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Background: Sport-related concussion is a public concern with between 1.6 and 3.8 million sport- and recreationrelated injuries occurring annually. An estimated 65% to 90% of concussed athletes show oculomotor disruption such as difficulty with saccades, accommodation, smooth pursuit, and fixation. A rapid number-naming saccade test, the King-Devick (K-D) test, has shown promising results as part of a multifaceted concussion assessment tool. Purpose: The purpose of the current study was to evaluate the two versions of the K-D in collegiate aged (18-24) athletes to determine the agreement between versions. A secondary purpose was to investigate the association of K-D scores with sport, sex, use of glasses or contacts, and age of the athlete. Study design: Descriptive laboratory study. Methods: Division 1 NCAA collegiate athletes across ten sports were recruited to participate in baseline concussion assessments at the beginning of their respective athletic season. Correlations and multivariable logistic regression analyses were used to investigate the association of K-D scores with sex and age. Results: One-hundred and nine athletes (69 males, 40 females; mean age =20.40±1.38 years) were baseline tested. There was excellent agreement (ICC=0.93, 95% CI: 0.90, 0.95) between the paper and computer version. Preseason K-D scores were statistically different (r2=0.873, p<0.05) with athletes scoring a mean of 37.58 seconds on the paper version (95% CI, 36.21, 38.96) and athletes scoring a mean of 41.48 seconds for the computerized tablet version (95% CI, 40.17, 42.91). There were no significant differences in sex, sport, or use of glasses noted for both versions. Age differences were identified; eighteen-year-old athletes took statistically longer than their peers for both K-D versions. Pairwise comparisons showed statistically significant differences between 18-year olds up to the age of 21-year-olds (p<0.05) for the computer version and statistically significant differences between 18-year olds up to 22-year-olds (p<0.05) for the paper version. Conclusion: This study supports the use of either version of the K-D test as a potential part of a multifaceted concussion assessment. The age of the athlete influences scores and therefore a K-D baseline should be repeated annually for collegiate athletes. Clinicians should not substitute K-D versions (computer vs. paper) in comparing baseline to a post-concussion K-D score as the scores are quite different. [ABSTRACT FROM AUTHOR]

Age and Ageing is now inviting papers on healthcare improvement for older people. In this article we outline the nature and scope of healthcare improvement and reference improvement models and the tools and methods of improvement science. We emphasise the issues of sustainability, including scale and spread; evaluation – including associated ethical consideration and the involvement of patients and the public in healthcare improvement and associated research. Throughout we refer to resources the authors have found useful in their own work, and provide a bibliography of sources and web-links which will provide essential guidance and support for potential contributors to this new category of submission to Age and Ageing. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the 30-day emergency department (ED) return rate between patients given a Take Home Medication pack (THM) versus a standard paper prescription (SPP) prior to discharge. Methods: This was an observational, prospective cohort study in an urban, university-affiliated, level I trauma center. Patients were identified through daily pharmacy reports. Consecutive adult patients discharged from the ED with either a THM or equivalent SPP were included. For each patient, baseline characteristics including age, gender, primary care provider (PCP), primary language, ethnicity, marital status, and insurance status were recorded from the electronic medical record (EMR). Review of the EMR was used to determine whether patients returned to the ED within 30 days and whether the return visit was for all-causes or for the same complaint targeted by the THM or SPP from the index visit. Similarly, visits to other providers in the health system within 30 days were recorded. Results: A total of 711 patients were included in the study, with 268 receiving a THM and 443 receiving a SPP. In comparison with the SPP group, the THM group was more likely to have an all-cause return (Relative Risk [RR] = 1.7, P < .01). Variables associated with increased odds of returning to the ED within 30 days included study group (adjusted Odds Ratio [aOR]: 1.7), male gender (aOR: 1.6), African American ethnicity (aOR: 3.0), public insurance (aOR: 3.3), and institutional financial assistance (aOR: 5.0). The difference between study groups for index visit complaint-specific returns was not significant. Conclusions: Patients receiving a THM demonstrated a higher all-cause return rate than patients receiving a SPP. A randomized study is needed evaluating the effect of THM on return ED visits. [ABSTRACT FROM AUTHOR]

Background: The aim of this research was to study the epidemiology, microbiology, prophylaxis, and antibiotic therapy of surgical site infections (SSIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), and identify the risk factors for these infections. In Italy SSIs occur in about 5 % of all surgical procedures. They are predominantly caused by staphylococci, and 30 % of them are diagnosed after discharge. In every surgical specialty there are specific procedures more associated with SSIs. Methods: The authors conducted a systematic review of the literature on SSIs, especially MRSA infections, and used the Delphi method to identify risk factors for these resistant infections. Results: Risk factors associated with MRSA SSIs identified by the Delphi method were: patients from long-term care facilities, recent hospitalization (within the preceding 30 days), Charlson score > 5 points, chronic obstructive pulmonary disease and thoracic surgery, antibiotic therapy with beta-lactams (especially cephalosporins and carbapenem) and/or quinolones in the preceding 30 days, age 75 years or older, current duration of hospitalization >16 days, and surgery with prothesis implantation. Protective factors were adequate antibiotic prophylaxis, laparoscopic surgery and the presence of an active, in-hospital surveillance program for the control of infections. MRSA therapy, especially with agents that enable the patient's rapid discharge from hospital is described. Conclusion: The prevention, identification and treatment of SSIs, especially those caused by MRSA, should be implemented in surgical units in order to improve clinical and economic outcomes. [ABSTRACT FROM AUTHOR]

Part II of the paper presents the results of the experimental data processing presented in Part I dedicated to distribution of water content in the standard Kraft paper along the height of HV windings during aging of experimental transformers and comparisons of paper aging rates of experimental transformers and laboratory models. The dependence of aging constant (pre-exponential factor of Arrhenius equation) on the moisture content of cellulose insulation is introduced. The developed functional dependence is obtained by detailed processing of the data — hot-spot temperature, moisture and degree of polymerization of cellulose insulation during 460 days of aging experiment of two transformers on load, with conductor insulation moisture of ca. 1 % and ca. 4 % and 300 days of aging experiment on corresponding laboratory models. Based on the results shown in this paper, aging curve, i.e. change of degree of polymerization during transformer operation insulated with Kraft paper and inhibited mineral oil was proposed, including varying water contents during aging. Using this equation it is possible to evaluate aging rate of solid insulation, starting from known hot-spot temperature and moisture content in cellulose insulation. Good comparison of aging curves of experimental transformers and laboratory models, i.e. measured and calculated values of degree of polymerization of paper to existing literature findings was obtained. [ABSTRACT FROM AUTHOR]

Context: Neurocognitive testing is a recommended component in a concussion assessment. Clinicians should be aware of age and practice effects on these measures to ensure appropriate understanding of results. Objective: To assess age and practice effects on computerized and paper-and-pencil neurocognitive testing batteries in collegiate and high school athletes. Design: Cohort study. Setting: Classroom and laboratory. Patients or Other Participants: Participants consisted of 20 collegiate student-athletes (age = 20.00 ± 0.79 years) and 20 high school student-athletes (age = 16.00 ± 0.86 years). Main Outcome Measure(s): Hopkins Verbal Learning Test scores, Brief Visual-Spatial Memory Test scores, Trail Making Test B total time, Symbol Digit Modalities Test score, Stroop Test total score, and 5 composite scores from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) served as outcome measures. Mixed-model analyses of variance were used to examine each measure. Results: Collegiate student-athletes performed better than high school student-athletes on ImPACT processing speed composite score (F1,38 = 5.03, P = .031) at all time points. No other age effects were observed. The Trail Making Test B total time (F2,66 = 73.432, P < .001), Stroop Test total score (F2,76 = 96.85, P = < .001) and ImPACT processing speed composite score (F2,76 = 5.81, P = .005) improved in test sessions 2 and 3 compared with test session 1. Intraclass correlation coefficient calculations demonstrated values ranging from 0.12 to 0.72. Conclusions: An athlete's neurocognitive performance may vary across sessions. It is important for clinicians to know the reliability and precision of these tests in order to properly interpret test scores. [ABSTRACT FROM AUTHOR]

Purpose: Most patient-reported outcome (PROs) used in thrombosis research and clinical practice are delivered using technology like online questionnaires. However, only few have undergone formal electronic adaptation from paper to digital versions, threatening the validity and reliability of the PROs. The present study aimed to perform an electronic adaption and cross-cultural translation of two PROs measuring health-related quality of life in a Danish cohort of patients with venous thrombosis (VTE), specifically the VEINES-QoL/Sym questionnaire and the PEmb-QoL questionnaire. Methods: The electronic adaption and cross-cultural translation processes followed the international guidelines recommended by ISPOR. The migration of the questionnaires from paper to electronic versions was conducted in the Research Electronic Data Capture (REDCap). Following approval of the electronically adapted and translated versions, a pretest of the questionnaires was performed by cognitive interviewing patients with VTE recruited from a hospital setting. Results: Nine men and ten women between the age of 19 and 73 years participated in cognitive interviews. The questionnaires were successfully adapted from paper to electronic versions, and during the migration process only a few modifications to the content and format were made. Most comments were related to technicalities, e.g. touch functions and checkboxes. The cross-cultural translation of both questionnaires was satisfactory, as only minor rephrasing was required. Conclusions: The original and Danish version of VEINES-QoL/Sym and PEmb-QoL were successfully adapted into electronic versions and are ready to share for REDCap users. Furthermore, the Danish versions of the two questionnaires have shown satisfactory face validity. [ABSTRACT FROM AUTHOR]

Background: Diabetic autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), especially in patients with long-term, poorly controlled diabetes. This study investigates the effects of exercise on autonomic nervous system activity in T2DM patients over time. Methods: A literature review using MEDLINE, Embase, Cochrane Library, Scopus, and PubMed identified studies assessed via heart rate variability. Papers were categorized into three groups: immediate effects (within 60 min), short-term effects (2–3 months), and long-term effects (over 4 months). Results: Nine articles with 161 T2DM patients were included in the meta-analysis. RMSSD changes after exercise were −4.3 (p = 0.227), 8.14 (p < 0.001), and 4.17 (p = 0.002) for the immediate, short-term, and long-term groups, respectively. LF/HF ratio changes were 0.21 (p = 0.264), −3.04 (p = 0.102), and −0.05 (p = 0.006) for the respective groups. Meta-regression indicated age, male gender, and exercise duration were associated with increased RMSSD, with coefficients of 2.36 (p = 0.001), 13.76 (p = 0.008), and 1.50 (p = 0.007), respectively. Age positively correlated with the LF/HF ratio, with a coefficient of 0.049 (p = 0.048). Conclusions: Regular exercise (≥3 times per week) for over 2 months increases parasympathetic activity in T2DM patients, while sympathetic activity decreases significantly after 4 months. Further study is needed to validate these findings. [ABSTRACT FROM AUTHOR]

As people age they are at increased risk of cardiovascular disease, the leading cause of mortality and morbidity worldwide. Understanding cardiovascular ageing is essential to preserving healthy ageing and preventing serious health outcomes. This collection of papers published in Age and Ageing since 2011 cover key themes in cardiovascular ageing, with a separate collection on stroke and atrial fibrillation planned. Treating high blood pressure remains important as people age and reduces strokes and heart attacks. That said, a more personalised approach to blood pressure may be even more important as people age to lower blood pressure to tight targets where appropriate but avoid overtreatment in vulnerable groups. As people age, more people experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This can predispose them to falls. The papers in this collection provide an insight into blood pressure and orthostatic hypotension. They highlight areas for further research to understand blood pressure changes and management in the ageing population. Inpatient clinical care of older people with heart attacks differs from younger people in UK national audit data. People aged over 80 had improved outcomes in survival after heart attack over time, but had lower rates of specialist input from cardiology compared with younger people. This may partly reflect different clinical presentations, with heart attacks occurring in the context of other health conditions, frailty and multimorbidity. The care and outcomes of acute and chronic cardiovascular disease are impacted by the frailty and health status of an individual at baseline. The research included in this collection reinforces the wide variations in the ageing population and the necessity to focus on the individual needs and priorities, and provide a person-centred multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

The authors assessed the utility and cost-effectiveness of using a World Wide Web-based questionnaire in a large prospective cohort study, the Black Women's Health Study (BWHS). In 1995, 59,000 African-American women were recruited into the BWHS through a paper questionnaire. Follow-up paper questionnaires have been mailed every 2 years since then. During the 2003, 2005, and 2007 questionnaire cycles, participants were given the option of completing a Web-based questionnaire. The cost of developing and processing a returned paper questionnaire was 4 times that of a returned Web questionnaire, primarily because of return postage costs and greater processing time for paper questionnaires. The proportion of respondents who completed a Web questionnaire doubled from 2003 to 2007, from 10.1% to 19.9%, but the characteristics of those completing the Web questionnaire remained the same. Web response was greatest at younger ages (20.9% of those aged <30 years) and declined with age to 3.6% among women aged 60 years or more. Web questionnaires were filled out more completely than paper questionnaires, regardless of the sensitivity of a question. The use of a Web questionnaire in the BWHS resulted in cost savings and more complete responses. Although there are advantages to using a Web questionnaire, the use of multiple means of soliciting questionnaire responses is still needed. [ABSTRACT FROM PUBLISHER]

Background: Management of short bowel syndrome in children has been surrounded by much debate with timing of the lengthening procedure still controversial. Early bowel lengthening procedure (EBLP) has been defined as any bowel lengthening procedure performed before 6 months of age. The purpose of this paper is to report the institutional experience in EBLP and to review the literature on this subject to identify common indications. Methods: An institutional retrospective analysis of all the intestinal lengthening procedures was performed. Furthermore, an Ovid/Embase search regarding children who underwent bowel lengthening in the past 38 years was conducted. Primary diagnosis, age at procedure, type of procedure, indication, and outcome were analyzed. Results: Ten EBLP were performed in Manchester from 2006 to 2017. Median age at surgery was 121 days (102-140), preoperative small bowel (SB) length was 30 cm (20-49) while postoperative SB length was 54 cm (40-70), with a median increased bowel length of 80%. Ninety-seven papers were reviewed, with more than 399 lengthening procedures performed. Twenty-nine papers matched criteria with more than 60 EBLP were observed of which 10 were performed in a single center from 2006 to 2017. EBLP was performed due to SB atresia, to excessive bowel dilatation or failure to enteral feeds, at a median age of 60 days (1-90). Serial transverse enteroplasty was the most frequent procedure used lengthening the bowel from 40 cm (29-62.5) to 63 cm (49-85), with a median increased bowel length of 57%. Conclusions: This study confirms that no clear consensus on indication or timing to perform early SB lengthening is reported. According to the gathered data, EBLP should be considered, only in cases of actual necessity after review of qualified intestinal failure center. [ABSTRACT FROM AUTHOR]

During the COVID-19 epidemic, social media has become the main channel for people to learn information related to the epidemic, among which information in the form of videos has played a significant role in the prevention and control of COVID-19. However, few studies have analyzed the process of knowledge learning of individuals through watching COVID-19 videos. Therefore, to explore the process of COVID-19 video viewers' knowledge acquisition, this paper constructs a knowledge learning path model based on the cognitive mediation model and dual coding theory. A sample of 255 valid questionnaires was collected to validate this model. The results of this study show that an individual's perceived risk of COVID-19 affects their surveillance motivation positively, while surveillance motivation further stimulates the attention and elaboration about the information in COVID-19 videos. Among them, attention positively influences the elaboration about the information. Ultimately, both an individual's attention and elaboration positively influence the knowledge he or she acquires from the COVID-19 videos. This paper not only verifies the hypothesized relationships in the original cognitive mediation model, but also extends the model to the context of video knowledge learning. Analyzing the knowledge learning process of COVID-19 video viewers, this paper can provide suggestions for government propaganda departments and relevant media to improve public knowledge of COVID-19. [ABSTRACT FROM AUTHOR]

The variation of the journal impact factor is affected by many statistical and sociological factors such as the size of citation window and subject difference. In this work, we develop an impact factor dynamics model based on the parallel system, which can be used to analyze the correlation between the impact factor and certain elements. The parallel model aims to simulate the submission and citation behaviors of the papers in journals belonging to a similar subject, in a distributed manner. We perform Monte Carlo simulations to show how the model parameters influence the impact factor dynamics. Through extensive simulations, we reveal the important role that certain statistics elements and behaviors play to affect impact factors. The experimental results and analysis on actual data demonstrate that the value of the JIF is comprehensively influenced by the average review time, average number of references, and aging distribution of citation. [ABSTRACT FROM AUTHOR]

This paper examines retirement by older workers with intellectual disability. Much research and intervention about retirement and intellectual disability in the last decade or so emanates from Australia, although there are some current cross-sectional and descriptive studies from other developed countries. The Australian literature stands out as the forerunner in the development and controlled evaluation of interventions to support the process of preparing for, practising, and then experiencing retirement. Therefore, this paper begins by briefly describing retirement-related aspects of employment for people with intellectual disability in Australia. Next, we present a critical summary of Australian research on the retirement of people with intellectual disability, supported by a briefer analysis of international literature. Then, key issues, such as financial factors, age of retirement, the time course of retirement (sudden or gradual), and self-determination regarding the decision to retire, are explored. Finally, to help guide future research and policy, we identify a number of retirement-related research questions that are currently under-researched or unexamined. [ABSTRACT FROM AUTHOR]

Ceramic-on-ceramic (COC) total hip arthroplasties (THAs) with large heads (>36 mm) were introduced to reduce dislocation rates and restore the hip anatomy as closely as possible to the native one. To date, the literature is scarce and fragmented; a review is desirable to point out the outcomes and the possible specific complications (noise, groin pain, and taperosis). A systematic review about large-diameter COC THAs was conducted according to the PRISMA guidelines. The PubMed and Cochrane databases were searched using the terms "large", "big", "head", "hip", and "ceramic." The methodological quality of the papers was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Seven papers (level of evidence: 5 case series and 2 case-control studies) met the inclusion criteria. Clinical outcomes were excellent in >90% of the patients. Groin pain was reported in only 1 article (7%). Radiological outcomes were positive. Minimal revision rates (<2%) were reported at short- to mid-term follow-ups. Dislocation rates were usually <1%. No bearing surfaces failed. No case of trunnionitis was reported. Noise occurred in up to 30% of the patients, mostly squeaking. The noise did not influence clinical outcomes or patients' satisfaction. Noise was inconstantly associated with component positioning, younger age, high articular excursions, and larger sizes. Large-diameter heads in COC THAs (≥40 mm) showed promising clinical and radiological outcomes with minimal revision rates. Noise is a cause of concern and should be carefully evaluated at longer follow-ups and in larger, prospective, and specifically designed case series. [ABSTRACT FROM AUTHOR]

Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis. [ABSTRACT FROM AUTHOR]

Backgrounds: Freezing of gait (FoG) is a common and debilitating symptom of Parkinson's disease (PD) that can lead to falls and reduced quality of life. Wearable sensors have been used to detect FoG, but current methods have limitations in accuracy and practicality. In this paper, we aimed to develop a deep learning model using pressure sensor data from wearable insoles to accurately detect FoG in PD patients. Methods: We recruited 14 PD patients and collected data frommultiple trials of a standardized walking test using the Pedar insole system. We proposed temporal convolutional neural network (TCNN) and applied rigorous data filtering and selective participant inclusion criteria to ensure the integrity of the dataset. We mapped the sensor data to a structured matrix and normalized it for input into our TCNN. We used a train-test split to evaluate the performance of the model. Results: We found that TCNN model achieved the highest accuracy, precision, sensitivity, specificity, and F1 score for FoG detection compared to othermodels. The TCNN model also showed good performance in detecting FoG episodes, even in various types of sensor noise situations. Conclusions: We demonstrated the potential of using wearable pressure sensors andmachine learningmodels for FoG detection in PD patients. The TCNNmodel showed promising results and could be used in future studies to develop a real-time FoG detection system to improve PD patients' safety and quality of life. Additionally, our noise impact analysis identifies critical sensor locations, suggesting potential for reducing sensor numbers. [ABSTRACT FROM AUTHOR]

Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

Background: Delirium is a common disorder affecting patients' psychiatric illness, characterized by a high rate of underdiagnosis, misdiagnosis, and high risks. However, previous studies frequently excluded patients with psychiatric illness, leading to limited knowledge about risk factors and optimal assessment tools for delirium in psychiatric settings. Objectives: The scoping review was carried out to (1) identify the risk factors associated with delirium in patients with psychiatric illness; (2) synthesize the performance of assessment tools for detecting delirium in patients with psychiatric illness in psychiatric settings. Design: Scoping review. Data sources: PubMed, Web of Science, and Embase were searched to identify primary studies on delirium in psychiatric settings from inception to Dec 2023 inclusive. Two independent reviewers screened eligible studies against inclusion criteria. A narrative synthesis of the included studies was conducted. Results: A final set of 36 articles meeting the inclusion criteria, two main themes were extracted: risk factors associated with delirium in patients with psychiatric illness and assessment tools for detecting delirium in psychiatric settings. The risk factors associated with delirium primarily included advanced age, physical comorbid, types of psychiatric illness, antipsychotics, anticholinergic drug, Electroconvulsive therapy, and the combination of lithium and Electroconvulsive therapy. Delirium Rating Scale-Revised-98, Memorial Delirium Assessment Scale, and Delirium Diagnostic Tool-Provisional might be valuable for delirium assessment in patients with psychiatric illness in psychiatric settings. Conclusions: Delirium diagnosis in psychiatric settings is complex due to the overlapping clinical manifestations between psychiatric illness and delirium, as well as their potential co-occurrence. It is imperative to understand the risk factors and assessment methods related to delirium in this population to address diagnostic delays, establish effective prevention and screening strategies. Future research should focus on designing, implementing, and evaluating interventions that target modifiable risk factors, to prevent and manage delirium in patients with psychiatric illness. What is already known about the topic?: • Delirium is common among individuals living in psychiatric settings and remains clinically under-detected, and it is associated with the length of hospital stay and poor prognoses. • Dementia with behavioral and psychological symptoms of dementia (BPSD) and other psychiatric illnesses has been shown to make delirium more likely. However, despite extensive research on factors associated with delirium, there is a notable lack of studies conducted in psychiatric settings. • Early detection and identification of delirium are crucial in psychiatric settings; however, literature regarding the assessment and identification of delirium has not been synthesized, particularly in the context of comorbid psychiatric illness. What this paper adds?: • Risk factors associated with delirium in patients with psychiatric illness primarily include advanced age, physical comorbid, types of psychiatric illness, antipsychotics, anticholinergic drug, Electroconvulsive therapy (ECT), and the combination of lithium and ECT. • Delirium Rating Scale-Revised-98, Memorial Delirium Assessment Scale, and Delirium Diagnostic Tool-Provisional might hold promising value as assessment tools for delirium in patients with psychiatric illness in psychiatric settings. [ABSTRACT FROM AUTHOR]

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access. [ABSTRACT FROM AUTHOR]

Background: Meaningful involvement of adolescents in health research is their fundamental human right and has many benefits. A lack of awareness among researchers on how to meaningfully involve adolescents in health research has been linked to adolescent under involvement in health research. To address this barrier, studies have reported the need for more guidance. To inform the development of better guidelines on adolescent involvement, there is a need to first consolidate the currently available guidance on adolescent involvement in health research and to identify the gaps in these guidelines. This review aims to systematically identify all the currently available guidelines on adolescent involvement in health research and evaluate their scope, content, context, and quality. Methods: This rapid review was pre‐registered with PROSPERO #CRD42021293586. It included documents that incorporated tangible recommendations on the involvement of adolescents in health research. We searched six databases for peer‐reviewed literature: MEDLINE, CINAHL, Embase, Scopus, Web of Science, and ERIC. We conducted a grey literature search in Google Scholar, Google, websites of 472 relevant organisations and sought expert input. The quality of the guidelines was assessed using the Appraisal of Guidelines for REsearch & Evaluation (AGREE‐II) Instrument. Data was analysed using descriptive analyses and narrative synthesis. Results: We found that the current guidelines on adolescent involvement in health research are often narrow in scope, targeting specific users and populations while focusing on limited research areas. The guidelines individually fail to provide comprehensive coverage of recommendations across all topics related to adolescent research involvement, that are collectively addressed across all included guidelines. Furthermore, these guidelines tend to be context‐specific and are generally of low quality, often due to inadequate stakeholder involvement and a lack of rigorous development methods. Conclusion: This review provides a consolidated list of guidelines on adolescent involvement in health research along with their quality scores as a resource for researchers to select the guidelines suitable for their research topic, context, and scope for adolescent involvement. There is a need to develop a set of guidelines on adolescent involvement in research, which are comprehensive in scope, cover all key aspects of adolescent involvement in health research, can be adapted for different contexts, and which are based on rigorous and systematic methods. Patient and Public Involvement: Adolescent co‐researchers D. B. and C. W. were involved at different stages of the review process. D. B. screened 25% of the peer‐reviewed articles at the title and abstract screening stage and 10% at full‐text screening stage. C. W. extracted data from 10% of the included guidelines. Both co‐researchers reviewed and shared their feedback on the article and are co‐authors on this paper. They will also be invited to contribute to further dissemination of the findings from this review. [ABSTRACT FROM AUTHOR]

Simple Summary: The current approach to breast cancer screening, which is based on a person's age, overlooks individual-level differences in breast cancer risk. As a result, many people are over- or under-screened according to their actual risk of breast cancer. Risk-stratified breast screening may overcome the limitations of age-based screening, but there are still many knowledge gaps regarding how best to implement it in the population setting. This study will generate the first Canadian evidence on the adoption of breast cancer risk assessment in the population setting, to support the future implementation of risk-stratified breast cancer screening. This study demonstrated that, while risk assessment for risk-stratified screening at the population level is feasible, an equity lens must be considered in implementation to ensure cancer-screening disparities are not widened. Risk-stratified breast screening has been proposed as a strategy to overcome the limitations of age-based screening. A prospective cohort study was undertaken within the PERSPECTIVE I&I project, which will generate the first Canadian evidence on multifactorial breast cancer risk assessment in the population setting to inform the implementation of risk-stratified screening. Recruited females aged 40–69 unaffected by breast cancer, with a previous mammogram, underwent multifactorial breast cancer risk assessment. The adoption of multifactorial risk assessment, the effectiveness of methods for collecting risk factor information and the costs of risk assessment were examined. Associations between participant characteristics and study sites, as well as data collection methods, were assessed using logistic regression; all p-values are two-sided. Of the 4246 participants recruited, 88.4% completed a risk assessment, with 79.8%, 15.7% and 4.4% estimated at average, higher than average and high risk, respectively. The total per-participant cost for risk assessment was CAD 315. Participants who chose to provide risk factor information on paper/telephone (27.2%) vs. online were more likely to be older (p = 0.021), not born in Canada (p = 0.043), visible minorities (p = 0.01) and have a lower attained education (p < 0.0001) and perceived fair/poor health (p < 0.001). The 34.4% of participants requiring risk factor verification for missing/unusual values were more likely to be visible minorities (p = 0.009) and have a lower attained education (p ≤ 0.006). This study demonstrates the feasibility of risk assessment for risk-stratified screening at the population level. Implementation should incorporate an equity lens to ensure cancer-screening disparities are not widened. [ABSTRACT FROM AUTHOR]

Background With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection. Methods This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. traditional paper forms to complete self-report psychiatric symptoms. Geriatric psychiatry outpatients (n = 72) and adult psychiatry inpatients (n = 50) were recruited to complete the Brief Symptom Inventory (BSI-53), the Activities of Daily Living (ADL), and Patient Health Questionnaire (PHQ-9) questionnaires. Results Geriatric psychiatry outpatients completed the iPad and paper questionnaires at similar rates (91.7% vs. 97.2%, Fisher's Exact p = .61). In two-way ANOVA, including patients aged ≥ 60 (n = 85), outpatient status (F(1,81) = 4.48, p = .037) and iPad format (F (1,81) = 8.96, p = .04) were associated with a shorter time to completion. The effect of questionnaire formats was especially prominent in the inpatient group on time to completion. Conclusions Older adults with mental illness demonstrate a similar ability to complete self-report questionnaires whether iPads or paper forms. iPad questionnaires may even require less time to complete in geriatric psychiatry inpatients. Patients also found iPad questionnaires to be easy to use and read. Tablets could potentially be used for psychiatric symptom assessment for clinical, research, and population health purposes. [ABSTRACT FROM AUTHOR]

Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( I 2 ). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results. The overall pooled proportion of adolescents' contraceptive uptake was 40% ( I 2 = 99.70 , p ≤ 0.001 ; 95 % CI = 19 , 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia. [ABSTRACT FROM AUTHOR]

The extent to which dengue virus has been circulating globally and especially in Africa is largely unknown. Testing available blood samples from previous cross-sectional serological surveys offers a convenient strategy to investigate past dengue infections, as such serosurveys provide the ideal data to reconstruct the age-dependent immunity profile of the population and to estimate the average per-capita annual risk of infection: the force of infection (FOI), which is a fundamental measure of transmission intensity. In this study, we present a novel methodological approach to inform the size and age distribution of blood samples to test when samples are acquired from previous surveys. The method was used to inform SERODEN, a dengue seroprevalence survey which is currently being conducted in Ghana among other countries utilizing samples previously collected for a SARS-CoV-2 serosurvey. The method described in this paper can be employed to determine sample sizes and testing strategies for different diseases and transmission settings. Author summary: The historical circulation of dengue virus is still poorly understood in many parts of the world, and age-stratified seroprevalence surveys can provide the data to quantify population exposure to dengue and its transmission intensity. In this work, we developed a simulation-based method that can be used to identify the sample sizes and age-distribution of the samples needed to obtain informative estimates of dengue force of infection from existing blood samples. We apply this method to data obtained from a SARS-CoV-2 serological survey, previously conducted in three cities in Ghana. The methods and code developed in this paper can be used to design serological surveys for dengue and other pathogens when using existing blood samples with accompanying information on age and location. [ABSTRACT FROM AUTHOR]

This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful rehabilitation treatments to draw on. This research included the parents or caregivers of pediatric patients diagnosed with autism spectrum disorder and placed within a therapeutic clinic. The sample is composed of 111 children, males and females, aged between 2 and 10 years, and includes 60 children diagnosed with autism and 51 children with normotypical development, similar in characteristics but without the disorder. The standardized questionnaire, "Brief Autism Mealtime Behavior Inventory", was developed to examine behavior during meals, especially in children with ASD. The "Brief Sensory Profile", and the "Child Oral and Motor Proficiency Scale", were also administered. The results obtained from the analysis lead to evidence of eating and food selectivity difficulty. Additionally, our study demonstrates that food selectivity can be caused by extreme sensory modulation and sensory problems related to the smell, texture, color, and temperature of food. In fact, the results obtained emphasize the correlation between food selectivity and the sensory domains of taste and smell. Furthermore, this research highlights a correlation between motor skills and eating skills, particularly regarding food selectivity, which is closely associated with atypical and disruptive behaviors during meals. [ABSTRACT FROM AUTHOR]

Objectives: As people remain physically active later in life, there is an increased incidence of anterior cruciate ligament (ACL) injuries in patients 50 years of age and older. Historically, ACL reconstructions have not been recommended for patients over 50 years of age. While there is abundant literature on the outcomes of ACL reconstruciton in patients under 40 years of age, little has been published on the outcomes in this age group. The purpose of this study was to investigate whether ACL reconstruction in patients fifty years of age and older rwill esult in an improvement in function, stability, and quality of life at 5-year follow up. We also study the indications, outcomes, and tips for success. Methods: A retrospective review was performed of patients fifty years or older with a minimum follow up of two years who underwent an ACL reconstruction using a bone patellar tendon bone (BPTB) allograft by a single fellowship trained orthopedic sports medicine surgeon over a sixyear period. Patients were excluded from the study if they had significant radiographic osteoarthritic changes, or concurrent ligamentous or bony procedures performed. Patients were asked to return for an evaluation, including physical examination and KT-2000 instrumented stability measurements. Both the operative and non-operative knees were evaluated for range of motion, tenderness, stability on anterior drawer, Lachman, and pivot shift testing. Bilateral KT-2000 measurements which were taken at 10, 20, and 30 pounds as well as maximum manual testing. Each measurement was taken three times and averaged. The following scores were used pre- and post-operatively to assess function and pain: Lysholm, International Knee documentation Committee (IKDC), Tegner Activity, and SF-12. A physical examine including KT-2000 measurements was performed in a subset of these patients. Results: Fifty patients with an average follow-up of 5 years (range 2-8 years) underwent an ACL reconstruction using BPTB allograft. The average age at surgery was 55 years (range 50-68 years). Tegner scores improved from a pre-operative score of 3.3 to a post-operative score of 5.3 (p =.0001, 95% CI 2.2-3.5). The average post-operative IKDC score was 81.3 (SD 16.4), Lysholm score 88.5 (SD 16.3), SF-12 physical 54.3 (SD 6.6) and SF-12 mental 51.8 (SD 8.3). Forty (80%) patients reported good to excellent results, six (12%) patients reported fair results and four (8%) patients reported poor results. The patients that returned for a physical examinaiton had a range of motion that averaged flexion to 135 (SD 5.4), and all achieved full extension. There was one patient (2%) that had greater than 4mm translation on Lachman testing, and no patients had a positive pivot shift. There were no identified surgical complications. Conclusions: An anterior cruciate ligament reconstruction using BTB allograft successfully restores stability and allows return to pre-injury level of activity with few complications in patients 50 years or older at an average of 5 years follow-up. Our data set represents the largest case series of ACL reconstructions for this age demographic in the literature, using validated outcome tools, and complimented with a physical examination in a sub-set of the cohort. We have found no comparison that yields a clinically significant difference (based on MCID of 10 on theLysholm scale). Thus, older patients can be counseled to expect a functional return close to their pre-injury level, similar to younger patient cohorts. [ABSTRACT FROM AUTHOR]