Acceptable Strategy Research Articles

Interaction between acceptability and probability: Evidence from predicate agreement with a coordinated subject in Russian

The study aims to establish whether language models trained on unlabeled text data can parametrize agreement variation. We compared the acceptability judgments made by native speakers and the probability metrics predicted by the language model ruBERT without fine-tuning. As a specific linguistic phenomenon, we considered predicate agreement with a coordinated subject in Russian. We analyzed in detail which syntactic, morphological, and semantic factors influenced sentence acceptability and probability. The experimental data enables us to reveal the role of each factor and their interaction. Besides the standard logarithmic probability, we considered sentence length and unigram probability. We assumed that the model would assign the highest probability to the most acceptable agreement strategy. However, our hypothesis was not confirmed: the correlation between probability and acceptability is lower for sentences with agreement variation than for sentences without variation. The linear position — the subject-predicate order and the conjuncts’ order — turned out to be the only factor which equally influences the acceptability and probability of a sentence. If the gender features of conjuncts match, the acceptability of singular agreement increases while the probability does not change. The animacy of conjuncts and the predicate symmetry influence neither acceptability nor probability. Our research demonstrates that ruBERT cannot be used to parametrize predicate agreement with a coordinated subject. The acceptability of a sentence is based on subtle linguistic contrasts which are not significant for the computer evaluation of its probability.

Effect of torque customization with composite resin bases on the shear bond strength and adhesive remnant patterns of lingual brackets : An in vitro evaluation.

This study evaluated the effect of torque customization of lingual brackets with resin-modified bases on their shear bond strength (SBS), adhesive remnant index (ARI), and bond failure patterns (BFP). The sample comprised 200 lingual lower incisor brackets (DTC® ORG, DTC Medical Apparatus, Hangzhou, China); 40brackets were tested as-received and 4groups with 40brackets each were customized for -10, -20, +10 and +20° torque respectively with light-cured composite resin (Transbond XT™, 3M Unitek, Monrovia, CA, USA) bases. All brackets were bonded to bovine mandibular incisors. Their SBS were estimated in auniversal testing machine (INSTRON®, Norwood, MA, USA) with agingivally directed force applied at the incisal bracket-adhesive interface with 1 mm/min crosshead speed. Their ARI and BFP were evaluated under 20× magnification. The SBS was 19.9 ± 7.6 MPa for noncustomized brackets, 20.1 ± 9.0 and 18.7 ± 8.2 MPa for brackets with 10 and 20° of negative torque, and 16.6 ± 5.68 and 19.45 ± 5.84 MPa for brackets with 10 and 20° of positive torque, respectively. The differences were not statistically significant (p = 0.097). Teeth with the -20° brackets exhibited higher median ARI scores than noncustomized brackets (1.5 vs 2, p = 0.018). Adhesive-cohesive bond failure with nearly axial split was more frequent in noncustomized brackets than customized ones, the reverse being true for adhesive-cohesive failure with nearly vertical split (p < 0.05). Truly cohesive bond failures were seen only in brackets with positive torque. Torque customization with aresin base is an acceptable strategy for metal orthodontic brackets as it does not affect their SBS. However, their BFP differed from noncustomized brackets, depending on the type of torque introduced.

What makes peers credible? A qualitative analysis to operationalize peer credibility in HIV-prevention and treatment programs for Latino MSM

ABSTRACT The potential of peers to be effective in delivering HIV interventions is linked at least in part to the degree to which they are perceived as credible sources of HIV-related information. This study aimed to operationalize qualities that would make a LMSM peer implementer credible. We conducted a qualitative analysis of semi-structured interviews with 20 LMSM and focus groups with 11 HIV service implementers. The parent study collected formative data to inform the design of a strategy to enhance the reach of HIV prevention and treatment services to LMSM. The present study examined participant views on qualities necessary for peer implementers to establish credibility among LMSM. We identified five themes regarding peer credibility, including (1) Peers must be trained in HIV prevention and care, (2) Peers should be verified and have a special designation indicating their knowledge and trustworthiness, (3) Peers should convey accurate information and not spread misinformation, (4) Peers should be relatable and interpersonally skilled, and (5) Peers should be engaged with the general LGBTQ + community to generate trust and credibility. Findings can inform the development of acceptable peer strategies for LMSM, peer recruitment, training, and peer supervision.

How beliefs and policy characteristics shape the public acceptability of nutritional policies- a survey study in Germany

BackgroundDespite the high prevalence of obesity in Germany, few effective political measures have been implemented to protect population health and improve the sustainability of food systems. One argument frequently raised against policy implementation is the lack of acceptability for policy measures in the German population. AimWe aimed to evaluate the acceptability of policy measures currently discussed in Germany's national nutrition strategy and how perceived policy characteristics and participant characteristics influence policy acceptability. MethodWe conducted an online survey with 2001 participants between 06.12.2023 and 05.01.2024, in which we collected data on perceived policy characteristics (acceptability, equity, societal and personal effectiveness), as well as participant values and beliefs. ResultsMost policies were highly acceptable, with policies such as the introduction of free school lunches (84% acceptability), the introduction of a ban on fast food advertising aimed at children (71%) or a sugar tax (53%) being acceptable to a majority of the sample. The least acceptable policy was the introduction of a tax on animal products (36%). Logistic regression analyses showed that perceived equity and societal and personal effectiveness predicted policy acceptability. Likewise, environmental values and beliefs about state intervention of participants influenced policy acceptability. ConclusionThe high acceptability observed in this study suggests an opportunity for German policymakers to implement evidence-based and acceptable nutritional strategies to improve population health.

Parental vaccine hesitancy toward routine childhood immunizations and COVID-19 vaccines in Japan: A cross-sectional study

BackgroundThis study aimed to elucidate the prevalence and characteristics of parental vaccine hesitancy towards routine infant immunizations and COVID-19 vaccines in Japan.MethodsA web-based survey was conducted among 3,227 parents of children aged 0–11 years to assess vaccine-related hesitancy for routine infant immunizations and COVID-19 vaccines for children using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Data were collected from January 18 to 25, 2023. Covariates included demographic characteristics, economic status, COVID-19 infection status, decisional conflict scale, and the fear of COVID-19 Scale.ResultsVaccine hesitancy was found to be 52.4% for routine infant immunizations and 73% for COVID-19 vaccines. Significant differences in parental attitudes were observed between general childhood vaccines and COVID-19 vaccines for 12 out of 13 PACV survey items. The COVID-19 vaccines showed higher hesitancy rates in 10 items; largest discrepancies were noticed in schedule adherence (22.5% vs 61%), overall hesitancy (40% vs 55.1%), and trust in pediatric doctors (37.2% vs 53.6%). Safety concerns were high for both vaccine types, exceeding 50%. Multivariable analysis identified decisional conflict (RR: 1.01 95% CI: 1.00–1.02) and COVID-19-related fear (RR: 1.04, 95% CI: 1.02–1.05) as hesitancy predictors for routine immunizations.ConclusionVaccine-related hesitancy for COVID-19 was significantly higher than that for routine immunizations, with decisional conflict emerging as a primary predictor for both. Fear of COVID-19 was associated with routine immunization-related hesitancy. These findings provide critical insights for future pandemic preparedness and vaccine acceptance strategies, highlighting the importance of strengthening trust between healthcare providers and parents, providing clear and reliable information, and implementing decision support tools.

Pilot evaluation on an adapted tele-behavioral activation to increase physical activity in persons with depression: a single-arm pilot study

BackgroundPhysical activity has the potential to improve physical and mental health outcomes of persons with depression. However, feasible and acceptable strategies to integrate physical activity interventions into real-world settings are needed.ObjectiveTo assess the feasibility and acceptability of a manualized Behavioral Activation intervention aimed to increase physical activity in persons with depression (defined as a PHQ-9 score ≥ 10).MethodsA single-arm pilot study was conducted. The intervention consisted of 8 tele-therapy sessions delivered over a 10-week period. Measures of feasibility included screening, enrollment, intervention adherence, outcome data availability, and intervention fidelity. Acceptability was assessed with a post-intervention survey and qualitatively through focus groups and interviews. Preliminary efficacy of the intervention was assessed by evaluating pre-to-post changes in physical activity and depressive symptoms.ResultsAll feasibility metrics exceeded predetermined feasibility goal metrics with the exception of Fitbit wear and screening rate, which was due to a greater than anticipated enrollment rate. Participants (n = 15) reported perceived benefits from the intervention and convenience in attending tele-therapy sessions. Depressive symptoms, as measured by the PHQ-9 improved (16.8 at enrollment to 10.1 post intervention, Cohen’s d = 1.13). Self-reported moderate-to-vigorous physical activity (MVPA) increased from 22.0 min/week at baseline to 36.67 min/week post-intervention (d = 0.58). Physical activity as measured by the Fitbit showed little change (daily step 5543.29 during Week 1 to 6177.48 during Week 10, (d = 0.14); MVPA 21.23 min/week during Week 1 to 19.22 at Week 10 (d = 0.0.06).ConclusionsResults of the pilot study suggest the intervention is feasible to deliver and acceptable to participants. Preliminary results suggest the intervention may be effective in improving depressive symptoms and increasing self-reported physical activity.Trial registrationClinicalTrials.gov NCT04990401, Registered July 21, 2021.

To act or wait: The impact of disruption duration estimates on manufacturer’s response strategies

In the event of a disruption at a primary supplier, the manufacturer’s sourcing and production operations are inevitably affected, necessitating a response strategy based on the estimated disruption duration. This article derives the optimal production policy for each response strategy, aiming to minimize total costs over a planning horizon within a dynamic programming framework. We characterize these production policies across various model parameters, particularly focusing on the estimated disruption duration and initial inventory level. Our analysis identifies when the passive acceptance strategy and the backup strategy each hold an advantage, and how the cost benefits of each strategy vary with different model parameters. Additionally, we examine the consequences of overestimating or underestimating the disruption duration, providing insights into how the chosen response strategy and production policy, based on the estimated duration, diverge from the true optimal ones as the actual duration unfolds. We also highlight the cost implications of these discrepancies. Finally, in scenarios where the true duration follows a probabilistic distribution, our numerical experiments demonstrate how strategy selection and the cost of misestimation are influenced by the mean of the true disruption duration and the initial inventory level. These analyses offer decision-makers valuable guidance on when to act or wait in the face of disruptions.

An exploration of attitudes regarding the use of a state tobacco Quitline for smoking cessation among low-income adults with a history of smoking.

Smoking rates among low-income smokers are significantly elevated. State tobacco quitlines offer free and evidence-based treatments for smokers living in that state. This study investigated knowledge, attitudes, and beliefs associated with engagement with the Illinois Tobacco Quitline among confirmed smoking patients at a Federally Qualified Health Center (FQHC). Further goals were to obtain recommendations for strategies to improve patient awareness and engagement. Data for this study were collected from August to October 2021 from patients receiving care in an FQHC in a large midwestern city in the USA. Clinic-based recruitment was used to enroll a sample of adult current smokers. In-depth interviews and brief surveys were completed with a volunteer sample of patients recruited from an FQHC. The interviews took approximately 60 minutes. Data analysis used descriptive statistics to summarize the responses to the study and deductive thematic analysis to analyze the qualitative interviews. Study participants (n=25) were primarily male, African American, and middle-aged (mean age: 52.5 years). The majority were daily smokers. Over half had heard about the Quitline from sources such as radio advertisements, but usage was low. Barriers to use included low motivation to quit, questions about effectiveness, and poor success with prior Quitline attempts. Participants described factors that would increase the appeal of the Quitline, including testimonials, personalization, and an empathetic approach. Participants were asked about the acceptability of receiving information about the Quitline via patient portals, and most were in support. Interventions are needed to raise awareness and utilization of Quitlines among patients receiving care in FQHC settings. Distribution of Quitline information via patient portals is an acceptable strategy for increasing awareness of services.

School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review.

Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation. This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health. We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies. After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality. The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.

Market Acceptance Strategy through Customer Centricity Approach in Electric Truck Product Development with Systematic Method Literature Review

Transportation is one of the contributors to CO2 pollutants that cause Greenhouse Gas (GHG) emissions, ultimately impacting global climate change. The creation of electric vehicles is concerned with clean energy and handling global climate change. This aligns with the 17 global goals of the United Nations, which are the world agenda to protect planet Earth and for everyone to live a decent life by 2030. However, creating innovations in production and transforming consumers to switch from fuel vehicles to electric vehicles, especially electric trucks, is equally difficult. In 2022, based on data from Vehicle Type Approval, electric truck sales in Indonesia have the lowest number compared to other types of electric vehicles. This study aims to discover how innovation should be carried out and how consumer desires can be fulfilled from these innovations so that the market easily accepts electric truck products with the hope that interest and sales can increase. This study uses a literature study method that provides an overview of how the customer-centricity approach is applied to support innovation during production. The results of this study provide suggestions in the development of electric trucks that companies should not only focus on technology but also focus on consumer needs to adopt electric truck technology such as cost and economic benefits, charging infrastructure available in various locations, government support and policies, social influence, economic and social factors, promotion policies and regional support.

“Saying ‘thank you’ or something more than lip service”: a variational analysis of the influence of gender and social status on responses to congratulations on Chinese WeChat

Abstract Existing studies on responses to congratulations to date have displayed a general culturally-bound finding that Chinese speakers prefer to take a detour approach. However, the effect of social constraints on response strategies have not received the attention it deserves. Drawing on a variational pragmatic approach, this study explores the constraints of gender and social status on the pragmatic variation of Chinese WeChat users’ responses to congratulations. Building upon an integrative data set of congratulatory interactions in actual online messages, the findings suggest that gender and social status overlap in complex ways, but with a clear tendency: both men and women significantly tend towards an acceptance strategy when responding to congratulations on WeChat, while social status influences the sub-strategies used in accepting congratulations across both male and female groups. The findings challenge previous stereotypes about Chinese language variation in responses to congratulations. The current results suggest that Chinese speakers have already made a transition from following the Modesty Maxim to using the Agreement Maxim, and have also incorporated the Obligation Maxim. Chinese speakers also consider rapport and reciprocity when responding to kind congratulatory remarks.

Can a mindfulness programme in schools for students with ADHD symptoms improve emotional well-being?

Abstract Background This study employs a cluster randomized controlled trial to investigate the effectiveness of a universal mindfulness-based intervention (MBI) in classrooms in improving emotional well-being and emotion regulation among adolescents with elevated ADHD symptoms. Methods The study comprised 342 students: 164 in an MBI group, 128 in a relaxation control group, and 47 in an inactive control group. Positive and negative emotional states and the emotion regulation strategies of rumination, acceptance, catastrophizing, positive reappraisal, and self-kindness were measured at the pre- (T0) and post-intervention (T9) and the 26-week follow-up (T26). Linear mixed models were used to analyze the intervention effects among all participants and separately by gender and ADHD symptom type. Results The results showed that compared to the controls, there was a beneficial effect on the MBI group concerning acceptance at T9; acceptance remained at the baseline level in the MBI group but decreased in the inactive control group. In contrast, in the inactive control group, rumination decreased at T9, and positive reappraisal increased at T26 compared to the MBI group. The MBI had no detectable effects on self-kindness, catastrophizing, or positive/negative emotional states. Findings on the emotion regulation strategies varied by gender. In boys, the MBI increased acceptance at T9 compared to the inactive control group, whereas in girls, the programme reduced catastrophizing at T9 and T26 compared to the active control group. Contrary in boys, MBI group exhibited less reduction in catastrophizing at T9 compared to the inactive control group. Conclusions Universal MBIs may have some beneficial effects on emotion regulation in adolescents with elevated ADHD symptoms. Both girls and boys might be responsive to universal MBIs as part of the school curriculum, however not all consequences are positive (especially in boys). Key messages • Universal MBIs in classrooms may have some beneficial effects on emotion regulation among adolescent with elevated ADHD symptoms; however, the results are contradictory and more research is needed. • Even though, universal MBIs may have some benefits, they may require modifications to lead to more beneficial effects on emotional well-being when used with this subgroup of students.

Carving out space for co-creation in implementation of evidence-based mental health interventions

Abstract Background Mental health is identified as a pressing public health priority for European countries challenged by societal changes. The ADVANCE project aims to strengthen our understanding of mental health promotion and prevention in seven countries in Europe. In Denmark, the research project sets out to understand how WHO’s stress management intervention Self Help Plus can be embedded within social and integration programmes for adults who have experienced migration. Methods We are using a common methodology across the 7 country projects oriented by co-creation with end users and relevant stakeholders to initially develop implementation scenarios and stigma reduction strategies. We will present findings from this process and reflect on the tension and potential of the co-creation methodology in the implementation of evidence-based mental health interventions. Results In the first project phase of problem analysis and co-creation, the project’s society advisory group discussed 10 tailored intervention scenarios. Then, a Delphi survey and two rounds of scenario-based workshops with additional involvement of 16 end users/actors resulted in a final implementation scenario and stigma reduction strategies. We identified and reflected on questions around ownership of the project, boundaries of the proposed intervention, alignment of expectations, and intervention sustainability within the parameters of the ADVANCE project. Conclusions Even when interventions are pre-selected in response to funding calls, co-creation can facilitate the development of acceptable and sustainable implementation strategies. However, meaningful co-creation requires time, flexibility, and negotiation, which is not always guaranteed. Key messages • Co-creation creates productive tension and potential for the implementation of ADVANCE. • Space for co-creation was negotiated with collaborators to ensure meaningful engagement.

Virtual practice facilitation as an implementation strategy for launching opioid safety committees for quality improvement in primary care: feasibility, acceptability, and intervention fidelity

BackgroundPractice facilitation (PF) is an evidence-based multicomponent in-person implementation strategy. COVID-19-related lockdowns caused many implementation initiatives to rapidly shift to virtual settings, but there is limited evidence on PF deployed exclusively using virtual meeting platforms. Our objective was to assess the feasibility and acceptability of virtual PF used in a primary care setting to implement interdisciplinary opioid safety committees (OSCs) to improve care for patients using opioid medicines for persistent pain and reduce high-dose opioid prescribing. We also describe alignment of virtual PF with the core functions of PF and fidelity of participating clinics to the OSC intervention.MethodsWe applied qualitative and quantitative methods to evaluate virtual PF used to implement a quality improvement project at Kaiser Permanente Washington, an integrated health system in Washington State. We established interdisciplinary OSCs in primary care clinics using virtual PF. OSCs were tasked with promoting opioid safety and high-quality pain care through population management and chart reviews. We used administrative data to calculate feasibility measures including attendance and retention. Acceptability data came from interviews with OSC members conducted by evaluators. Measures of fidelity to the OSC intervention were abstracted from meeting notes and administrative data. We used qualitative methods to assess the adherence of virtual PF to the core functions of PF.ResultsFacilitators carried out a comprehensive PF approach virtually and demonstrated adherence to the core functions of PF. We established OSCs in eight clinics and conducted an average of 17.5 virtual PF meetings over eight months of PF for each clinic. Average attendance was 75% and we had 84% retention. OSC members were highly satisfied with virtual PF. Facilitators effectively supported teams through implementation and technical challenges and OSC members gained skills through virtual PF. We implemented OSCs with high fidelity, suggesting virtual PF is an effective implementation strategy.ConclusionsWe found virtual PF is a feasible and acceptable implementation strategy for this intervention and identified strategies to support care teams through challenges. Our findings can help inform future implementation efforts, especially those hoping to engage geographically dispersed clinics or remote clinical staff.Trial registrationNot applicable.

Evaluating a virtual facilitation workshop with antimicrobial stewardship teams within a cluster randomized stepped-wedge trial

BackgroundAntimicrobial stewardship programs (ASP) often function naturally as facilitators within clinical hospital settings, by working with individuals and teams to reduce unnecessary antibiotics. Within implementation science, facilitation has been studied and evaluated as an implementation strategy that can accelerate and improve fidelity to implementation efforts. This study describes a novel, virtual facilitation strategy developed and served as an intervention within the optimizing perioperative antibiotics for children trial (OPERATIC trial). This paper: (1) describes ASP team’s preferences for and use of a facilitation workshop and (2) describes sustained use of facilitation skills throughout the study period.MethodsStudy participants included antimicrobial stewardship team members from the nine children’s hospitals that participated in this study and completed facilitation training. All individuals who completed facilitation training were asked to evaluate the training through an online survey. Additionally, site leads were interviewed by the site coordinator every other month and asked about their team’s use of facilitation skills throughout the rest of the study period. Survey data were managed and coded in R, and qualitative interview data were analyzed using rapid methodology.Results30 individuals, including both physicians and pharmacists, completed the evaluation. Individuals largely rated themselves as novice facilitators (53%). Individuals reported satisfaction with virtual facilitation and identified different components of the workshops as valuable. An additional 108 interviews were performed throughout the study period. These interviews found that facilitators reported using all skills throughout the study period and described varied use of skills over time. All nine sites applied facilitation strategies, team building techniques, and communication/conflict skills at some point during the intervention phase.ConclusionWe describe the use of virtual facilitation as an acceptable and appropriate strategy to enhance facilitation skills for ASP teams working to reduce unnecessary postoperative antibiotics. Participants reported different useful components of facilitation training and described using differing facilitation skills throughout the trial. Overall, the use of facilitation skills continued throughout the duration of the study period. This paper outlines how facilitation training can be conducted virtually in a way that is feasible and acceptable to clinicians.Trial registrationNCT04366440, April 24, 2020.

Student-Led Mobility Interventions for Hospitalized Adults: A Mixed-Methods Feasibility and Acceptability Study.

Inactivity in hospitalized patients often leads to functional decline. We created an undergraduate course to promote mobilization, provide hands-on learning, and address staff shortages. To assess the feasibility and acceptability of undergraduate students providing mobility-focused interventions for hospitalized adults. This mixed-methods study was conducted at a level 1 trauma academic center. We analyzed program feasibility and acceptability using quantitative data and thematic analysis of interviews and focus groups. In total 47 individuals (n=14 students, n =9 patients, and n =24 clinicians) were included. Students averaged 4.1 mobility sessions per 4-hour shift. All stakeholders agreed the program is acceptable, and 98.6% affirmed the program is feasible. The themes identified included positive impacts on patient care, enhanced student professional development, and practical implementation challenges. Student-led mobility interventions can be an acceptable strategy to mitigate immobility harm in hospitalized patients. The integration of students enhances patient care and provides valuable educational experiences.

Jehovah's Witnesses: Challenges in liver disease management and in liver transplantation.

Patients of Jehovah's Witnesses faith who are in need of liver transplantation pose unique challenges. These patients should be seen at transplant centers with experience in caring for Jehovah's Witnesses to formulate careful preoperative, intraoperative, and postoperative strategies on an individualized basis with multidisciplinary input to mitigate the risk of bleeding complications and to prepare for potentially catastrophic scenarios. In-depth and individualized conversations about what constitutes acceptable bloodless transfusion strategies both for the patient and for the transplant center should begin as early as possible with an experienced coordinator or church liaison. A therapeutic physician-patient relationship is vital to formulating a safe care plan and to understanding the spectrum of beliefs among Jehovah's Witnesses. There remains a paucity of data on disparities in liver care and outcomes in patients of the Jehovah's Witnesses faith. Future research on liver diseases and liver transplantation in Jehovah's Witnesses should focus on creating registries of patient outcomes and centers with experience.

Store Safely: A firearm injury prevention strategy for rural families.

Firearms are the leading cause of death for youth in the US. Safe firearm storage is an evidence-based risk reduction technique, yet many families with children maintain unsecured firearms. In rural areas where gun ownership is common and rates of firearm-related suicides are increasing, developing culturally acceptable and feasible safe storage prevention strategies may have promise for reducing morbidity and mortality. This pilot study used a community-based participatory approach to develop a culturally tailored multi-component online safe storage preventive intervention called Store Safely. Participants were 45 rural firearm owning parents representing 45 unique families (35% male, 65% female, M age = 37.88, SD = 6.14) who had at least one child living at home. Acceptability, feasibility, and preliminary impact on firearm storage behaviors were measured via pre-test and post-test self-report surveys. Of the 43 parents (43 families) retained at follow-up, 97.7% completed the intervention and 86% utilized a home safety checklist. 40% of participants reported improving their storage, offering examples such as purchasing gun locks, safes, or lockboxes; separating ammunition from weapons; reviewing or discussing the safety of current storage; and relocating firearms to reduce child access. 84% found the website culturally sensitive and would recommend the materials to other parents. This firearm safe storage preventive intervention, developed in partnership with a rural community and tailored to reflect community norms and values, was associated with high levels of parental acceptability, engagement, and behaviors in support of safe firearm storage, suggesting its promise as a firearm injury prevention strategy.

Implementing African Continental Free Trade Area: Lessons from Afro-Pessimists and Afro-Optimists

Global cooperation has been an acceptable strategy for addressing many of the world’s challenges. The African Continental Free Trade Area (AfCFTA) agreement which entered into force on 30 May 2019 was designed in a similar light for Africa’s development. Its objectives among others are to create a single market for goods, and services, and deepen the economic integration of the African continent by the vision of an integrated, prosperous, and peaceful Africa as enshrined in the Agenda 2063. However, these benefits may not be realized unless member states garner concerted and sustained efforts to ensure the effective implementation of the AfCFTA. These efforts often elude most developing countries, and it is against this backdrop that this study attempts to investigate whether the contrasting perspectives of the Afro-pessimists and Afro-optimists could be of relevance to AfCFTA implementation. Using desk review methodology, the study synthesized both empirical and theoretical literature and found that Afro-pessimists are very critical and paint a gloomy picture of Africa. Whereas the Afro-optimists, are more positive looking with the claim that Africa is mistreated and its achievements are inordinately ignored. Significantly, both perspectives deepen understanding of the strengths and weaknesses of Africa’s development, providing a useful context for either the failure or success of the AfCFTA’s implementation. The key lesson the study draws is for Africans to maximize their strengths as much as possible and minimize their weaknesses. This will actualize the “Africa rising” phrase and lead to the majority of Africans rising with Africa.

Predictors of recurrent restenosis after repeat drug-coated balloon therapy for drug-coated balloon restenosis in femoropopliteal lesions: Results of the RECURRENCE study.

Despite the widespread use of drug-coated balloons (DCBs) for femoropopliteal (FP) lesions, there is still no consensus on treatment strategies for DCB restenosis. This study aimed to determine the risk factors for recurrent restenosis after repeat DCB therapy for DCB restenosis in FP lesions. This multicenter retrospective study assessed 1176 consecutive limbs in 860 patients who successfully received initial DCB therapy for FP lesions at four cardiovascular centers between May 2018 and December 2022. Among these patients, 118 consecutive limbs of 104 patients treated via repeat DCB for primary DCB restenosis were enrolled. The Kaplan-Meier estimate of freedom from recurrent restenosis was 74.6% at 1 year. Cox proportional hazard multivariate analysis revealed that recurrent restenosis was independently associated with the time from initial DCB to primary restenosis (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.79-0.92; p < 0.001), history of ≥2 endovascular therapies (EVTs) (HR, 3.11; 95%CI, 1.36-7.12; p = 0.007), and PACSS grade 3 or 4 (HR, 2.76; 95%CI, 1.15-6.63; p = 0.023). Furthermore, receiver operating characteristic curve analysis showed that the cutoff value of the time from initial DCB to primary restenosis to prevent recurrent restenosis was 12.6 months, with an area under the curve of 0.841 (p < 0.001). Repeat DCB therapy for DCB restenosis might be an acceptable strategy, particularly for restenosis that occurred more than 12.6 months after initial DCB, given the rate of freedom from recurrent restenosis.