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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.

It is absolutely critical that high school games be organized in the safest way possible--both for the students, the staff who are directly involved and for all the spectators who watch these games. School officials have become vigilant with safety measures as a string of violent incidents has occurred in several school athletic events across the nation over the past year. In this article, the author discusses several strategies to combat violence at school sports events.

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.

IntroductionWith Alzheimer's disease and related dementias (ADRD) representing an enormous public health challenge, there is a need to support individuals in learning about and addressing their modifiable risk factors (e.g., diet, sleep, and physical activity) to prevent or delay dementia onset. However, there is limited availability for evidence-informed tools that deliver both quality education and support for positive behavior change such as by increasing self-efficacy and personalizing goal setting. Tools that address the needs of Latino/a, at higher risk for ADRD, are even more scarce.MethodsWe established a multidisciplinary team to develop the Healthy Actions and Lifestyles to Avoid Dementia or Hispanos y el ALTo a la Demencia (HALT-AD) program, a bilingual online personalized platform to educate and motivate participants to modify their risk factors for dementia. Grounded in social cognitive theory and following a cultural adaptation framework with guidance from a community advisory board, we developed HALT-AD iteratively through several cycles of rapid prototype development, user-centered evaluation through pilot testing and community feedback, and refinement.ResultsUsing this iterative approach allowed for more than 100 improvements in the content, features, and design of HALT-AD to improve the program's usability and alignment with the interests and educational/behavior change support needs of its target audience. Illustrative examples of how pilot data and community feedback informed improvements are provided.DiscussionDeveloping HALT-AD iteratively required learning through trial and error and flexibility in workflows, contrary to traditional program development methods that rely on rigid, pre-set requirements. In addition to efficacy trials, studies are needed to identify mechanisms for effective behavior change, which might be culturally specific. Flexible and personalized educational offerings are likely to be important in modifying risk trajectories in ADRD.

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: 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]

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]

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]

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 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]

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]

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]

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]

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]

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]

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. [ABSTRACT FROM AUTHOR]

Background/Aims: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, 103.4 million cases and 1.1 million deaths have occurred nationally as of November 2023. Despite the benefit of mitigating measures, the pandemic's effect on participant safety is rarely documented. Methods: This study assessed noncompliance occurring from July 2019 to August 2021 that were stratified by the date of noncompliance (before or after restrictions). Events were described by size, site, noncompliance type, primary category, subcategory, and cause. In addition, noncompliance associated with COVID-19 was analyzed to determine characteristics. Results: In total, 323 noncompliance events occurred across 21,146 participants at risk in 35 protocols. The overall rate of noncompliance increased from 0.008 events per participant to 0.022 events per participant after the COVID-19 restrictions (p < 0.001). For onsite protocols, the median within protocol change in rates was 0.001 (interquartile range = 0.141) after the onset of COVID-19 restrictions (p = 0.54). For large-sized protocols (n ≥ 100), the median within protocol change in rates was also 0.001 (interquartile range = 0.017) after COVID-19 restrictions (p = 0.15). For events related to COVID-19 restrictions, 160/162 (99%) were minor deviations, 161/162 (99%) were procedural noncompliance, and 124/162 (77%) were an incomplete study visit. Conclusion: These noncompliance events have implications for clinical trial methodology because nonadherence to trial design can lead to participant safety concerns and loss of trial data validity. Protocols should be written to better facilitate the capture of all safety and efficacy data. This recommendation should be considered when changes occur to the protocol environment that are outside of the study team's control. [ABSTRACT FROM AUTHOR]

Building safety has become a serious and important topic for the development of the construction industry, as well as for the preservation of contractors' and workers' lives and property. With the development and expansion of a sensitive and complex monitoring system for the safety of buildings, allowing accidents to occur is no longer acceptable. Therefore, risk management identifies potential hazards before any operations take place, and the safety system operates based on a planned, organized, and systematic process known as "pre-incident." This plan is based on the analysis-control method. Failure to utilize risk management methods and the acceleration of the construction industry can lead to a decrease in the safety of residents and introduce unpredictable risks. While nowadays risk management is less utilized for project control, contractors face numerous problems after construction. Lack of resources and facilities in this regard can be problematic, but emerging building technologies, which are slowly being identified, can solve and separate most of the industry's safety issues. Therefore, utilizing innovative building technologies not only enhances quality, speed, and cost reduction in construction but also contributes significantly to industrialization and the reduction of risks resulting from deteriorated structures towards building safety. In this study, the extraordinary effects of innovative technologies on building safety have been examined, and the relationship between risk management and innovative technologies has been investigated using a questionnaire. The impacts of all risk management and safety aspects are examined in this research, which ultimately resulted in clarifying the direct and meaningful connection between risk management and safety with modern technologies and determining the necessary corrective measures to improve building safety performance through the use of innovative building technologies. [ABSTRACT FROM AUTHOR]

This paper presents a methodology to evaluate life safety risk of coastal communities vulnerable to seismic and tsunami hazards. The work explicitly incorporates two important aspects in tsunami evacuation modeling: (1) the effect of earthquake-induced damage to buildings on building egress time, (2) the effect of earthquake-induced debris on horizontal evacuation time. The city of Seaside, Oregon, is selected as a testbed community. The hazard is based on a megathrust earthquake and tsunami from the Cascadia Subduction Zone that was defined in a previous study. The built environment consists of buildings and the transportation network for the city. Fragility analysis is used to estimate the seismic damage to buildings and resulting debris that covers portions of the road network. The horizontal evacuation time is determined based on the shortest path to shelters, including the increased travel time due to the earthquake-generated debris. The effects of different mitigation strategies are quantified. Results indicate the fatality and life safety risk of a near-field tsunami increases by 4.2–8.3 times when the effects of building egress and earthquake-induced debris are considered. The choice of population layer affects the life safety risk and thus the maximum risk is obtained when daytime populations are considered. Use of mitigation strategies result in a significant decrease in the number of fatalities. For hazards with recurrence intervals larger than 500- to 1000-years, the seismic retrofit is comparable to vertical evacuation and an effective strategy in reducing fatalities and associated risks. Implementing all mitigation strategies reduces the life safety risk by 90%. [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.

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]

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]

In the models developed by probabilistic safety analyses (PSA) and in their applications associated with nuclear power plants (NPPs), the risk importance of a particular feature can be, most generally, divided into two categories: importance with respect to the risk-increase potential and importance with respect to the risk-decrease potential. A representative measure of the first category is risk achievement worth (RAW), while a representative measure of the second category is risk reduction worth (RRW). The present paper discusses the use of RAW and RRW in achieving safe design and points out some implications of their mutual dependency on the selection of a risk-reduction strategy. A simple example is provided to illustrate the differences between the two basic strategies and point out to the main issues and conclusions.

Introduction: Cardiovascular diseases (CVDs) have many risk factors; few can be modified through health education. Traditional patient counselling methods fail to impact health behaviours to prevent or reduce the risk of CVDs. Objectives: This study was conducted to estimate the effect of various risk communication methods on CVD risk reduction and medication adherence. Design: An open-label superiority randomised control trial was conducted where 159 patients were randomised into three groups: Communication of 10-year Framingham CVD risk score, heart age, and routine care. Follow-up was done 3 months after recruitment. The primary outcome was a difference in excess 10-year Framingham CVD risk score in the end-line compared to baseline. The status of modifiable behavioural risk factors at baseline was expressed as ‘yes’ and ‘no’, and follow-up was defined as ‘action’, ‘positive maintenance’, ‘negative maintenance’, and ‘defaulter’. The trial was registered with the Clinical Trials Registry India (CTRI NO. CTRI/2020/10/028614). Setting: The study setting was screening outpatient department (OPD), General Medicine OPD, and Cardiology OPD of a tertiary care hospital in Central India. Participants: Participants aged >30 years, residing in Bhopal for more than 6 months, diagnosed with hypertension or diabetes mellitus or both, and having any of the four CVD behavioural risk factors: tobacco use, alcohol use, physical inactivity, or unhealthy diet. Results: Median excess 10-year Framingham CVD risk scores were 0.945% (CI: 1.275–4.297), –0.850% (–3.932–2.075), and –1.300% (–5.100–0.900) (10-year Framingham CVD risk score vs Heart age vs Routine care) and 0.000% (–3.125–5.925), –1.600% (–3.760–1.475), and –1.400% (–6.600–5.900) before and after intervention, respectively (P > 0.05). Positive maintenance was higher in both intervention groups concerning all modifiable behaviours, with a higher proportion reported in the 10-year Framingham risk score. The action phase was reported higher in intervention groups for medication adherence, addiction, and dietary changes. Conclusion: Systematic risk communication methods reduced the probability of contracting CVD in the future, though this finding was statistically insignificant.

Objectives Data Sources and Study Setting Study Design Data Collection/Extraction Methods Principal Findings Conclusions 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).2012–2024 VA administrative and survey data.This is a summary of findings and impacts from four effectiveness‐implementation projects focused on in‐person and/or online DPP across VA sites.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.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.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]

Introduction: Over one‐third of US adolescents engage in health risk and problem behaviors. Additionally, significant percentages of problem‐free youth aren't flourishing. Left unaddressed, the lifetime mental/physical health and financial burdens may be substantial. Social‐Emotional Learning (SEL) and Positive Youth Development (PYD) programs have proliferated to address the drivers of adaptive versus risk behaviors. Research suggests SEL/PYD program outcomes can be improved by adding techniques that physiologically induce calmness, yet few studies exist. Methods: This randomized controlled trial of 79 urban eighth‐graders examined a standardized bio‐psycho‐social program, SKY Schools, which incorporates a physiologically calming component: controlled yogic breathing. Results: Repeated‐measures ANOVAs demonstrated that compared to controls, SKY graduates exhibited significant improvements in emotion regulation, planning and concentration, and distractibility. After 3 months, significant improvements were evidenced in emotion regulation, planning and concentration, identity formation, and aggressive normative beliefs. Conclusion: SEL/PYD programs may benefit by incorporating biologically‐calming techniques to enhance well‐being and prevent risk/problem behaviors. [ABSTRACT FROM AUTHOR]

Disasters and climate-related events, including tropical storms, droughts, coastal erosion, and ocean acidification, threaten small island nations. Given the urgency of reducing disaster risks and the effects of climate change on vulnerable populations, this reflection essay pursues three objectives. First, it highlights the role of anthropology, ethnography, and multi-sited research in exploring disaster impacts, climate crises, and public policy in island communities. It then highlights national planning and inter-regional activities to build awareness of various risk reduction efforts by island nations and multi-governmental organizations. This article concludes with discussion prompts to engage researchers, scholars, students, and practitioners studying and working in small island nations. Due to the growing interest in climate equity and justice, this paper argues that anthropologists can offer valuable methodologies and approaches to develop transdisciplinary and nuanced insights into researching disaster risk reduction efforts and climate policy networks in and across island nations. [ABSTRACT FROM AUTHOR]

Background Flavorings in cigars increase their appeal, mask the harsh taste of tobacco, and may hinder successful cigar smoking cessation; however, limited evidence has examined whether flavors are associated with short- or long-term cigar smoking cessation. Aims and Methods Using restricted data from the Population Assessment of Tobacco and Health Study Waves 1–5, we examined whether flavored cigar use was associated with 30-day-plus and 1-year-plus cigar smoking cessation among US adults. Multivariable discrete-time survival models were fit to a nationally representative sample of US adult (18+) respondents who had a current, established cigar use, smoked five or more days in the past 30 days, and did not exclusively smoke traditional premium cigars at baseline. Models adjusted for age, sex, race and ethnicity, income, cigar and cigarette smoking intensity, and blunt use. Results At baseline, 44.6% of respondents (n = 674) were 18–34 years old, 75.0% were male, 56.7% were non-Hispanic White, 78.9% had household incomes of <$50,000, and 56.2% smoked flavored cigars. In fully adjusted models, flavored cigar use was associated with a lower risk of 30-day-plus (HR = 0.76, 95% CI = 0.60, 0.97) but not 1-year-plus cigar smoking cessation (HR = 0.81, 95% = 0.62, 1.05). Conclusions We found that flavored cigar use was associated with a lower risk of short-term but not long-term cigar smoking cessation. More work is needed to understand the dynamics of cigar smoking transitions, including initiation, cessation, and relapse, particularly in larger cohorts and among those who exclusively use cigars or dual-use cigars and cigarettes. Implications As local and some state jurisdictions continue to adopt partial or complete bans of flavored cigar products and the United States Food and Drug Administration considers a national ban of all characterizing flavors in cigars, there is a need for more longitudinal work examining the associations between flavorings in cigars and short and long-term cigar-smoking behaviors, including but not limited to initiation, cessation, intensity of use, and relapse, particularly in diverse cohorts. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) is effective in the primary and secondary prevention of noncommunicable diseases. However, PA levels of most people are still too low. Almost all current treatment guidelines recommend counselling and motivating patients to become more physically active. How can such counselling be implemented effectively and efficiently in general practice? Objectives: The authors provide an overview of the relevance of the topic, of studies and recommendations on the implementation and effectiveness of PA counselling by general practitioners (GPs), and drawing conclusions for GP practice and research. Materials and methods: Nonsystematic summary of the scientific and nonscientific literature on the topic. Results: Counselling on PA by GPs can provide an impetus to motivate patients to increase their PA levels. It can be delivered as brief advice and is particularly effective when including an offer of support, specific recommendations that can be implemented by the patients, and focused follow-up contacts. Studies often show structural barriers to the implementation of appropriate PA advice or counselling. These barriers represent research topics relevant to general practice. Conclusion: By offering brief advice on PA, GPs can make an important contribution to reduce the burden of chronic diseases. Therefore, effective strategies to strengthen GP-initiated promotion of PA should be developed. Relevant approaches of action comprise the improvement of structural conditions as well as the improvement of practical skills and confidence in implementing effective advice on PA for GPs. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease and related dementias (ADRD) incidence varies based on demographics, but mid-life risk factor contribution to this variability requires more research. Objective: The purpose of this study is to forecast the 20-year incidence of dementia in the U.S. overall and stratified by race/ethnicity, socioeconomic status (SES), and U.S. geographic region given prior mid-life risk factor prevalence and to examine the extent to which risk factor differences 20 years ago may explain current SES, race/ethnicity, or regional disparities in dementia incidence. Methods: We applied the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) prediction model to the 2006 wave of the Health and Retirement Study (HRS) in participants aged 45 to 64 to estimate the 20-year risk of incident ADRD. Results: The 20-year risk of dementia among middle-aged Americans was 3.3% (95% CI: 3.2%, 3.4%). Dementia incidence was forecast to be 1.51 (95% CI: 1.32, 1.71) and 1.27 (95% CI: 1.14, 1.44) times that in Hispanic and Non-Hispanic Black individuals respectively compared statistically to Non-Hispanic White individuals given mid-life risk factors. There was a progressive increase in dementia risk from the lowest versus highest SES quintile. For geographic region, dementia incidence was forecast to be 1.17 (95% CI: 1.06, 1.30) and 1.27 (95% CI: 1.14, 1.43) times that in Midwestern and Southern individuals respectively compared statistically to Western individuals. Conclusions: Some disparities in dementia incidence could be explained by differences in mid-life risk factors and may point toward policy interventions designed to lessen the ADRD disease burden through early prevention. [ABSTRACT FROM AUTHOR]

Background: Diabetes inpatient specialist services vary across the country, with limited evidence to guide service delivery. Currently, referrals to diabetes inpatient specialists are usually 'reactive' after diabetes-related events have taken place, which are associated with an increased risk of morbidity/mortality and increased length of hospital stay. We propose that a proactive diabetes review model of care, delivered by diabetes inpatient specialist nurses, may contribute to the prevention of such diabetes-related events and result in a reduction in the risk of harm. Method: We will conduct a cluster randomised feasibility study with process evaluation. The proactive diabetes review model (PDRM) is a complex intervention that focuses on the prevention of potentially modifiable diabetes-related harms. All eligible patients will receive a comprehensive, structured diabetes review that aims to identify and prevent potentially modifiable diabetes-related harms through utilising a standardised review structure. Reviews are undertaken by a diabetes inpatient specialist nurse within one working day of admission. This differs from usual care where patients are often only seen after diabetes-related harms have taken place. The trial duration will be approximately 32 weeks, with intervention delivery throughout. There will be an initial 8-week run-in phase, followed by a 24-week data collection phase. Eight wards will be equally randomised to either PDRM or usual care. Adult patients with a known diagnosis of diabetes admitted to an included ward will be eligible. Data collection will be limited to that typically collected as part of usual care. Data collected will include descriptive data at both the ward and patient level and glucose measures, such as frequency and results of capillary glucose testing, ketonaemia and hypoglycaemic events. The analysis aims to determine the fidelity and acceptability of the intervention and the feasibility of a future definitive trial. Whilst this study is primarily about trial feasibility, the findings of the process evaluation may lead to changes to both trial processes and modifications to the intervention. A qualitative process evaluation will be conducted in parallel to the trial. A minimum of 22 patients, nurses, doctors, and managers will be recruited with methods including direct non-participant observation and semi-structured interviews. The feasibility of a future definitive trial will be assessed by evaluating recruitment and randomisation processes, staffing resources and quality of available data. Discussion: The aim of this cluster randomised feasibility trial with a process evaluation is to explore the feasibility of a definitive trial and identify appropriate outcome measures. If a trial is feasible and the effectiveness of PDRM can be evaluated, this could inform the future development of inpatient diabetes services nationally. Trial registration: UK Clinical Research Network, 51,167. ISRCTN, ISRCTN70402110. Registered on 21 February 2022. [ABSTRACT FROM AUTHOR]

BackgroundMethodResultsConclusionsAlthough 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.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.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.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]

In March 2024 the “National Plan of prevention to tackle Fentanyl misuse and other synthetic opioid” was published by the Minister of Health in Italy. Despite the increasing number of overdoses associated with Fentanyl misuse in other countries, such as USA and Canada, this phenomenon is still limited in Italy. Few data are available and the experience in the management of these cases is still poor in the addiction treatment services. The internet represents one of the main sources of information both in terms of scientific literature and ‘grey literature’ provided by people who use drugs. Erowid is a great example of harm reduction resource based on patients’ direct experience and scientific contributions from health professionals. [ABSTRACT FROM AUTHOR]

Protected and conserved areas (PCAs) are key ecosystem management tools for conserving biodiversity and sustaining ecosystem services and social cobenefits. As countries adopt a 30% target for protection of land and sea under the Global Biodiversity Framework of the United Nations Convention on Biological Diversity, a critical question emerging is, which 30%? A risk‐based answer to this question is that the 30% that returns the greatest reductions in risks of species extinction and ecosystem collapse should be protected. The International Union for Conservation of Nature (IUCN) Red List protocols provide practical methods for assessing these risks. All species, including humans, depend on the integrity of ecosystems for their well‐being and survival. Africa is strategically important for ecosystem management due to convergence of high ecosystem diversity, intense pressures, and high levels of human dependency on nature. We reviewed the outcomes (e.g., applications of ecosystem red‐list assessments to protected‐area design, conservation planning, and management) of a symposium at the inaugural African Protected Areas Congress convened to discuss roles of the IUCN Red List of Ecosystems in the design and management of PCAs. Recent progress was made in ecosystem assessment, with 920 ecosystem types assessed against the IUCN Red List criteria across 21 countries. Although these ecosystems spanned a diversity of environments across the continent, the greatest thematic gaps were for freshwater, marine, and subterranean realms, and large geographic gaps existed in North Africa and parts of West and East Africa. Assessment projects were implemented by a diverse community of government agencies, nongovernmental organizations, and researchers. The assessments have influenced policy and management by informing extensions to and management of formal protected area networks supporting decision‐making for sustainable development, and informing ecosystem conservation and threat abatement within boundaries of PCAs and in surrounding landscapes and seascapes. We recommend further integration of risk assessments in environmental policy and enhanced investment in ecosystem red‐list assessment to fill current gaps. [ABSTRACT FROM AUTHOR]

Aim: Ovarian surveillance in women with hereditary breast and ovarian cancer who do not undergo risk‐reducing salpingo‐oophorectomy has been controversial. Therefore, this study aimed to demonstrate the clinical features of ovarian surveillance at our institution using a technique that combines serum cancer antigen 125 measurements, transvaginal ultrasonography, and uterine endometrial cytology. Methods: We retrospectively examined 65 women, who had not undergone risk‐reducing salpingo‐oophorectomy diagnosed with hereditary breast and ovarian cancer between 2000 and 2021 at our hospital. Clinical information was obtained and analyzed through a chart review. The details of the treatment course were reviewed for patients who had developed ovarian cancer. Results: Overall, 5 of the 65 women were diagnosed with ovarian cancer based on abnormal findings during periodic surveillance. All patients who developed ovarian cancer were asymptomatic, even if the cancer was at an advanced stage. Two of the 65 patients had endometrial cytology abnormalities, both of whom had ovarian cancer. All patients who developed ovarian cancer underwent primary debulking surgery, and complete gross resection was achieved. None of the patients experienced ovarian cancer recurrence. Conclusions: The ovarian surveillance strategy at our institution for women with hereditary breast and ovarian cancer who do not undergo risk‐reducing salpingo‐oophorectomy can identify asymptomatic ovarian cancer and contribute to achieving complete gross resection during primary surgery. Ovarian surveillance may contribute to a reduction in ovarian cancer mortality. [ABSTRACT FROM AUTHOR]