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This article reviews cultural and methodological considerations when developing effective preventive interventions among Latino families. A prevention approach guides the discussion of five key issues in prevention science, including (a) the role of risk and protective factors, (b) fidelity and adaptation strategies, (c) program effectiveness, (d) methodological consideration, and (e) bridging prevention research and practice. An annotated bibliography complements our discussion of conceptual and methodological considerations and prevention and intervention practices when working with Latinos.

Young injecting drug users are a particularly vulnerable group for Hepatitis C (HCV) infection. One method for minimising the risk of contraction of Hepatitis C for amphetamine users (not widely explored in the research to date) is through encouraging non-injecting routes of administration (NIROA). Self-report data from 150 young injecting amphetamine users was analysed to investigate the influence of Hepatitis C threat on the decision to cease injecting and the worth of promoting the use of NIROA. Application of the Transtheoretical Model of Behaviour Change and the Expanded Health Belief Model showed that threat of Hepatitis C was not perceived as reason to cease injecting at any stage in the injecting career. Cessation was a result of personal choice, rather than response to any type of threat. This supports the promotion of harm reduction rather than abstinence campaigns. Furthermore, the deficits in knowledge of Hepatitis C threat are worthy of campaign attention.

Sexually transmitted infections, including human immunodeficiency virus (HIV), disproportionately affect African American adolescents and young adults. Many of our current strategies and approaches have been inadequate in the promotion of risk reduction among youth and need to be reconceptualized. This article identifies issues that may guide researchers to better address the risks faced by African American youth. Some of these issues include tailoring of intervention messages and programs, timing of intervention delivery, consideration of contextual factors that influence risk behaviors, and increasing the breadth of our intervention focus. Discussions of how these strategies and approaches may enhance intervention effectiveness are highlighted.

At a seminar, two Congressional staff members offered good tips on how it is best to communicate with legislators. Although offered in the context of communicating with Congress, these insights are also valuable when working with state and local legislators. This article discusses the key points that were provided in the seminar. In addition to these general communication strategies, it has also become more important than ever to use effective email strategies with members of Congress and their staffers because of the anthrax letter scares of a few years ago. Email is becoming an increasingly common and acceptable way to communicate in the business world, and offices on Capitol Hill are no exception. Many Capitol Hill staffers today have Blackberries, the latest device in communication technology, which allow them to receive and send emails wherever they are. Despite this technology, many people still wonder how effective email communication is when they are trying to get their message to their congressperson and/or senators. The answer to this really depends on the particular legislator and his or her staffers. If one has a well-established working relationship with a legislative aide in the office, email can be an extremely easy and effective way to follow up on meetings and phone conversations, or to make specific requests. Some guidelines to follow should one choose to communicate this way are also presented.

To review the criteria for the selection of estrogens and especially progestogens for optimizing Menopausal Hormone Therapy (MHT). The main criteria are primarily derived from the Women's Health Initiative (WHI)-trial, disclosing the main risks like endometrial cancer, coronary heart disease (CHD), stroke, venous tromboembolism (VTE) and breast cancer. In addition observational studies must be considered for individualizing MHT, because WHI has tested only one preparation and has a lot of problems like early opening of the hormone/placebo-code (i.e., loss of placebo control), in 60% MHT-initiation too late, and in 40% risk factors for cardiovascular diseases and breast cancer. Pharmacological properties should be considered, such as only oral, but not transdermal estradiol increases VTE-risk. The choice of progestogens could be dependent on the different "partial effects" on steroid receptors, e.g., use of anti-androgenic progestogens in metabolic syndrome, Polycystic Ovary Syndrome (PCOS) etc., taking advantage of the anti-mineralocorticoid effect of drospirenone to stabilize blood pressure and reduce the risk of stroke, selection of tibolone for patients with sexual dysfunctions because its androgenic properties etc. Most important for the selection of the progestogen is endometrial efficacy, primary indication for progestogens in MHT. Therefore regular endometrial monitoring is reommended, using sequential or continuous combined regimens; "hormonal curettage" and/or the progestogen challenge text to avoid endometrial hyperproliferation. Levonorgestrel-IUD as progestogen component can reduce progestogen-dependent risks, offering also contraception, but often with longer bleeding problems, in contrast to sequential regimens of MHT, which can be used to treat irregular bleedings. Other main indications are treatment of climacteric complaints and prevention of osteoporosis and possible other preventive options. Regarding contraindications, according to the general rules of "class-labeling", they are the same for every MHT despite there are differences in benefits and risks. Choice of the timing of MHT-initiation is crucial to whether cardiovascular prevention (early start) or (like in WHI) increased risk of CHD and stroke occurs. The increased risk of breast cancer can be reduced using progesterone or its isomer dydrogesterone. Since, however, this risk cannot been excluded with any MHT, recommendations for screening on the possible development of breast cancer are given, on the basis of own recent research. Criteria for the selection of MHT are mainly to reduce possible risks as seen in WHI since for every MHT efficacy is good and essentially the same. Often the best choice is estradiol combined with progesterone or dydrogesterone, but also other progestogens should be considered including LNG-IUD, to optimize and individualize MHT. [ABSTRACT FROM AUTHOR]

Because alcohol consumption is an established cause of female breast cancer, understanding whether cessation affects risk is of public health importance. In a recent meta-analysis, compared with continuing consumption, the relative risk (RR) for cessation was 0.95 (95% confidence interval [CI] 0.88–1.01). Because intake of alcohol is more consistently associated with estrogen receptor positive (ER+) than negative (ER-) subtypes, we conducted a meta-analysis of alcohol cessation for ER-specific breast cancer risk using data from three cohort studies and one population-based case-control study (ER + n = 3,793; ER- n = 627) with information reported on cessation and ER status. Compared with continuing consumption, cessation was associated with lower risk of ER+ (RR = 0.88, 95%CI, 0.79–0.98) but not ER- (RR = 1.23, 95%CI, 0.98–1.55) breast cancer. These results suggest that, compared with continuing consumption, alcohol cessation may reduce ER + but not ER- breast cancer risk. However, research that considers duration of cessation is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To describe the impacts of four Veterans Health Administration (VA) Quality Enhancement Research Initiative (QUERI) projects implementing an evidence‐based lifestyle intervention known as the Diabetes Prevention Program (DPP). Data Sources and Study Setting: 2012–2024 VA administrative and survey data. Study Design: This is a summary of findings and impacts from four effectiveness‐implementation projects focused on in‐person and/or online DPP across VA sites. Data Collection/Extraction Methods: Patient demographics, participation data, and key findings and impacts were summarized across reports from the VA Diabetes‐Mellitus Quality Enhancement Research Initiative (QUERI‐DM) Diabetes Prevention Program (VA DPP) Trial, QUERI‐DM Online DPP Trial, the Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) QUERI DPP Project, and EMPOWER 2.0 QUERI Program. Principal Findings: Between 2012 and 2024, four VA QUERI studies enrolled 963 Veterans in DPP across 16 VA sites. All participants had overweight/obesity with one additional risk factor for type 2 diabetes (i.e., prediabetes, elevated risk score, or history of gestational diabetes) and 56% (N = 536) were women. In addition to enhancing the reach of and engagement in diabetes prevention services among Veterans, these projects resulted in three key impacts as follows: (1) informing the national redesign of VA MOVE! including recommendations to increase the number of MOVE! sessions and revise guidelines across 150+ VA sites, (2) enhancing the national evidence base to support online DPP delivery options with citations in national care guidelines outside VA, and (3) demonstrating the importance of gender‐tailoring of preventive care services by and for women Veterans to enhance engagement in preventive services. Conclusions: Over the past decade, the evolution of VA QUERI DPP projects increased the reach of and engagement in diabetes prevention services among Veterans, including women Veterans who have been harder to engage in lifestyle change programs in VA, and resulted in three key impacts informing type 2 diabetes and obesity prevention efforts within and outside of VA. [ABSTRACT FROM AUTHOR]

Background: Although older adults with intellectual and/or developmental disabilities face high risks of maltreatment, there are few interventions available to reduce these risks. This study describes the development of a research-based intervention that aims to reduce the risks of maltreatment for this population. Method: The development involved close collaboration with a program advisory board (PAB). It used a three-phase approach with a cross-cultural perspective: (1) performing a needs assessment, (2) determining content and design, and (3) evaluating the usability of the intervention. Results: The needs assessment results and input from the PAB yielded critical information that helped shape the intervention's development. Feedback from the trainers confirmed the intervention's usefulness and revealed suggestions for enhancing its usability. Conclusions: The intervention developed appears to be promising for enhancing the knowledge and skills of older populations to reduce their exposure to maltreatment risks; future research should be conducted to assess its efficacy. [ABSTRACT FROM AUTHOR]

• This research explores public perceptions of reportable safety incidents. • Falls were incorrectly identified as nonreportable by a plurality of respondents. • Ascope of practice intervention was incorrectly identified as a safety incident. • Research is vital to test strategies that enhance perception of reportable safety risks. Introduction: Patients may not feel responsible for reporting safety events, and social norms may prevent patients from questioning health care providers' judgment. There is a paucity of research regarding public awareness of reportable safety events/risks. Educating the public about reporting is paramount in error prevention. Because more than 70% of errors (e.g., errors in diagnosis, communication errors, unsafe medication practices, and care fragmentation) occur in primary care settings, the purpose of this study was to explore public perceptions of when to report safety events/risks in these settings. Method: System-level primary and outpatient facility safety incident scenarios conducive to safety events/risk reporting were developed and administered via online survey methodology. Following completion of the scenario questions, participants were asked a single open-text item: "As you were reading the scenarios above, what did you think makes an event/risk 'reportable'?" Results: At least one-third of participants responded incorrectly in 70% of the scenarios. The percentage of incorrect responses ranged from 5.2% to 62.3% with "unwitnessed falls" and "nursing scope of practice" queries incorrectly reported at 44.5% and 53.9%, respectively. Rationales for inappropriate events/risk reporting included "risk prediction at the management/system level," "legal repercussions/protection (e.g., negligence, legal responsibility to patient)," "violations of scope of practice/professional expectations," "degree of potential/actual lethality," and "personnel errors." Conclusion: This study revealed a gap between understanding why to report an event/risk and when to correctly report (or not report) an actual healthcare issue. Practical applications: Awareness of reasons for correctly reporting incidents and how correct reporting builds a culture of safety needs to be strengthened. [ABSTRACT FROM AUTHOR]

Hereditary cancer syndromes associated with gynecologic malignancies account for up to 18% of all cases of ovarian, uterine, and cervical cancers, and identification of these syndromes has implications for cancer screening and risk reduction techniques in affected patients. The associated cancer risks with moderate-penetrance genes are rapidly evolving and present variable risks for the provider counseling the patient. In this review, we detail the cancer risk and management of patients with germline PV in the moderate-risk hereditary cancer genes ATM , BRIP1 , RAD51C , RAD51D , and PALB2. [ABSTRACT FROM AUTHOR]

Introduction: Extracellular vesicles (EVs) have been identified as playing a role in atherosclerosis. Methods: A group of 37 hypercholesterolemic patients with atherosclerotic cardiovascular diseases (ASCVD) and 9 patients requiring hemodialysis (HD) were selected for the study. Results: EVs were comparably reduced by various LA methods (Thermo: 87.66% ± 3.64, DALI: 87.96% ± 4.81, H.E.L.P.: 83.38% ± 11.98; represented as SEM). However, LDL‐C (66%; 55%; 75%) and Lp(a) (72%; 67%; 79%) were less effectively reduced by DALI. There was no significant difference in the reduction of EVs when comparing different techniques, such as hemoperfusion (DALI; n = 13), a precipitation (H.E.L.P.; n = 5), and a double filtration procedure (Thermofiltration; n = 19). Additionally, no effect of hemodialysis on EVs reduction was found. Conclusions: The study suggests that EVs can be effectively removed by various LA procedures, and this effect appears to be independent of the specific LA procedure used, as compared to hemodialysis. [ABSTRACT FROM AUTHOR]

Social isolation and loneliness among older adults present serious public health challenges linked to increased dementia risk. This systematic review analyzes interventions addressing social isolation and loneliness in older adults and their cognitive effects to inform future dementia prevention programs. We systematically searched databases (PUBMED, PsycINFO, SCOPUS, EBSCO, and SAGE Journals) from February to May 2023 and updated from August to November 2023 using terms like social isolation, loneliness, intervention, and cognitive outcome. We included studies that assessed cognitive outcomes (such as global cognition or specific domains) and non-cognitive outcomes (including depression, well-being, and functionality). Study quality was assessed using Cochrane’s RoB 2, ROBINS-I, and other appraisal tools, with results synthesized narratively. Nine studies (1025 participants) were included, with a high risk of bias in most randomized trials (except one) and a low-to-moderate risk in non-randomized studies. Six studies showed improved cognitive function post-intervention, five of which involved technology. Two studies demonstrated reduced loneliness and improved cognition. Technological interventions promise to reduce social isolation and loneliness, positively impacting cognitive function. Despite this, these interventions did not directly impact social isolation, which requires future and larger studies to understand more in-depth the role of these approaches for individuals with social isolation. The interventions promoting social interactions could lead to higher social identification, well-being, and interest in life. Multidomain interventions, including technology, are effective. Limitations include study scarcity and heterogeneity, highlighting the need for more robust research on interventions to alleviate social isolation and loneliness and enhance cognitive function. Systematic Review Registration PROSPERO CRD42023460933 [ABSTRACT FROM AUTHOR]

Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multimodal lifestyle intervention yielded cognitive and other health benefits in older adults at risk of cognitive decline. The two-year multinational randomized controlled LETHE trial evaluates the feasibility of a digitally supported, adapted FINGER intervention among at-risk older adults. Technology is used to complement in-person activities, streamline the intervention delivery, personalize recommendations, and collect digital biomarkers. Methods: Trial includes older adults (60–77 years) with digital readiness/experience with smart devices and increased dementia risk but without substantial cognitive impairment. Participants are enrolled at four sites (Austria, Finland, Italy, Sweden). At baseline, participants were randomized 1:1 ratio to 1) intervention i.e., structured multimodal lifestyle program (including diet, exercise, cognitive training, vascular/metabolic risk management, social stimulation, sleep/stress management) where in-person activities led by professionals are supported with an Android mobile phone application developed by the consortium (the LETHE App); or 2) control i.e., self-guided program (regular health advice; simplified App with no personalized/interactive content). All participants wear smartwatches to gather passive data (e.g., physical activity, sleep). Primary outcomes are retention, adherence, and change in validated dementia risk scores. Secondary outcomes include changes in lifestyle, cognition, stress, sleep, health-related quality of life, and health literacy. Additional outcomes (exploratory) include e.g. participant experiences and dementia-related biomarkers (Alzheimer’s disease blood markers, neuroimaging). A sub-study explores the feasibility of novel interactive technology (audio glasses, social robot). Results: Recruitment began in September 2022, and the last participant was randomized in June 2023. In total, 156 individuals were randomized (mean age 69 years, 65% women; balanced recruitment across the four sites). Vascular and lifestyle risk factors were common (e.g., 65% with hypertension, 69% with hypercholesterolemia, 39% physically inactive), indicating successful recruitment of a population with risk reduction potential. Trial will be completed by summer 2025. Retention until the first post-baseline visit at 6 months is high (n = 2 discontinued, retention 98.7%). Conclusion: LETHE provides crucial information about the feasibility of technology and a digitally supported FINGER lifestyle program to promote brain health. Digital tools specifically designed for older adults could offer potential for large-scale, cost-effective prevention programs. Trial registration: ClinicalTrials.gov (NCT05565170). [ABSTRACT FROM AUTHOR]

Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke's Cognitive Examination–Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p =.050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p =.013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities. [ABSTRACT FROM AUTHOR]

With the intensification of global warming and sea level rise, extreme weather and climate events occur frequently, increasing the probability and destructive power of marine disasters. The purpose of this paper is to propose the specific application of artificial intelligence (AI) in marine disaster risk reduction. First, this paper uses computer vision to assess the vulnerability of the target and then uses CNN-LSTM to forecast tropical cyclones. Second, this paper proposes a social media communication mechanism based on deep learning and a psychological crisis intervention mechanism based on AIGC. In addition, the rescue response system based on an intelligent unmanned platform is also the focus of this research. Third, this paper also attempts to discuss disaster loss assessment and reconstruction based on machine learning and smart city concepts. After proposing specific application measures, this paper proposes three policy recommendations. The first one is improving legislation to break the technological trap of AI. The second one is promoting scientific and technological innovation to break through key technologies of AI. The third one is strengthening coordination and cooperation to build a disaster reduction system that integrates man and machine. The purpose of this paper is to reduce the risk of marine disasters by applying AI. Furthermore, we hope to provide scientific references for sustainability and human adaptation to climate change. [ABSTRACT FROM AUTHOR]

Introduction Operating room fires can have devastating consequences and as such must be prevented. There exists a paucity of literature requiring further elucidation regarding manufacturer recommendations of a predefined waiting period prior to patient draping after using alcohol-based surgical antiseptics, in order to reduce the risk of operating room fires. Methods This was further investigated by exposing two common alcohol-based surgical antiseptics to electrosurgery and open flames at various power settings and time intervals in an ex vivo porcine model. The simulated surgical site was prepped following manufacturer recommendations and exposed to monopolar electrosurgery at low and high power, using both PURE CUT and COAGULATION modes, and open flame, at 15-s increments after application. Results While using PURE CUT mode at both low and high power, no ignition was observed on hairless surgical sites prepped with ChloraPrep® at any time point. However, use of COAGULATION mode at both low and high powers resulted in ignition consistently out to 1-min post-application. Additionally, if the prepped area subjectively appeared wet, especially with pooling of the antiseptic, both COAGULATION mode and open flame caused ignition. Dry time was found to be about 59 s for both prep solutions. It was also observed that the amount of pressure directly correlated with the amount of prep dispersed and increased dry times. Conclusion In conclusion, our data suggest an average dry time of less than 1-min, with ignition only observed when the antiseptic was visibly wet. Ignition did not occur on hairless skin with electrocautery on CUT mode using ChloraPrep at any time point. Additionally, ignition on hair-bearing skin was not observed past 3 min, with current manufacturer recommendations stating 1 h wait time for hair-bearing skin. Arbitrarily waiting a specific predetermined dry time until patient draping, as recommended by the manufacturers, may be unnecessary and lead to hours' worth of time wasted each year. Ongoing research will further investigate the utility of drying the antiseptic after application and its affect on not only preventing ignition but also antimicrobial efficacy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the association between adolescents' adherence to attention‐deficit/hyperactivity disorder (ADHD) medication and their risk of committing minor offenses. Methods: Using two Dutch databases, Statistics Netherlands (CBS) and the Foundation for Pharmaceutical Statistics (SFK), we aimed to investigate the association between adherence to ADHD medication and registered minor offenses between 2005 and 2019 of 18,234 adolescents (12–18 years). We used Cox regression analyses to compare the rate of committing minor offenses of adolescents during periods of high ADHD medication adherence compared to periods of low adherence (i.e., periods with or without sufficient amounts of dispensed medication). We additionally tested associations with adherence to selective serotonin reuptake inhibitors (SSRIs) as control medication and analyzed potential reverse causation. Results: High ADHD medication adherence was associated with a reduced risk of committing a minor offense of between 33% and 38% compared to low adherence periods of ≥3 months (hazard ratio [HR] 0.67, confidence interval [CI] 0.64–0.71) or ≥6 months (HR 0.62, CI 0.59–0.65). The reduction in risk can likely be attributed to ADHD medication, given the absence of effects of SSRIs and no reverse causation. The reduction rate remained between 16% and 55% per sex, stimulant versus non‐stimulant medication, different offense categories and further sensitivity analyses. Conclusions: Among adolescents using ADHD medication, rates of criminality were lower during periods of high medication adherence, suggesting that adherence to ADHD medication may contribute to prevention of minor offenses in adolescents. [ABSTRACT FROM AUTHOR]

Recognition of patients at high risk (HR) for breast cancer allows earlier screening and opportunities for risk reduction. We compare patients referred to our breast clinic as HR vs referrals for other reason (ROR) and found to be HR. We evaluate under-recognized factors and treatment differences. A retrospective chart review of patients found to be HR but referred for any reason to our breast clinic from July 2012 to December 2022 was performed. Referral reason, demographics, hormonal history, family history, and other risk factors were evaluated and compared (HR vs ROR). While other risk models were used for screening, Gail and Tyrer-Cuzick version 7 (TCv7) were used for comparison. Breast imaging received, hormonal therapy, and genetics referral evaluations were compared. 195 patients were referred to our breast team, 113 (58%) were referred as HR while 82 (42%) were ROR. Average age was 47 years old. 175 (91%) were Caucasian. 74 (65.5%) were referred for genetic testing, and 32 (26%) tested positive for a genetic mutation (n = 10, 12% ROR). 67 (35%) were recommended chemoprevention (n = 32, 16.4% took chemoprevention). 6 (3.1%) underwent prophylactic mastectomies and 163 (85%) had supplemental breast imaging. Comparison of HR vs ROR did not show significant differences in hormonal factors or treatments received; however, TCv7 was higher in the group referred as HR (P < .001). Our study showed that HR patients are more commonly referred secondary to family history but undergo similar treatments as those ROR. Accessibility to screening tools and education of risk factors, especially in minorities and those not otherwise being screened, may help better recognize HR. [ABSTRACT FROM AUTHOR]

Postoperative complications related to anastomosis, including postoperative anastomotic bleeding and anastomotic leakage, remain a serious issue. The effect of anastomotic devices on suture complications during intestinal anastomosis remains unclear. The present study examined the utility of automated anastomotic devices for reducing anastomotic complication risks. A retrospective cohort study of colorectal cancer surgeries in which an anastomosis device was used at Osaka University Hospital (Suita, Japan) between January 2018 and December 2022 was conducted. Cases of emergency surgery, inflammatory bowel disease and simultaneous surgery for other cancers were excluded. Experienced gastrointestinal surgeons performed manual anastomosis using the ETHICON Circular Stapler CDH or EEA Circular Stapler, and automatic anastomosis using the ECHELON CIRCULAR Powered Stapler, with no observed operator bias. Additionally, a meta-analysis that included other study results was performed. The outcomes included postoperative complications, mainly anastomotic leakage. The study included 414 patients: 231 in the manual circular stapler group and 183 in the powered circular stapler (PCS) group. Although this retrospective study found no statistically significant association between the anastomotic device used and anastomotic complications, an increased risk ratio was observed in the manual group compared with the automatic group when restricted to elderly patients. Similarly, a meta-analysis found a significantly higher anastomotic complication risk in the manual group compared with the automatic group (random-effects model; odds ratio, 0.376; 95% confidence interval, 0.232-0.610; P<0.0001). The findings of the present study suggested that a PCS is useful for reducing the anastomotic complication risk in patients undergoing colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Prehispanic agricultural populations in the central Andes exhibit some of the highest rates of lethal and sublethal trauma ever recorded. Explanations for high rates of violence focus on what factors drove proactive conflict. While it is true that incentives for proactive violence must exist for high rates of trauma to ensue, it is far less recognized how ecological conditions may promote economic activities that constrain violence avoidance tactics and thus influence rates of violence. Here, we draw on models from behavioral ecology to generate predictions about how violence co-varies with environmental gradients, related subsistence strategies, and attendant defensive tactics. We hypothesize that rates of violence will be highest in marginal and variable environments where high-mobility subsistence strategies serve to reduce subsistence risk while increasing the costs of violence avoidance. Our results show that high elevation locations with variable topography where high mobility subsistence strategies are common exhibit the highest rates of generalized interpersonal violence. These results suggest that as ecological conditions become marginal and variable, risk-reducing subsistence strategies are emphasized, which result in increased exposure to violence. This study shows that environmental influences on the efficacy of violence avoidance tactics are important for explaining variability in rates of violence. [ABSTRACT FROM AUTHOR]

Background: Black race, inadequate health literacy, and poor perceived control are predictors of increased cardiovascular disease (CVD) risk. The purpose of this study was to explore the relationships among race, health literacy, perceived control, and CVD risk while controlling for known risk factors in incarcerated men. Methods: We included data from 349 incarceratedmen to examine race and CVD risk (Framingham Risk Score) using a serial mediation model with health literacy and perceived control using 95%confidence intervals (CIs) from 5000 bootstrap samples. Results: Of the participants (age, 36 ± 10; education, 12 ± 2; bodymass index, 28.3 ± 5.0), 64.2%wereWhite and 35.8%were Black. Black incarcerated men were younger (P = .047) with lower levels of health literacy (P < .001). All 3 indirect effects of race on CVD were significant, whereas the direct effect of race was not. Black incarcerated men had higher levels of CVD risk through health literacy (a1b1 = 0.3571; 95%CI, 0.0948-0.7162) and lower levels of CVD risk through perceived control (a2b2 = -0.1855; 95%CI, -0.4388 to -0.0077). Black incarceratedmen had higher levels of CVD risk through health literacy influenced by perceived control (a1b2d21 = 0.0627; 95% CI, 0.0028-0.1409), indicating that despite the protective effect of higher levels of perceived control in Black incarcerated men, CVD risk remained higher compared with their White counterparts. Conclusion: Future CVD risk reduction interventions in incarcerated men, specifically Black incarcerated men, should include goals of improving health literacy and perceived control as modifiable risk factors. [ABSTRACT FROM AUTHOR]

Background: Coronary calcification is a well-established risk factor for cardiovascular events. This retrospective study sought to determine the predictive value of coronary calcification in a specific group of patients with chronic kidney disease. Methods: We included 1094 asymptomatic patients (724 males, 370 females, age 62 ± 9.3 years) referred for cardiological examination. Patents were divided into two groups depending on their renal function. Coronary calcification was determined with a multi-slice computer tomography (CT) scanner. For quantification of coronary calcification the Agatston score was calculated. Over a mean follow up period of 6.2 ± 1.3 years we observed the rate of cardiovascular events (185 events, 61 myocardial infarctions, 103 revascularizations, 21 cardiac deaths). Results: The calcium score was significantly higher in patients with severe kidney disease (glomerular filtration rate (GFR) =30 mL/min/1.72 m²) compared with those with normal to moderate reduced renal function (GFR =30 mL/min/1.72 m²) (207 ± 190 vs.121 ± 169, p = 0.001). The event rate in patients with severe impaired renal function was significantly higher compared to patients with normal to moderate reduced renal function (20.6% vs. 14.8%, p = 0.0001). The hazard ratio for cardiovascular events increased constantly with the calcium score in both groups. The hazard ratio in patients with severe kidney disease was significantly lower compared to patients in corresponding groups with regular to moderate reduced renal function (7.3 vs. 9.3, p = 0.01). No cardiac events were observed in patients with a calcium score of 0. Conclusions: We could demonstrate that risk prediction with the calcium score is possible in patients with severe chronic kidney disease even if the calcium score overestimates the risk for future cardiovascular events compared to patients with normal to moderate reduced renal function. [ABSTRACT FROM AUTHOR]

Purpose: Falls among older adults are a growing public health concern in Saudi Arabia. The Otago Exercise Program (OEP) is an evidence-based intervention aimed at reducing fall risk in this population. This study assessed the knowledge and attitudes of Saudi Arabian physical therapists toward the OEP and examined potential gender-based differences. Patients and Methods: A cross-sectional survey was conducted between November 2023 and April 2024, involving 120 licensed physical therapists from Saudi Arabia, recruited via Email and social media. The survey captured sociodemographic data, knowledge, and attitudes regarding the OEP. Responses were analyzed using descriptive statistics, chi-square tests, and Cramér's V to assess the strength of associations, with a significance level set at p < 0.05. Results: Most physical therapists reported knowledge of the OEP's clinical effectiveness (36.7%), cultural compatibility (35.0%), and fall prevention benefits (28.3%). Gender was not significantly associated with knowledge of clinical effectiveness (χ² = 3.84, p = 0.57), contraindications (χ² = 4.44, p = 0.48), cost-effectiveness (χ² = 4.15, p = 0.52), or fall prevention in older adults (χ² = 2.44, p = 0.78), with moderate effect sizes observed (Cramer's V = 0.233 to 0.467). Attitudes toward the OEP were generally positive, with 51.7% supporting its use in regular aging care and 45.0% expressing confidence in delivering the program. There were no significant gender differences in understanding the OEP's recommendations (χ² = 7.45, p = 0.11) or confidence in program delivery (χ² = 7.62, p = 0.10), although strong association effects were noted (Cramer's V = 0.696 and 0.680, respectively). Conclusion: This study highlights the strong knowledge and positive attitudes of Saudi physical therapists toward the OEP, underscoring its potential for integration into national healthcare strategies to improve geriatric care and reduce fall-related risks. The findings emphasize the importance of continuous professional development to address knowledge gaps and optimize the implementation of evidence-based fall prevention programs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Public health messaging increasingly emphasizes the importance of "lifestyle interventions" to reduce dementia risk. Our study aimed to understand how people interpret and respond to information about dementia risk. In a second sub-aim, we examined how these interpretations may contribute to dementia-related lifestyle stigma. Research Design and Methods: We engaged in a secondary analysis of 50 semi-structured interviews using a framework approach to understand, from the perspective of community-dwelling middle-aged and older adults, how they may interpret, make sense of, and respond to information about dementia risk and risk reduction. During the interpretive and narrative phase, the authors began to elucidate participant responses analytically and identified that these responses could be interpreted within the health locus of control literature. Results: Of the 23 participants who discussed dementia risk, 13 felt some sense of personal responsibility and control over their dementia risk. Of those 13, four participants believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in knowing they had done what they could to reduce their risk and working to alleviate self-attribution of blame if diagnosed with dementia. Discussion and Implications: The tendency to internalize responsibility may inadvertently contribute to the stigmatization of dementia as a 'lifestyle disease' creating dementia-related lifestyle stigma. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to combatting the 'lifestyle stigma' increasingly associated with the condition. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Review Methods Data Sources Results Conclusion Impact Patient or Public Contribution To identify the components and characteristics of disaster risk reduction education for people with disabilities and to explore the contents and results of disaster risk reduction education.A systematic review and narrative synthesis.The review was conducted in accordance with Tawfik's guidelines and followed the reporting standards outlined in the Preferred Reporting Items for Systematic reviews and Meta‐Analysis. The quality appraisal was guided by the mixed methods appraisal tool. The contents of each type of education were narratively synthesised.The literature search was conducted in December 2023 using several electronic databases, including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO.Eight quantitative studies were selected for this study. Disaster risk reduction education for people with disabilities has focused mainly on fires and earthquakes, and drills were the most used teaching method. Some of the education was conducted by designating a 1:1 ratio of educators and participants or modifying the ratio according to the type of disability. The staff mainly conducted the education, and after education, the effect of disaster risk reduction education was confirmed in terms of the knowledge and response of people with disabilities during drills.This review provides insights for developing disaster risk reduction education for people with disabilities. However, only a few randomised controlled trial (RCT) studies and quasi‐experimental studies have been conducted, and several studies have bias risks. Thus, practical, continuous, quality interventions are needed for effective disaster risk reduction education for people with disabilities.This systematic review analysed the research trends of disaster risk reduction education for people with disabilities. The results provide the basis for quality evaluations of the operation, methods and achievements of educational programmes. Efforts are needed to promote collaboration between researcher and the practitioners to conduct further quality research.No Patient or Public Contribution: Systematic review. [ABSTRACT FROM AUTHOR]

Background Infectious complications of substance use are increasingly encountered in infectious diseases (ID) clinical care. In this study, we surveyed ID fellows in the United States to assess training experiences, clinical practices, and perspectives in caring for people who use drugs (PWUD). Methods An 18-item survey was distributed to ID fellows via email and social media platforms. Four focus groups were conducted with a subset of participants to elucidate themes in fellowship experiences and training needs. Results Among 196 survey respondents (estimated 24% response rate), all reported caring for PWUD in ID fellowship. Forty-nine percent received some formal fellowship-based didactics around care of PWUD, and 64% worked with faculty seen as advocates for PWUD. Integrated care practices for PWUD were infrequently employed: 50% offered risk reduction counseling, and 33% discussed medications for opioid use disorders, naloxone, or HIV preexposure prophylaxis. Risk reduction counseling was felt to be "extremely" within scope of ID practice (69%), although comfort level with this skill was low; fellows' likelihood of offering counseling was significantly associated with their comfort (P ≤.0001). Common themes in caring for PWUD included an expanded role for ID consultants, a lack of formalized training, and benefits of developing dedicated opportunities in this field. Conclusions ID fellows frequently care for PWUD but may have gaps in knowledge or comfort that affect care practices. Increased fellowship training in the care of PWUD has potential to improve clinical practices and support growing interest in this field among current and prospective ID fellows. [ABSTRACT FROM AUTHOR]

Background: Primary care practitioners worldwide are urged to promote dementia risk reduction as part of preventive care. To facilitate this in Australian primary care, we developed the Umbrella intervention, comprising a waiting room survey and patient information cards for use in consultations. Educational and relational strategies were employed to mitigate implementation barriers. Methods: In this cross-sectional, non-randomised implementation study within the South East Melbourne Primary Health Network, we employed mixed-methods outcome evaluation. Antecedent outcomes (acceptability, appropriateness, and feasibility) and actual outcomes (adoption, penetration, and fidelity) were assessed from the perspective of primary care practitioners and patients. Results: Five practices piloted the intervention and implementation strategies, including 16 primary care practitioners engaging with 159 patients. The Umbrella intervention was deemed acceptable, appropriate, and feasible, but penetration was limited. Approximately half of eligible primary care practitioners used the intervention, with moderate fidelity. Engagement with implementation strategies was similarly limited. While most strategies were well-received, improvements in online peer discussions and staff readiness were desired. Conclusions: The Umbrella intervention is a viable approach to promoting dementia risk reduction in Australian general practice, supported by educational and relational strategies. Stakeholder-informed refinements to enhance uptake are recommended before advancing to a definitive trial. Primary care practitioners should be promoting dementia risk reduction as part of preventive care. Using a rigorous, theory-driven, evidence-based, stakeholder-informed approach, we developed an intervention for promoting dementia risk reduction that was acceptable, appropriate, feasible, and complemented by acceptable and appropriate implementation strategies. However, preventive interventions will not be taken up widely in general practice until they are prioritised above competing demands on resources. [ABSTRACT FROM AUTHOR]

Background and Objectives Recent guidelines point to lifestyle as a tool for decreasing Alzheimer's disease (AD) risk. To address the limited practice and availability of AD risk reduction interventions, this study aimed to explore the feasibility of a community-level lifestyle intervention targeting high-risk groups. Research Design and Methods Diverse older adults (60+) living in the Richmond, VA, local area, with the following risk factors, incomes below $12,000/year and managing diabetes or cardiovascular disease, were offered weekly lifestyle telephone health coaching for 12 weeks in 2019–2020 (intervention group). The health coaching sessions provided Alzheimer's disease (AD) lifestyle risk reduction education and goal setting/planning. The intervention sample (n  = 40, mean age 68 years (range: 60–76 years), was 90% African American/Black (n  = 36) and 45% male (n  = 18). Thereafter, in 2021–2022, n  = 37 individuals in the same area were recruited as a comparison group and not given health coaching (control group), mean age of 65.5 years (range: 57–83 years), 92% African American/Black (n  = 34), and 50% male (n  = 18). Results Repeated-measures intervention effects were seen for cognitive ability, indicating greater improvement in the intervention group (p  < .01). Significant difference scores indicated greater cognitive ability (p  < .01) and physical activity (p  < .001) gains in the intervention group, with intervention subjects with reported memory problems showed relatively less physical activity gains (p  < .05). Discussion and Implications This work creates the impetus for future large-scale AD risk reduction investigations to mitigate and improve modifiable risk among diverse older adults. Our positive trends in AD risk reduction support telephone-based health coaching as a feasible AD risk reduction intervention. [ABSTRACT FROM AUTHOR]

Abstract Because alcohol consumption is an established cause of female breast cancer, understanding whether cessation affects risk is of public health importance. In a recent meta-analysis, compared with continuing consumption, the relative risk (RR) for cessation was 0.95 (95% confidence interval [CI] 0.88–1.01). Because intake of alcohol is more consistently associated with estrogen receptor positive (ER+) than negative (ER-) subtypes, we conducted a meta-analysis of alcohol cessation for ER-specific breast cancer risk using data from three cohort studies and one population-based case-control study (ER + n = 3,793; ER- n = 627) with information reported on cessation and ER status. Compared with continuing consumption, cessation was associated with lower risk of ER+ (RR = 0.88, 95%CI, 0.79–0.98) but not ER- (RR = 1.23, 95%CI, 0.98–1.55) breast cancer. These results suggest that, compared with continuing consumption, alcohol cessation may reduce ER + but not ER- breast cancer risk. However, research that considers duration of cessation is warranted.

Abstract Background The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multimodal lifestyle intervention yielded cognitive and other health benefits in older adults at risk of cognitive decline. The two-year multinational randomized controlled LETHE trial evaluates the feasibility of a digitally supported, adapted FINGER intervention among at-risk older adults. Technology is used to complement in-person activities, streamline the intervention delivery, personalize recommendations, and collect digital biomarkers. Methods Trial includes older adults (60–77 years) with digital readiness/experience with smart devices and increased dementia risk but without substantial cognitive impairment. Participants are enrolled at four sites (Austria, Finland, Italy, Sweden). At baseline, participants were randomized 1:1 ratio to 1) intervention i.e., structured multimodal lifestyle program (including diet, exercise, cognitive training, vascular/metabolic risk management, social stimulation, sleep/stress management) where in-person activities led by professionals are supported with an Android mobile phone application developed by the consortium (the LETHE App); or 2) control i.e., self-guided program (regular health advice; simplified App with no personalized/interactive content). All participants wear smartwatches to gather passive data (e.g., physical activity, sleep). Primary outcomes are retention, adherence, and change in validated dementia risk scores. Secondary outcomes include changes in lifestyle, cognition, stress, sleep, health-related quality of life, and health literacy. Additional outcomes (exploratory) include e.g. participant experiences and dementia-related biomarkers (Alzheimer’s disease blood markers, neuroimaging). A sub-study explores the feasibility of novel interactive technology (audio glasses, social robot). Results Recruitment began in September 2022, and the last participant was randomized in June 2023. In total, 156 individuals were randomized (mean age 69 years, 65% women; balanced recruitment across the four sites). Vascular and lifestyle risk factors were common (e.g., 65% with hypertension, 69% with hypercholesterolemia, 39% physically inactive), indicating successful recruitment of a population with risk reduction potential. Trial will be completed by summer 2025. Retention until the first post-baseline visit at 6 months is high (n = 2 discontinued, retention 98.7%). Conclusion LETHE provides crucial information about the feasibility of technology and a digitally supported FINGER lifestyle program to promote brain health. Digital tools specifically designed for older adults could offer potential for large-scale, cost-effective prevention programs. Trial registration ClinicalTrials.gov (NCT05565170).

Abstract Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke’s Cognitive Examination–Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.

Obesity is a risk factor for end-stage hip osteoarthritis. While total hip arthroplasty (THA) is commonly performed to reduce pain and improve function associated with osteoarthritis, obesity has been associated with an increased risk of complications after THA. Although bariatric surgery may also be utilized to reduce weight, the impact of bariatric surgery on THA outcomes remains inadequately understood. This retrospective cohort analysis utilized multicenter electronic medical record data ranging from 2003 to 2023. Patients who have obesity who underwent THA were stratified based on prior bariatric surgery. The final bariatric cohort comprised 451 patients after propensity score matching. Complication rates and revision risks were compared between cohorts at 6, 24, and 72 months. Additional analysis stratified patients by interval between bariatric surgery and THA. At 6-month follow-up, the bariatric cohort had significantly lower risks of surgical site infection, wound dehiscence, and deep vein thrombosis (DVT). At 24 months, the bariatric cohort had a lower risk of DVT. At 72-month follow-up, the bariatric cohort had reduced rates of revision, mortality, cardiac morbidity, and Clavien-Dindo grade IV complications. Obese patients who underwent bariatric surgery prior to THA experienced reduced medical complications at all time points and reduced rates of revision at 72 months relative to a matched cohort who did not undergo bariatric surgery. [ABSTRACT FROM AUTHOR]

International research attention on evacuation issues has increased significantly following the human and natural disasters at the turn of the century, such as 9/11, Hurricane Katrina, Cyclones Idai and Kenneth, the Black Saturday forest fires and tsunamis in Japan. The main problem concerning when a disaster can occur involves studying the risk reduction. Risk, following all the theoretical and experimental studies, is determined by the product of three components: occurrence, vulnerability and exposure. Vulnerability can be improved over time through major infrastructure actions, but absolute security cannot be achieved. When the event will occur with certainty, only exposure remains to reduce the risk to people before the effect hits them. Exposure can be improved, under fixed conditions of occurrence and vulnerability, by improving evacuation. The main problem in terms of evacuating the population from an area is the available transport system, which must be used to its fullest. So, if the system is well managed, the evacuation improves (shorter times), meaning the exposure is reduced, and therefore, the risk is reduced. A key factor in the analysis of transport systems under emergency conditions is the behavior of the user, and therefore, the study of demand. This work identifies the main research lines that are useful for studying demand under exposure-related risk conditions. The classification of demand models that simulate evacuation conditions in relation to the effect on the transportation system is summarized. The contribution proposes a model for updating choice in relation to emergency conditions and utility. The contribution of emerging ICTs to actualization is formally introduced into the models. Intelligent technologies make it possible to improve user decisions, reducing exposure and therefore risk. The proposed model moves within the two approaches of the literature: it is an inter-period dynamic model with the probability expressed within the discrete choice theory; furthermore, it is a sequential dynamic model with the probability dependent on the previous choices. The contribution presents an example of application of the model, developing a transition matrix considering the case of choice updating under two extreme conditions.

The effects of global warming, coupled with the continuing expansion of urbanization, have significantly increased vulnerability to urban flooding, widespread erosion risks, and related phenomena such as shallow landslides and mudflows. These challenges are particularly evident in both lowland and hill/foothill environments of urbanized regions. Improving resilience to urban flooding has emerged as a top priority at various levels of governance. This paper aims to perform an initial analysis with the goal of developing an early warning system to efficiently manage intense convective rainfall events in urban areas. To address this need, the paper emphasizes the importance of analyzing different hazard scenarios. This involves examining different hydro-meteorological conditions and exploring management alternatives, as a fundamental step in designing and evaluating interventions to improve urban flood resilience. The Turin Metropolitan Area (TMA), located in north-western Italy, represents a unique case due to its complex orography, with a mountainous sector in the west and a flat or hilly part in the east. During the warm season, this urban area is exposed to strong atmospheric convection, resulting in frequent hailstorms and high-intensity rainfall. These weather conditions pose a threat to urban infrastructure, such as drainage systems and road networks, and require effective management strategies to mitigate risks and losses. The TMA’s urban areas are monitored by polarimetric Doppler weather radars and a dense network of rain gauges. By examining various summer precipitation events leading to urban flooding between 2007 and 2021, this study assesses the practicability of deploying a weather-radar early-warning system. The focus is on identifying rainfall thresholds that distinguish urban flooding in lowland areas and runoff erosion phenomena in urbanized hills and foothills.

Abstract The occurrence of debris flow events in small-scale watersheds with dense vegetation in mountainous areas that result in significant loss of life and missing individuals challenges our understanding and expertise in investigating and preventing these disasters. This has raised concerns about the occurrence of large debris flow disasters from small watersheds. This study focused on a catastrophic debris flow that took place in Longtou Gully (0.45 km2) in Tianquan County, Ya’an City on 25 September 2021, which resulted in 14 deaths and missing individuals. Through comprehensive field investigations, high-precision remote sensing data analyses, and numerical simulations, we analyzed the triggering mechanisms and dynamic processes of this event. Our results indicate that the convergence hollow at the channel head exhibited higher hydraulic conditions during rainfall compared to gentle slopes and convex terrains, leading to the instability of colluvial soil due to the expansion of the saturated zone near the soil–bedrock interface. The entrainment of material eroded from the channel resulted in an approximately 4.7 times increase in volume, and the channel scarp with a height of about 200 m amplified the destructive power of the debris flow. We emphasize the need to take seriously the possibility of catastrophic debris flows in small-scale watersheds, with colluvial deposits in hollows at the channel head under vegetation cover that serve as precursor material sources, and the presence of channel scarps formed by changes in the incision rate of the main river, which is common in the small watershed on both sides. This study provides insights for risk assessment of debris flows in small-scale catchments with dense vegetation cover in mountainous areas, highlighting the importance of vigilance in addressing disasters in small-scale catchments, particularly in regions with increasing human–environment conflicts.

Meteorological information and forecasts are of great importance to reduce agro-meteorological hazards. However, the gap between production and application of these forecasts is one of the most ambiguous issues of crop management at the farmers' level. In this regard, investigating the factors influencing Iranian farmers willingness to use meteorological information and predictions was selected as the main aim of the present study. To this end, an extended version of Theory of Planned Behavior (TPB) was employed and modeled. The results revealed that attitude towards the use of meteorological information and predictions, subjective norms in the use of meteorological information and predictions, perceived behavioral control and self-identity in the use of meteorological information and prediction, and moral norm variables regarding the use of meteorological information and predictions positively and significantly affected willingness to use meteorological information and predictions. These variables could account for 46% of willingness to use meteorological information and predictions variance. According to the results, it was suggested that by creating multimedia programs, the agricultural community become aware of the benefits and consequences of using meteorological information in their activities. Furthermore, it was recommended that social cooperation and research groups be formed on the use of meteorological information in agricultural activities. This can contribute to examine the various dimensions (strengths, weaknesses, threats, and opportunities) of using meteorological information from a collective perspective. Making a social decision in this regard can have a profound effect on a person's subjective norms and dramatically increase the speed of using meteorological information. The results of this study can help policymakers and decision-makers in the field of agriculture to design suitable intervention programs for the effective use of meteorological information by farmers. Also, the results of this study help farmers to effectively reduce the impacts of meteorological hazards. [ABSTRACT FROM AUTHOR]

On 1 September 2022, a landslide in Hongya Village, Weiyuan Town, Huzhu Tu Autonomous County, Qinghai Province, caused significant casualties and economic losses. To mitigate such risks, InSAR technology is employed due to its wide coverage, all-weather operation, and cost-effectiveness in detecting landslides. In this study, focusing on the landslide in Hongya Village, SBAS-InSAR and Sentinel-1A satellite data from July 2021 to September/October 2022 were used to accurately identify the areas of active landslides and to analyze the landslide deformation trends, in combination with the geological characteristics of the landslides and rainfall data. The results showed that strong deformation was detected in the middle and back of the landslide in Hongya Village, with a maximum deformation rate of approximately -13 mm/year. The surface of the landslide consisted of mainly Upper Pleistocene wind-deposited loess, which is extremely sensitive to water. The deformation of the landslide was closely related to the rainfall, and the deformation of the landslide increased with the increase in rainfall. The research results prove that the combination of ascending and descending orbit data based on SBAS-InSAR technology is highly feasible in the field of landslide deformation monitoring and is of great practical significance for landslide disaster prevention and mitigation. [ABSTRACT FROM AUTHOR]

Simple Summary: For more than a decade, researchers have been gathering evidence suggesting pregnancy may alter the resistance of women to the development of diseases later in life. We wondered if parity—pregnancy resulting in live offspring—could enhance or diminish resistance of bitches to subsequent non-reproductive disease conditions, a hypothesis previously untested in domestic dogs. To pursue this goal, we constructed detailed lifetime reproductive and medical histories from 65 purebred Rottweiler bitches enrolled in an exceptional longevity study. An advantage of studying these bitches was that we could conduct a long-term evaluation of the relationship between parity and the lifelong occurrence of a commonly diagnosed degenerative disease, cranial cruciate ligament (CCL) rupture. Notably, we found parous bitches had a significantly lower likelihood of CCL rupture than nulliparous bitches. This 5.5-fold lower incidence of CCL rupture among parous females could not be explained by differences in diet, physical activity, overweight body condition, or reason for nulliparity. Our work may guide future mechanistic studies on the apparent association between parity and CCL rupture resistance. The research may also stimulate investigations into other non-reproductive health outcomes, such as autoimmune diseases, whose occurrence later in life may be impacted by parity. Emerging evidence in women supports the notion that pregnancy may reset disease resistance, thereby providing protection against subsequent adverse health outcomes, but this hypothesis has not been adequately explored in domestic dogs. Cranial cruciate ligament (CCL) rupture is a degenerative orthopedic disease that frequently affects pet dogs, and its risk has been associated with disruption of the reproductive hormone axis. Our research team is conducting a lifetime cohort study of purebred Rottweilers in North America that have lived 30% longer than breed-average. Detailed medical and reproductive histories of 33 nulliparous and 32 parous Rottweilers were generated from questionnaires and review of medical records. Interviews with owners of bitches in the nulliparous group served to limit selection bias, confirming that in no instance was the reason for nulliparity based upon the owner's suspicion that a bitch had a heightened risk for CCL rupture. The risk of CCL rupture associated with parity and other exposure variables was estimated using multivariate logistic regression. Overall, CCL rupture was diagnosed in 17 of 65 (26%) bitches. Median age at first litter and CCL rupture were 3.6 and 6.5 years, respectively. Compared to nulliparous, parous bitches had a significant 94% reduction in CCL rupture risk adjusted for duration of ovary exposure, overweight body condition, dietary pattern, habitual physical activity, and work/sport activity [ORadjusted (95% CI) = 0.06 (0.01–0.46); (p = 0.006)]. The observed parity-associated CCL rupture risk reduction remained robust in sensitivity analysis excluding six nulliparous bitches for which decision not to breed was based on diagnosis of hip or elbow dysplasia, conditions which may be genetically linked to CCL rupture [ORadjusted (95% CI) = 0.08 (0.01–0.58); (p = 0.01)]. This work sets the stage for replication studies in other canine populations that should begin to explore the mechanistic basis for parity-associated CCL rupture risk reduction and to pursue other non-reproductive health outcomes in bitches whose incidence or severity may be parity-sensitive. [ABSTRACT FROM AUTHOR]

Introduction Illnesses among Navy divers degrade readiness, decrease manpower levels, and increase costs for medical care. Prior research has shown that Navy divers have high rates of the types of illnesses that might be because of diving in contaminated water. The objectives of this study were to examine medical records of U.S. Navy Sailors from 2016 to 2022 and determine if divers have higher incidence rates of health conditions that might be associated with contaminated water diving compared to non-divers. Materials and Methods For this retrospective cohort study, we used data from the Defense Medical Epidemiology Database (DMED). The DMED is operated by the Armed Forces Health Surveillance Division and uses data from the Defense Manpower Data Center to classify occupations. The DMED provides free online access to a de-identified subset of data contained within the Defense Medical Surveillance System. The population was U.S. Navy enlisted males, aged 25 to 29 years. Divers were compared to non-divers using 8 selected diagnoses that may reasonably be associated with diving in contaminated water. Results During the study period, the database contained a total of 5,474 diver and 827,406 non-diver person-years. Of the 8 diagnoses, the ones with the largest number of cases for divers were upper respiratory infections with 128 and ear disorders with 62. The relative risks (RRs) for divers compared to non-divers were higher for otitis externa (RR = 1.44; confidence interval = 1.03, 2.01) and for ear disorders (RR = 1.15; confidence interval = 0.89, 1.47); for the other 6 diagnoses, the divers had lower rates than the non-divers. Conclusions The high RRs found for otitis externa and ear disorders support the need to devote resources to better understand the reasons for these higher risks and to develop, test, and implement targeted risk-reduction strategies. Future studies should attempt to link verified contaminated water exposures with adverse health outcomes and calculate risks based on criteria such as age and dive factors. [ABSTRACT FROM AUTHOR]

Introduction Department of the Air Force basic military training (BMT) is the 7.5-week initial entry training for all enlisting U.S. Air Force and Space Force recruits. Overuse musculoskeletal injuries (MSKI) during training threaten success in BMT, and trainees with nutritional deficiencies are at higher risk. Several efforts are made at BMT to mitigate these issues to help trainees graduate on time, such as the distribution of multivitamins (MVI) to female recruits. However, trainee compliance with the prescribed MVI has been reported to be low, calling into question the effectiveness of this intervention. This study evaluated the effect of briefing modality offered to these trainees at the time of distribution on educational effectiveness, MVI compliance, and injury rates. Materials and Methods This was a randomized controlled cohort study of BMT female trainees. Subjects included all female trainees of a single iteration of BMT concurrently completing training within the same squadron. At the outset of training, cohorts were randomly educated in one of two ways regarding the provided MVI. The control cohort (n  = 80) was presented with the standard educational video created by BMT-registered dietitians, while the test cohort (n  = 79) was presented the video and then also briefed in-person by a group of subject matter experts. At the end of BMT, the trainees completed a questionnaire regarding their knowledge, confidence, and compliance with the MVI. Additionally, a routinely collected training database was queried and analyzed for differences in injuries and training outcomes using the chi-squared test with significance set to α ≤ 0.05. Results Although both cohorts found their educational presentation useful, the "in-person" cohort reported significantly higher compliance rates and were found to be diagnosed with MSKI and bone stress injuries at significantly lower rates (43% and 66% relative risk reductions, respectively). Conclusions Education to female BMT trainees regarding the MVI, which included a face-to-face discussion with subject matter experts, resulted in greater compliance and reduced incidence of MSKI and bone stress injury, compared to a video prepared by registered dietitians alone. Such educational approaches should continue to be strived for in this and other military population health measures. This study's implication of MVI efficacy for injury risk reduction in female trainees should be further studied, verified, and improved upon in this and other populations. [ABSTRACT FROM AUTHOR]

Introduction Military transport can induce whole-body vibrations, and combat almost always involves high impact between lower extremities and the ground. Therefore, robust splinting technology is necessary for lower extremity fractures in these settings. Our team compared a novel one-step spray-on foam splint (FastCast) to the current military standard structured aluminum malleable (SAM) splint. Materials and Methods Ten cadaveric specimens were subjected to complete tibia/fibula osteotomy. Specimens were fitted with custom accelerometer and gyroscope sensors superior and inferior to the fracture line. Each specimen underwent fracture and splinting from a standard of care SAM splint and an experimental FastCast spray foam splint in a randomized order. Each specimen was manually transported to an ambulance and then released from a 1 meter height to simulate impact. The custom sensors recorded accelerations and rotations throughout each event. Repeated-measures Friedman tests were used to assess differences between splint method within each event and between sensors within each splint method. Results During splinting, overall summation of change and difference of change between sensors for accelerations and rotations were greater for SAM splints than FastCast across all axes (P  ≤ 0.03). During transport, the range of acceleration along the linear superior/inferior axis was greater for SAM splint than FastCast (P  = 0.02), as was the range of rotation along the transverse plane (P  < 0.01). On impact, the summation of change observed was greater for SAM splint than FastCast with respect to acceleration and rotation on the posterior/anterior and superior/inferior axes (P  ≤ 0.03), and the cumulative difference between superior and inferior sensors was greater for SAM than FastCast with respect to anterior-axis rotation (P  < 0.05). Conclusion FastCast maintains stabilization of fractured lower extremities during transport and impacts to a significantly greater extent than SAM splints. Therefore, FastCast can potentially reduce the risk of fracture complications following physical stressors associated with combat and extraction. [ABSTRACT FROM AUTHOR]

Tools to briefly assess diet among US Spanish-speaking adults are needed to identify individuals at risk for cardiometabolic disease (CMD) related to diet. Two registered dietitian nutritionists (RDNs) recruited bilingual medical students to translate the validated Diet Risk Score (DRS) into Spanish (DRS-S). Participants were recruited from a federally qualified health center. Students administered the DRS-S and one 24-h recall (Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool) on one day; a second recall was administered within 1 week. Recalls were scored using the Healthy Eating Index (HEI)-2015, a measure of adherence to the Dietary Guidelines for Americans. Spearman correlations, weighted kappa, and ANOVA were conducted using SAS 9.4 to assess the relative validity of the DRS-S. Thirty-one Spanish-speaking adults (female: n = 17, 53%; mean age: 58 (42–69)) completed assessments. The mean DRS-S was 9 (SD = 4.2) (max: 27; higher score = higher risk) and the mean HEI-2015 score was 65.7 (SD = 9.7) (max: 100; higher score = lower risk), with significant agreement between measures (r: −0.45 (p = 0.01)), weighted kappa: −0.3 (p = 0.03). The DRS-S can be used in resource-constrained settings to assess diet for intervention and referral to RDNs. The DRS-S should be tested in clinical care to assess the impact of dietary changes to reduce CMD risk. [ABSTRACT FROM AUTHOR]

Introduction: A significant proportion of breast cancer cases are hereditary and are potentially preventable. However, adoption of the preventive measures remains a significant challenge, particularly because of to lack of knowledge and awareness in low- to middle-income countries. Methods: This prospective study conducted at a high-volume tertiary care cancer center in North India to assess the knowledge, awareness, and attitudes of female breast cancer patients and impact of a brief educational intervention. The study involved three phases: pre-interventional assessment, educational intervention, and post-interventional assessment utilizing a structured questionnaire. Results: The study involved 300 newly diagnosed breast cancer patients; 16.7% were familial. At the outset, 87.0% patients had low knowledge of risk factors, 90.3% about screening, and 32.7% about treatment. Awareness levels were low: 13.7% aware of familial risk and 2.7% of breast cancer genes. Affordability of genetic testing was low (15.2%), and interest in testing for self and family members was limited (32.0% and 26.3%). Following educational intervention, a significant positive percentage change was noticed in knowledge (risk factors: 12.8%, screening: 36.2%, treatment: 82%), awareness (familial risk: 66.7%, BRCA gene: 12.3%), and attitude (testing for self: 17.8%, family: 19.5%). Conclusions: This study highlights the significant knowledge gaps among breast cancer patients regarding genetics. The educational intervention led to notable improvements in knowledge, awareness, and attitudes, underscoring the importance of tailored patient education in breast cancer care. [ABSTRACT FROM AUTHOR]

The effects of global warming, coupled with the continuing expansion of urbanization, have significantly increased vulnerability to urban flooding, widespread erosion risks, and related phenomena such as shallow landslides and mudflows. These challenges are particularly evident in both lowland and hill/foothill environments of urbanized regions. Improving resilience to urban flooding has emerged as a top priority at various levels of governance. This paper aims to perform an initial analysis with the goal of developing an early warning system to efficiently manage intense convective rainfall events in urban areas. To address this need, the paper emphasizes the importance of analyzing different hazard scenarios. This involves examining different hydro-meteorological conditions and exploring management alternatives, as a fundamental step in designing and evaluating interventions to improve urban flood resilience. The Turin Metropolitan Area (TMA), located in north-western Italy, represents a unique case due to its complex orography, with a mountainous sector in the west and a flat or hilly part in the east. During the warm season, this urban area is exposed to strong atmospheric convection, resulting in frequent hailstorms and high-intensity rainfall. These weather conditions pose a threat to urban infrastructure, such as drainage systems and road networks, and require effective management strategies to mitigate risks and losses. The TMA's urban areas are monitored by polarimetric Doppler weather radars and a dense network of rain gauges. By examining various summer precipitation events leading to urban flooding between 2007 and 2021, this study assesses the practicability of deploying a weather-radar early-warning system. The focus is on identifying rainfall thresholds that distinguish urban flooding in lowland areas and runoff erosion phenomena in urbanized hills and foothills. [ABSTRACT FROM AUTHOR]

International research attention on evacuation issues has increased significantly following the human and natural disasters at the turn of the century, such as 9/11, Hurricane Katrina, Cyclones Idai and Kenneth, the Black Saturday forest fires and tsunamis in Japan. The main problem concerning when a disaster can occur involves studying the risk reduction. Risk, following all the theoretical and experimental studies, is determined by the product of three components: occurrence, vulnerability and exposure. Vulnerability can be improved over time through major infrastructure actions, but absolute security cannot be achieved. When the event will occur with certainty, only exposure remains to reduce the risk to people before the effect hits them. Exposure can be improved, under fixed conditions of occurrence and vulnerability, by improving evacuation. The main problem in terms of evacuating the population from an area is the available transport system, which must be used to its fullest. So, if the system is well managed, the evacuation improves (shorter times), meaning the exposure is reduced, and therefore, the risk is reduced. A key factor in the analysis of transport systems under emergency conditions is the behavior of the user, and therefore, the study of demand. This work identifies the main research lines that are useful for studying demand under exposure-related risk conditions. The classification of demand models that simulate evacuation conditions in relation to the effect on the transportation system is summarized. The contribution proposes a model for updating choice in relation to emergency conditions and utility. The contribution of emerging ICTs to actualization is formally introduced into the models. Intelligent technologies make it possible to improve user decisions, reducing exposure and therefore risk. The proposed model moves within the two approaches of the literature: it is an inter-period dynamic model with the probability expressed within the discrete choice theory; furthermore, it is a sequential dynamic model with the probability dependent on the previous choices. The contribution presents an example of application of the model, developing a transition matrix considering the case of choice updating under two extreme conditions. [ABSTRACT FROM AUTHOR]

Background Different aspects of social relationships (e.g. social network size or loneliness) have been associated with dementia risk, while their overlap and potentially underlying pathways remain largely unexplored. This study therefore aimed to (1) discriminate between different facets of social relationships by means of factor analysis, (2) examine their associations with dementia risk, and (3) assess mediation by depressive symptoms. Methods Thirty-six items from questionnaires on social relationships administered in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing (n = 7536) were used for exploratory and confirmatory factor analysis. Factors were then used as predictors in Cox proportional hazard models with dementia until Wave 9 as outcome, adjusted for demographics and cardiovascular risk factors. Structural equation modeling tested mediation by depressive symptoms through effect decomposition. Results Factor analyses identified six social factors. Across a median follow-up time of 11.8 years (IQR = 5.9–13.9 years), 501 people developed dementia. Higher factor scores for frequency and quality of contact with children (HR = 0.88; p = 0.021) and more frequent social activity engagement (HR = 0.84; p < 0.001) were associated with lower dementia risk. Likewise, higher factor scores for loneliness (HR = 1.13; p = 0.011) and negative experiences of social support (HR = 1.10; p = 0.047) were associated with higher dementia risk. Mediation analyses showed a significant partial effect mediation by depressive symptoms for all four factors. Additional analyses provided little evidence for reverse causation. Conclusions Frequency and quality of social contacts, social activity engagement, and feelings of loneliness are associated with dementia risk and might be suitable targets for dementia prevention programs, partly by lowering depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Dementia is a global public health challenge. Evidence suggests that individuals from South Asian communities are an at‐risk group for dementia, partly as a result of early and cumulative exposure to known dementia risk factors, such as obesity and type 2 diabetes. There needs to be more culturally appropriate community engagement to increase awareness of dementia and identify better strategies to encourage participation in dementia‐related research. Methods: We aimed to better understand the barriers and facilitators towards engaging with, and participating in, diet and dementia related research among British South Asians. This was achieved using a public and patient involvement (PPI) approach. A community‐based, engagement event involving information sharing from experts and roundtable discussions with South Asian communities (n = 26 contributors) was held in June 2023 in Newcastle‐upon‐Tyne, UK. Collaboration from preidentified PPI representatives (n = 3) informed the content and structure of PPI activities, as well as recruitment. Data were synthesised using template analysis, a form of codebook thematic analysis. This involved deductively analysing data using relevant a priori themes, which were expanded upon, or modified, via inductive analysis. Results: The findings highlighted the importance of trust, representation and appreciation of cultural barriers as facilitators to engagement in diet and dementia risk reduction research. Consideration of language barriers, time constraints, social influences and how to embed community outreach activities were reported as driving factors to maximise participation. Conclusions: This PPI work will inform the design and co‐creation of a culturally adapted dietary intervention for brain health in accordance with the Medical Research Council and National Institute for Health and Care Research guidance for developing complex interventions. Key points: Patient and public involvement activities among British South Asians in the North East of England highlighted the importance of trust, representation and appreciation of cultural barriers as facilitators to engagement in diet and dementia risk reduction research.Language barriers, time constraints and community outreach were driving factors to maximise participation. [ABSTRACT FROM AUTHOR]

Background Molnupiravir and nirmatrelvir-ritonavir are orally administered pharmacotherapies for mild to moderate COVID-19. However, the effectiveness of these drugs among very old (≥80 years), hospitalised patients remains unclear, limiting the risk–benefit assessment of these antivirals in this specific group. This study investigates the effectiveness of these antivirals in reducing mortality among this group of hospitalised patients with COVID-19. Methods Using a territory-wide public healthcare database in Hong Kong, a target trial emulation study was conducted with data from 13 642 eligible participants for the molnupiravir trial and 9553 for the nirmatrelvir-ritonavir trial. The primary outcome was all-cause mortality. Immortal time and confounding bias was minimised using cloning-censoring-weighting approach. Mortality odds ratios were estimated by pooled logistic regression after adjusting confounding biases by stabilised inverse probability weights. Results Both molnupiravir (HR: 0.895, 95% CI: 0.826–0.970) and nirmatrelvir-ritonavir (HR: 0.804, 95% CI: 0.678–0.955) demonstrated moderate mortality risk reduction among oldest-old hospitalised patients. No significant interaction was observed between oral antiviral treatment and vaccination status. The 28-day risk of mortality was lower in initiators than non-initiators for both molnupiravir (risk difference: −1.09%, 95% CI: −2.29, 0.11) and nirmatrelvir-ritonavir (risk difference: −1.71%, 95% CI: −3.30, −0.16) trials. The effectiveness of these medications was observed regardless of the patients' prior vaccination status. Conclusions Molnupiravir and nirmatrelvir-ritonavir are moderately effective in reducing mortality risk among hospitalised oldest-old patients with COVID-19, regardless of their vaccination status. [ABSTRACT FROM AUTHOR]