have used large sample inference to assess impacts of weather on meningitis rates. However, in the case of rare events, the validity of such assumptions is uncertain. This work examines the meningitis trends in the context of rare events, with the specific objective of quantifying the underlying seasonal patterns in meningitis rates. We compare three main classes of models: the Poisson generalized linear model, the Poisson generalized additive model, and a Bayesian hazard model extended to accommodate count data and a changing at-risk population. We compare the accuracy and robustness of the models through the bias, RMSE, and standard deviation of the estimators, and also provide a detailed case study of meningitis patterns for data collected in Navrongo, Ghana. Supplementary materials accompanying this paper appear online. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic broke out at the end of 2019, and throughout 2020 there were intensive international efforts to find a vaccine for the disease, which had already led to the deaths of some five million people. In December 2020, several pharmaceutical companies announced that they had succeeded in producing an effective vaccine, and after approval by the various regulatory bodies, countries started to vaccinate their citizens. With the start of the global campaign to vaccinate the world's population against COVID-19, debates over the prioritization of different sections of the population began around the world, but the prison population has generally been absent from these discussions. Approach and Findings: This article presents the approach of Jewish ethics regarding this issue, that is, that there is a religious and a moral obligation to heal the other and to take care of his or her medical well-being and that this holds true even for a prisoner who has committed a serious crime. Hence, prisoners should be vaccinated according to the same priorities that govern the administration of the vaccine among the general public. Originality: The originality of the article is in a comprehensive and comparative reference between general ethics and Jewish ethics on a subject that has not yet received the proper attention. [ABSTRACT FROM AUTHOR]

Background: In August 2004 a series of debris flows caused significant disruption to the Scottish (strategic) Trunk Road Network. The subsequent Scottish Road Network Landslides Study identified a number of sites considered to be at highest risk. Some of these sites have been the subject of formal quantitative assessment of the risk from debris flow to mobile road users in vehicles. The A82 in Glen Coe has the added complication that two car parks have developed on debris fans exposing significant numbers of people to the risk while, they are essentially static and largely outside their vehicles. Methodology: The risk to road users is determined using a previously developed probabilistic methodology for mobile road users (mobile elements at risk) and a new and related methodology developed for static road users (static elements at risk) is described and applied. Within the latter, an entirely new metric of Annual Average Daily Visits is used to allow the temporal component of the probability of a landslide impacting a person to be determined given the occurrence of an event. Results: While Personal Individual Risk is at an acceptable level, including for frequent users, the risk presented to society as a whole presents a rather different picture; this is largely due to the number of visitors. The results assess the overall, societal risk for mobile elements at risk as As Low As reasonably Practicable, being at a similar level to other sites, albeit with a higher risk associated with higher numbers of fatalities. The results for the static elements at risk on the other hand suggest that the risks are classified as Unacceptable for higher numbers of fatalities. The assessment of the total societal risk, for mobile and static elements at risk, at the A82 Glen Coe suggests As Low As Reasonably Practicable for low numbers of fatalities but classify as Unacceptable for higher numbers of fatalities (around 20 to 250). [ABSTRACT FROM AUTHOR]

This study investigated the risk of heatwaves for people with disabilities and other socioeconomic attributes using Health Care Bigdata in South Korea. The Health Care Bigdata provides detailed information on heat-related illness (HRI) patients in 2011–2020 from seven major cities. We employed the Distributed Lag Nonlinear Model (DLNM) to measure heat waves' relative risk. Our findings are four-fold. First, the relative risk (RR) of disabled people was 5.075 (95% confidence interval 4.476–5.674), significantly surpassing that of non-disabled people, 3.296 (2.517–4.075). Second, among various personal characteristics studied, disability influenced RR the most, exceeding impacts from elderly (4.457: 3.748–5.166), low-income (3.909: 3.004–4.813), and outdoor (4.052: 2.940–5.164). Third, the disabled young group (5.305: 4.414–6.195) was more vulnerable than the non-disabled elderly group (4.287: 3.576–4.999). Lastly, no significant difference in relative risk was observed between the mild (4.413: 3.855–4.971) and severe disabled groups (4.013: 3.121–4.905). [ABSTRACT FROM AUTHOR]

Informal mentoring between youth and adults in their existing social networks can help promote positive and equitable outcomes for disadvantaged young people. Yet little published research exists examining contextual factors that may impact access to this type of beneficial relationship for under-resourced and minoritized youth. Using data from the National Survey of Children's Health (N = 32,883), a logistic regression model was run to examine the presence of an informal mentor in relation to multiple contextual factors: (1) family resources, (2) economic distress, (3) neighborhood resources, and (4) trauma. Four supplemental logistic regression models then were run testing the same relationship between informal mentorship and the identified contextual factors by race/ethnicity group. Results indicate that contextual factors matter in determining which youth have access to informal mentorship. In terms of demographic factors, there also is an indication that race/ethnicity may be more impactful than gender in determining which youth have access to informal mentorship. Several findings in the sub-sample analysis highlight the unique experiences of Black families versus families of other race/ethnicity minorities related to informal mentoring. By foregrounding a person-in-environment perspective in Critical Race Theory, the present study demonstrates how the social work perspective can be used to analyze various contextual factors of marginalization, while maintaining a focused analysis on the presence of systemic racial-inequities. In addition to these theoretical implications, identifying contextual barriers has important implications for practitioners and researchers creating interventions to expand access to informal mentoring relationships for disadvantaged youth. [ABSTRACT FROM AUTHOR]

This paper reviews the impact of exposure to man-made or natural disasters on adolescent substance use. It covers empirical studies published from 2005 to 2015 concerning (a) the scope of the problem, (b) vulnerable groups and risk and protective factors, and (c) evidence-based interventions. The review suggests a strong link between adolescent substance use and exposure to either man-made or natural disaster. Vulnerable groups include adolescents with previous exposure to traumatic events, living in areas that are continually exposed to disasters, and ethnic minorities. Risk and protective factors at the individual, familial, community, and societal levels are described based on the bioecological model of mass trauma. Given that mass trauma is unfortunately a global problem, it is important to establish international interdisciplinary working teams to set gold standards for comparative studies on the etiology for adolescent substance use in the context of disasters. [ABSTRACT FROM AUTHOR]

This paper evaluates the content of the syllabi of postgraduate courses on public health ethics (PHE) within accredited schools and programs of public health (PH) in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The 'Epidemiology and PHE Syllabi' project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools (52%) and 36 accredited programs (42%); 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. [ABSTRACT FROM AUTHOR]

Caring for children with mental and behavioral health conditions can lead to family strain. Research indicates that Latino children are less likely to adhere to recommended treatment for their mental health diagnoses, increasing the potential for family strain. Little research has focused on understanding the different predictors of family strain among white and Latino families of children with mental health or behavioral health diagnoses. This paper uses a model of family strain to understand how stressors, resources, and perceptions predict family strain for white and Latino parents of children with a mental or behavioral health condition. Data from a telephone survey of 268 parents of children with a mental or behavioral health condition were analyzed to understand predictors of strain using the Family Strain Index scale. Findings indicate that family strain does differ between white and Latino families. Latino families' strain was predicted by age of parent (β = −0.381, P < 0.001), perceptions of treatment quality (β = 0.306, P < 0.001), and child's current symptom burden (β = −0.390, P < 0.001). White family strain was related to their child's health status (β = −0.240, P < 0.001), symptom burden (β = −0.339, P < 0.001), and parent's level of education (β = −0.315, P < 0.001). [ABSTRACT FROM AUTHOR]

Community health centers (CHCs) screen patients for social determinants of health (SDoH). The study's purpose was to assess the relationship between demographic factors and unmet social needs (SDoH risk) among pregnant mothers. Patient data from 345 pregnant women between January 2019-December 2020 assessed SDoH risk, using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) tool. Chi-square analyses explored relationships between social needs and demographic factors, and a multivariate logistic regression examined associations between these variables controlling for covariates. Hispanic patients and those who preferred to speak Spanish had 2.35 and 5.39 times the odds, respectively as non-Hispanic Whites and English speakers of having moderate/high/urgent SDoH risks. Mothers who had not completed high school had increased odds (aOR = 7.38) of SDoH risk. By identifying indicators that increase social risk level, CHCs can connect patients to essential social services, improving the downstream health of mothers and children. [ABSTRACT FROM AUTHOR]

Over the centuries, slavery has become embedded into the social fabric of Mauritania with generations of abid and bizan (Mauritanian slaves and slave masters, respectively) born and raised knowing nothing but the institution of chattel slavery. Abid fleeing their station in Mauritania come to the USA with unique psychological needs that will affect all of their interactions with the medical community. This paper aims to assist health professionals and others concerned with the welfare of former chattel slaves in competently serving this vulnerable population. Discussion includes an overview of Mauritanian chattel slavery, deduced sequelae of chattel slavery, preliminary recommendations for mental health and medical treatment protocols, and suggestions for future research. A confidential Institutional Review Board (IRB)-approved case report will be used to illustrate these objectives. [ABSTRACT FROM AUTHOR]

There are many challenges to accessing PrEP and thus low uptake in the United States. This review (2007-2017) of PrEP implementation identified barriers to PrEP and interventions to match those barriers. The final set of articles (n = 47) included content on cognitive aspects of HIV service providers and individuals at risk for infection, reviews, and case studies. Cognitive barriers and interventions regarding patients and providers included knowledge, attitudes, and beliefs about PrEP. The “purview paradox” was identified as a key barrier—HIV specialists often do not see HIV-negative patients, while primary care physicians, who often see uninfected patients, are not trained to provide PrEP. Healthcare systems barriers included lack of communication about, funding for, and access to PrEP. The intersection between PrEP-stigma, HIV-stigma, transphobia, homophobia, and disparities across gender, racial, and ethnic groups were identified; but few interventions addressed these barriers. We recommend multilevel interventions targeting barriers at multiple socioecological domains. [ABSTRACT FROM AUTHOR]

Pharmacovigilance science has traditionally been a discipline focussed on the postmarketing or post-authorisation period, with due attention directed towards pre-clinical safety data, clinical trials and adverse events. As the biological sciences have evolved, pharmacovigilance has slowly shifted toward earlier, proactive consideration of risks and potential benefits of drugs in the pre- and peri-approval stages of drug development, leading to a maturing of drug safety risk management. Further advances in biology, pharmacology and improvements in computational applications to medicine have led to the development of more complex medicines previously unobtainable and have also permitted a more thorough assessment of risks and potential benefits even earlier in the development process. Elevated public concern with the safety of more sophisticated medicines, combined with new science, have led pharmaceutical innovators, regulators and healthcare professionals to collaborate to develop guidelines, which drive enhanced pharmacovigilance and safety risk management earlier in drug development.In this paper, we review international guidelines on pharmacovigilance planning applicable to the pre-approval phases of medicines development and provide author opinion on these guidelines’ potential drug safety implications. We discuss the possible evolution of a pharmaceutical industry model to respond to these guidelines; a view on multidisciplinary safety management teams is provided to encourage refinement of safety-signal identification and risk assessment early in drug development and to communicate important safety concerns to internal research efforts, patients, investigators and regulators. We further describe these functions in the context of the complexities of vulnerable populations, including the example of medicines research for paediatric populations. We also discuss the special role of epidemiology in pre-approval drug development and the impact on epidemiological science of changes to the pharmacovigilance paradigm. [ABSTRACT FROM AUTHOR]

The objective of this paper is to identify the incentives and barriers to marriage among cohabiting women, especially disadvantaged mothers who are targets of welfare reform. We use the newly released cohabitation data from the National Longitudinal Survey of Youth (1979-2000), which tracks the partners of cohabiting women across survey waves. Our results support several conclusions. First, cohabiting unions are short-lived--about one-half end within one year, and over 90% end by the fifth year. Unlike most previous research, our results show that most cohabiting unions end by dissolution of the relationship rather than by marriage. Second, transitions to marriage are especially unlikely among poor women; less than one-third marry within five years. Cohabitation among poor women is more likely than that among nonpoor women to be a long-term alternative or substitute for traditional marriage. Third, our multinomial analysis of transitions from cohabitation into marriage or dissolution highlights the salience of economically disadvantaged family backgrounds, cohabitation and fertility histories, women's economic resources, and partner characteristics. These results are interpreted in a policy environment that increasingly views marriage as an economic panacea for low-income women and their children. [ABSTRACT FROM AUTHOR]

Aim: We examined predictors of trust in the healthcare system during the COVID-19 pandemic in 27 European countries. Subjects and methods: We used population-based data drawn from the Living, working and COVID-19 survey (N = 21,884, 52% female, ages 18 to 92 years) covering 27 European countries dated June and July 2020. Multilevel linear regression, linear regression, and regression-tree analyses were conducted. Results: We found that most participants tended to trust the healthcare system, although a substantial part could still be classified as distrusting (approx. 21%). Multiple variables, including being middle-aged or of older age, being female, lower levels of education, unemployment, worse general health status, having income difficulties, having unmet needs for healthcare, no healthcare contact during the COVID-19 pandemic, higher mental distress, and loneliness, were significantly associated with lower levels of trust. Among these variables mental distress, income difficulties, and unmet needs for healthcare emerged as especially important and, across European regions and countries, consistent predictors for lower trust in the healthcare system during the COVID-19 pandemic. Conclusions: Medically vulnerable subgroups, such as individuals with unmet healthcare needs, higher levels of mental distress, and older age, as well as people living in socially and economically vulnerable situations, such as higher levels of loneliness and financial difficulties, were the least trusting of the healthcare system during the COVID-19 pandemic. As these vulnerable subgroups are also at highest risk for contracting COVID-19 and experiencing negative COVID-19-related outcomes, more targeted prevention and intervention efforts should be implemented in these groups. [ABSTRACT FROM AUTHOR]

The reduced prevalence of insulin resistance and type 2 diabetes in countries with endemic parasitic worm infections suggests a protective role for worms against metabolic disorders, however clinical evidence has been non-existent. This 2-year randomised, double-blinded clinical trial in Australia of hookworm infection in 40 male and female adults at risk of type 2 diabetes assessed the safety and potential metabolic benefits of treatment with either 20 (n = 14) or 40 (n = 13) Necator americanus larvae (L3) or Placebo (n = 13) (Registration ACTRN12617000818336). Primary outcome was safety defined by adverse events and completion rate. Homoeostatic model assessment of insulin resistance, fasting blood glucose and body mass were key secondary outcomes. Adverse events were more frequent in hookworm-treated participants, where 44% experienced expected gastrointestinal symptoms, but completion rates were comparable to Placebo. Fasting glucose and insulin resistance were lowered in both hookworm-treated groups at 1 year, and body mass was reduced after L3-20 treatment at 2 years. This study suggests hookworm infection is safe in people at risk of type 2 diabetes and associated with improved insulin resistance, warranting further exploration of the benefits of hookworms on metabolic health. A beneficial effect of parasitic worms on metabolic health has been postulated based on epidemiological and animal studies. Here, the authors show in a phase I clinical trial that treatment of people at risk of type 2 diabetes with hookworms is safe and may improve key measures of metabolic health. [ABSTRACT FROM AUTHOR]

Non–extenstive statistics play a significant role in studying the dynamic behaviour of COVID-19 to assist epidemiological scientists to take appropriate decisions about pandemic planning. Generic non–extensive and modified–Tsallis statistics are used to analyze and predict the morbidity and mortality rates in future. The cumulative number of confirmed infection and death in Egypt at interval from 4 March 2020 till 12 April 2022 are analyzed using both non–extensive statistics. Also, the cumulative confirmed data of infection by gender, death by gender, and death by age in Egypt at interval from 4 March 2020 till 29 June 2021 are fitted using both statistics. The best fit parameters are estimated. Also, we study the dependence of the estimated fit parameters on the people gender and age. Using modified–Tsallis statistic, the predictions of the morbidity rate in female is more than the one in male while the mortality rate in male is greater than the one in female. But, within generic non-extensive statistic we notice that the gender has no effect on the rate of infections and deaths in Egypt. Then, we propose expressions for the dependence of the fitted parameters on the age. We conclude that the obtained fit parameters depend mostly on the age and on the type of the statistical approach applied and the mortality risk increased with people aged above 45 years. We predict - using modified–Tsallis - that the rate of infection and death in Egypt will begin to decrease till stopping during the first quarter of 2025. [ABSTRACT FROM AUTHOR]

Community health workers (CHWs), or promotores de salud, have long played a role in health promotion, but the COVID-19 pandemic has brought renewed attention to the functions, sustainability, and financing of CHW models. ¡Andale! ¿Que Esperas? was a 12-month (June 2021–May 2022) campaign that expanded the CHW workforce to increase COVID-19 vaccination rates in structurally vulnerable, Latinx communities across California. This mixed-methods evaluation aims to elucidate (1) the role of CHWs in COVID-19 response, recovery, and rebuilding and (2) the importance, needs, and perils of CHW models in the COVID-19 era and beyond. CHWs facilitated 159,074 vaccinations and vaccine appointments by countering mis/disinformation, addressing mental health and social needs, building digital competencies, and meeting people where they are, all of which expanded access and instilled confidence in the COVID-19 vaccine. CHWs' success in engaging the community lies in their shared lived experience as well as their accessibility and recognition in the community, enabling their role in both immediate response and long-term recovery. Funding instability imperils the advances made by CHWs, and efforts are needed to institutionalize the CHW workforce with sustainable funding models. While Medicaid reimbursement models exist in some states, these models are often limited to healthcare services, overlooking a critical function of the CHW model: building community resilience and mobilizing the community for social change. [ABSTRACT FROM AUTHOR]

How do we judge others' behavior when they are both seen and not seen—when we observe their behavior but not the underlying traits or history that moderate the perceived riskiness of their behavior? We investigate this question in the context of the COVID-19 pandemic: How people make sense of, and judge, vaccination-contingent behaviors—behaviors, such as going to the gym or a bar, which are considered to be more or less risky and appropriate, depending on the target's vaccination status. While decision theoretic models suggest that these judgments should depend on the probability that the target is vaccinated (e.g., the positivity of judgments should increase linearly with the probability of vaccination), in a large-scale pre-registered experiment (N = 936) we find that both riskiness and appropriateness judgments deviate substantially from such normative benchmarks. Specifically, when participants judge a stranger's behavior, without being asked to think about the stranger's vaccination status, they tend to judge these behaviors similarly positively to behaviors of others who are known to be fully vaccinated. By contrast, when participants are explicitly prompted to think about the vaccination status of others, they do so, leading them to view others more disparagingly, at times even more negatively than what a normative benchmark would imply. More broadly, these results suggest new directions for research on how people respond to risk and ambiguity. We demonstrate that even subtle cues can fundamentally alter what information is "top of mind," that is, what information is included or excluded when making judgments. [ABSTRACT FROM AUTHOR]

Attitudes play a central role in intimate partner violence against women and are related to its origin, to the responses of women who suffer violence, and to the settings where it occurs. In fact, these attitudes are recognized as one of the risk factors linked to violent perpetration and to public, professional, and victim responses to this type of violence. However, even though available research generally shows a broad rejection of this violence, it remains a serious social and health problem that has reached epidemic proportions. This suggests that the information available about these attitudes (obtained through explicit and direct measures, i.e., self-reports) may be distorted or influenced by factors such as social desirability. In this context, the overall objective of our research project is to provide multi-method measures (explicit and implicit) of attitudes toward intimate partner violence against women, and the main goal of this paper is to propose an instrument for the implicit measurement of these attitudes. In this regard, the Implicit Association Test (IAT) is the most common procedure used, providing a superior predictive validity compared to explicit measures for socially sensitive topics. We will present an exploratory study that describes its adaptation for our purposes, and the development of the Gender Violence - Implicit Association Test (GV-IAT) to use among Spanish-speaking populations, and discuss the strengths and limitations of this proposal. [ABSTRACT FROM AUTHOR]

Purpose: Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression.Methods: Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression.Results: 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression.Conclusions: Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment. [ABSTRACT FROM AUTHOR]

Background: There is no characterization of resource use in the hospital setting for immigrants in Colombia, we aimed to describe the resource use by Venezuelan immigrants, comparing those enrolled in the national health insurance system with those with and without the ability to pay. Methods: Retrospective review in the billing data system of our Hospital from 2011 to 2020. We collected information for 6,837 hospital episodes associated with 1,022 Venezuelan patients, hospital's billing information for all services rendered was extracted. Results: The mean cost per patient event were 4,595 USD for those without the ability to pay, costing 2.37 times more than a legal resident insured. Care in the ICU, inpatient days, surgery, and OB-GYN department consume most resources provided to vulnerable migrants. Discussion: Enrolment in the national health insurance may allow better access to health services by vulnerable Venezuelan migrants and thus reduce resource use for the health system. [ABSTRACT FROM AUTHOR]

This study aimed to better understand the factors driving reported trends in domestic violence during the COVID-19 pandemic, particularly the effect of the pandemic on survivors' experiences of violence and ability to seek support. We conducted semi-structured qualitative interviews with 32 DV service providers operating in organizations across 24 U.S. cities. The majority of providers described a decrease in contact volume when shelter-in-place orders were first established, which they attributed to safety concerns, competing survival priorities, and miscommunication about what resources were available. For most organizations, this decrease was followed by an increase in contacts after the lifting of shelter-in-place orders, often surpassing typical contact counts from the pre-pandemic period. Providers identified survivors' ability to return to some aspects of their pre-pandemic lives, increased stress levels, and increased lethality of cases as key factors driving this increase. In addition, providers described several unique challenges faced by DV survivors during the pandemic, such as the use of the virus as an additional tool for control by abusers and an exacerbated lack of social support. These findings provide insight into the lived experiences driving observed trends in DV rates during COVID-19. Understanding the impact of the pandemic on survivors can help to shape public health and policy interventions to better support this vulnerable population during future crises. [ABSTRACT FROM AUTHOR]

Although empirical studies have documented associations between posttraumatic stress symptoms (PTSS) and parenting among various high-risk populations, there is a relatively limited amount of research on paternal parenting among veterans. Moreover, the understanding of possible mechanisms which may account for this effect is severely lacking. This study examined associations between military related PTSS and parenting sense of competence (PSOC) among veteran fathers. Furthermore, we examined the mediating role of experiential avoidance (EA) and parental reflective functioning (PRF) in the association between PTSS and PSOC. Participants were 189 Israel Defense Forces (IDF) male combat veterans (mean age = 30.03) who completed a set of validated self-report questionnaires in a cross-sectional design study. Results showed negative associations between PTSS and PSOC-parental satisfaction but not parental efficacy. Furthermore, EA mediated the association between PTSS and parental satisfaction and efficacy; PRF- Pre mentalizing modes mediated the association between PTSS and parental satisfaction. Our findings imply that EA and PRF may serve as mechanisms of the association between PTSS and PSOC among veteran fathers. These findings are discussed in light of a psychological trauma perspective, and clinical implications to increase fathers' mentalization and psychological flexibility are suggested. Highlights: We examined predictors of parenting sense of competence (PSOC) among veteran fathers. PTSS was negatively associated with parental satisfaction, but not parental efficacy. Experiential avoidance mediated the association between PTSS and PSOC. Pre mentalizing modes mediated the association between PTSS and parental satisfaction. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue including one on parental involvement in cognitive-behavioral therapy, one by Klein, Becker and Rinck on automatic avoidance tendencies in spider fear and one by Creswell, Shildrick and Field on parental threat cognitions and children's interpretation bias and anxiety.