Comprehensive Prevention Strategy Research Articles

Using a Public Health Approach to Prevent Child Sexual Abuse by Targeting Those at Risk of Harming Children

The evidence is clear that child sexual abuse is a public health concern internationally. Prevention of child sexual abuse requires a variety of interventions including those that stop individuals from either sexually assaulting a child or viewing sexually abusive online images. In contrast, most current approaches internationally focus on criminal justice strategies aimed at preventing reoffending rather than stopping the first offence. Additionally, and albeit there is a general paucity of relevant scholarship, there are few signs of countries adopting coherent, unified and evidence-based strategies to prevent individuals at risk of harming a child becoming actual or repeat offenders. The focus of interventions to date is largely on prevention at the tertiary end. Understanding and adopting an integrated public health approach represents an opportunity to incorporate a range of primary, secondary and tertiary prevention interventions and develop comprehensive prevention strategies at local, national, or international levels. A comprehensive approach to prevention targeted at stopping offending in the first place is required, and it needs to be able to recognise the complex nature of offending and the diversity therein. Research shows that those who harm children are diverse in their age and gender, the children they sexually abuse—intra-familial/extra-familial, prepubescent/pubescent, peer/younger children, male or female—and the type of abuse—contact, non-contact, or online. Preventing child sexual abuse is complex and requires more than an ad hoc collection of unrelated programs, if it is to succeed. This paper synthesises and integrates the disparate scholarly literature on the potential and actual perpetrators of child sexual abuse and responses to and prevention of such abuse. It recommends an increased focus on primary prevention within a comprehensive public health approach as a conceptual framework to prevent the occurrence of child sexual abuse. A systems approach is taken to develop the proposed conceptual framework.

Pre-exposure prophylaxis for HIV: effective and underused.

KEY POINTS Incidence of HIV has been rising in Canada. The Public Health Agency of Canada estimated 2242 new HIV infections in 2018, which highlights the need for comprehensive prevention strategies. [1][1] Pre-exposure prophylaxis (PrEP) is an important means of preventing acquisition of HIV

Linking health and finance ministries to improve taxes on unhealthy products.

The World Health Organization recommends economic measures such as taxes on tobacco, alcohol and unhealthy foods and beverages as part of a comprehensive strategy for prevention of noncommunicable diseases. However, progress in adopting these so-called health taxes has been hampered, in part, by different approaches and perceptions of key issues in different sectors of government. Health promotion is the responsibility of health policy-makers, while taxation is the mandate of finance ministries. Thus, strengthening cooperation between health and finance policy-makers is central to the successful adoption and implementation of effective health taxes. In this paper we identify the shared concerns of finance and health policy-makers about health taxes with the aim of enabling more effective cross-sector cooperation towards both additional financing for health systems and changes in unhealthy behaviours. For example, new approaches to supporting health taxation include the growing priority for health-system financing due to the growing burden of noncommunicable diseases, and the need to address the health and economic damage due to the coronavirus disease 2019 pandemic. As a result, high-level efforts to achieve progress on health taxes are gaining momentum and represent important progress towards using the combined expertise of health and finance policy-makers.

Prevalence of SARS-CoV-2 antibodies among university athletic club members: A cross-sectional survey.

School-based coronavirus disease 2019 (COVID-19) testing is an important part of a comprehensive prevention strategy in public health. To assess the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in a university athletic club community with repeated occurrences of SARS-CoV-2 infections, we conducted a cross-sectional survey for asymptomatic antibody prevalence using a SARS-CoV-2 rapid antibody test kit. On January 26, 2021 we administered questionnaires to determine their history of contact with infected individuals and took blood samples from 129 undergraduates. The prevalence of SARS-CoV-2 antibodies among the subjects was 3.9%. Only 6.2% of the participants reported close contact with infected individuals. In this study, we clarified the prevalence of asymptomatic SARS-CoV-2 antibodies in university athletic clubs where SARS-CoV-2 infections had repeatedly occurred, which will be helpful in discussing how to identify and prevent the transmission of infections within university athletic club communities.

Assessing the effect of COVID-19 stay-at -home orders on firearm injury in Maryland

This study sought to characterize frequency and demographic characteristics of firearm injury and penetrating trauma in Maryland over the first year of the pandemic, by comparing these characteristics to those of the three years prior to stay-at-home order issuance.Patients were identified in the Maryland Health Services Cost Review Commission database using ICD-10 codes for firearm injury by all intents and assaults by penetrating trauma. Cases from July 1, 2017 to March 31, 2020 (“pre-stay-at-home”) were compared to those from April 1, 2020 to March 31, 2021 (“post-stay-at-home”) using descriptive statistics.There was no significant change overall in frequency or demographics of firearm injury or penetrating trauma in the year after stay-at-home orders were issued. Youth between ages 15 and 24, overwhelmingly male, comprise a disproportionately high percentage of firearm injuries and assaults, and most penetrating trauma occurs in urban environments where Black non-Hispanic youth and children of low socioeconomic status are at high risk. Our study also found unintentional firearm injury among adults was significantly increased during the pandemic.While increased unintentional firearm injury among adults was the major significant change found in our study, the persistence of firearm injury, particularly in youth, racial and ethnic minority groups, and those in urban environments, should be deeply concerning. Stay-at-home policies did not keep youth safer from firearm injury. With continued high rates of firearm injury and the national debate over how to prevent these incidents, increased education and comprehensive strategies for prevention are needed.

The detection rate and influencing factors of high-risk groups of cardiovascular disease in Anhui, China: A cross-sectional study of 99,821 residents.

ObjectiveTo investigate the detection rate and influencing factors of high-risk population of cardiovascular disease in Anhui province.MethodsFrom March 2017 to August 2019, the residents aged 35–75 years old were selected using the multi-stage stratified cluster sampling method in 8 counties and districts of Anhui Province, and questionnaire survey, anthropometric measurement, and collection of biological samples were carried out among them.ResultsA total of 99,821 residents in Anhui Province were finally investigated, and among them 21,426 residents were detected to be high-risk groups of cardiovascular disease. The detection rate of high-risk groups was 21.46%. According to the high-risk types, the high-risk groups can be clustered. 74.57% of them had only one high-risk type, 22.57% of them had two high-risk types, and 2.86% had three or more high-risk types. The results of Generalized Linear Mixed Model (GLMM) showed that male, age ≥45 years old, not married, occupation as a farmer, annual family income <25,000 yuan, drinking, overweight and obesity, pre-central obesity and central obesity, snoring, feeling fatigued, sleepiness, and self-reported history of diabetes were more likely to be risk factors of cardiovascular disease (all P value < 0.05).ConclusionThe detection rate of high-risk groups of cardiovascular disease in Anhui Province is relatively high. Individualized intervention measures as well as comprehensive prevention and control strategies should be adopted focusing on the distribution characteristics of risk factors of high-risk groups.

Estimation of Agricultural Non-point Source TN and TP Export Coefficients Based on Soil Loss

Taking the Yellow River Delta as a typical research area, we constructed a coastal agricultural TN and TP non-point source pollution estimating model by analyzing the relationship between the surface soil pollutant loss risks and the monitored pollutant flux into the sea. On this basis, TN and TP non-point source export coefficients of paddy fields, irrigated land, and dry land were calculated, and the verification showed that the estimated export coefficients were acceptable. In the study area, the TN and TP export coefficients into the sea of arable land were 18.33 kg·(hm2·a)-1 and 1.02 kg·(hm2·a)-1, respectively. The agricultural non-point source pollution loads of arable land were relatively high in summer. The sub-basins with larger agricultural non-point source pollution loads were mainly located in the control areas of the Zhimai River, Guangli River, and Xiaodao River. The administrative regions with larger total agricultural TN and TP loads were mainly in the northern Huanghekou Town and Yong'an Town, and areas with larger loads per unit area were in the southwest. Therefore, it is necessary to pay more attention to the temporal effects of agricultural non-point source pollution, simultaneously coordinate the social and economic development, and formulate comprehensive agricultural non-point source pollution prevention and control strategies from the perspective of sub-basins and administrative units. This will allow us to improve the offshore pollution status from the perspective of land and sea coordination.

Spatial characteristics and multifactorial driving analysis of fly-tipping bulky waste in Beijing based on the random forest model

The phenomenon of fly-tipping of bulky waste is becoming increasingly serious with the development of economy and the improvement of living standards. The fly-tipping of bulky waste causes a waste stream with a high proportion of good quality recyclable materials and a wide range of social and environmental problems including damaging the environment and aggravating traffic in a megacity like Beijing. In this study, we analyzed the quantitative spatial distribution of fly-tipping bulky waste in Beijing for the first time and identified its driving forces to explore the fly-tipping rule of bulky waste. We used Anselin's Local Moran I method to reveal the spatial characteristics , and Random Forest machine learning method to examine the driving factors based on multiple data sources such as geographical, population and survey data. The results showed that the spatial agglomeration of fly-tipping presented a typical core edge diffusion spatial distribution pattern. High-High clusters of cases were found in most regions of Dongcheng District and the east part of Xicheng District. In the multifactorial drivers, the three most important driving factors were found to be accommodation, floating population and income level. Surprisingly, any kind of road and educational level had small effect on the fly-tipping case. These results provide a theoretical basis for the government to advance comprehensive prevention and control strategies of bulky waste fly-tipping. And it is helpful to formulate management policies of fly-tipping bulky waste and provide targeted guidance and suggestions for senior decision makers and managers. • Random forest machine learning method was used to analyze bulky waste fly-tipping. • Fly-tipping presented a typical core edge diffusion spatial distribution pattern. • 15 driving factors were extracted from multiple data sources. • Accommodation and floating population had the highest impact on fly-tipping.

Intergenerational Replication of Teenage Pregnancy and Educational Attainment in Mexico.

Mexico ranks among the OECD countries with the highest prevalence of teenage pregnancies, exhibiting a fertility rate of 70.6 births for every 1000 adolescents. Mexican adolescents with a history of pregnancy are twice as likely to lag behind in their studies as those who have not been pregnant. Research on adolescent maternity and its explanatory mechanisms is required as a basis for implementing policies and programs that effectively curb teenage pregnancy-related behaviors, prevent educational gaps, and reduce the intergenerational transmission of poverty. Based on quasi-experimental methodology and a non-recursive structural equation model with instrumental variables, this paper analyzed the intergenerational transmission of teenage pregnancy from mothers to daughters, as well as the relationship between teenage pregnancy and educational attainment. Using data from the 2009 National Survey of Demographic Dynamics in Mexico, our estimated model indicated a unidirectional relationship from teenage pregnancy to educational attainment. An association was observed between teenage pregnancy and an increased probability of a moderate or severe educational gap (≥ 1year) by 21% ± 5 and a severe educational gap (≥ 2years) by 33% ± 8. Adolescents whose mothers reported teenage pregnancy at < 15years of age were approximately 84% more likely to experience teenage pregnancy themselves than other adolescents. Relevant explanatory mechanisms included low socioeconomic status and a low level of education in the household. Mexico needs to formulate, implement, and expand comprehensive and early prevention strategies as well as teenage pregnancy care throughout its most vulnerable regions. Efforts should be made at the individual, family, and community levels; incorporate alliances with teenage networks; actively engage parents, teachers, and health care providers; and reinforce educational initiatives on sexual and reproductive health for adolescents. It would be convenient for the Government to implement public policies that emphasize the results obtained. There is no better instrument than to show the evidence of the gradual deterioration of human capital in Mexico associated with adolescent pregnancy.

County-Level Social Vulnerability and Emergency Department Visits for Firearm Injuries - 10 U.S. Jurisdictions, January 1, 2018-December 31, 2021.

At least 100,000 persons in the United States experience a fatal or nonfatal firearm injury each year.* CDC examined rates of firearm injury emergency department (ED) visits by community social vulnerability using data from CDC's Firearm Injury Surveillance Through Emergency Rooms (FASTER) program.† ED visit data, shared with CDC's National Syndromic Surveillance Program (NSSP)§ during 2018-2021, were analyzed for 647 counties in 10 FASTER-funded jurisdictions.¶ County-level social vulnerability data were obtained from the 2018 Social Vulnerability Index (SVI).** Rates of ED visits for firearm injuries (number of firearm injury ED visits per 100,000 ED visits) were calculated across tertile levels of social vulnerability. Negative binomial regression models were used to estimate rate ratios (RRs) and associated 95% CIs comparing rates of ED visits across social vulnerability levels. During 2018-2021, compared with rates in counties with low overall social vulnerability, the firearm injury ED visit rate was 1.34 times as high in counties with medium social vulnerability and 1.80 times as high in counties with high social vulnerability. Similar patterns were observed for the SVI themes of socioeconomic status and housing type and transportation, but not for the themes of household composition and disability status or racial and ethnic minority status and language proficiency. More timely data†† on firearm injury ED visits by social vulnerability can help identify communities disproportionately experiencing elevated firearm injury rates. States and communities can use the best available evidence to implement comprehensive prevention strategies that address inequities in the social and structural conditions that contribute to risk for violence, including creating protective community environments, strengthening economic supports, and intervening to reduce harms and prevent future risk (e.g., with hospital-based violence intervention programs) (1,2).

A new method to analyze the driving mechanism of flood disaster resilience and its management decision-making

Flood disaster resilience management and decision-making are comprehensive prevention and control strategies that integrate pre-disaster prevention, in-disaster scheduling and post-disaster reconstruction. In view of the many deficiencies in current flood disaster resilience research in terms of uncertainty measurement, dynamic regulation and management decision-making, a new method for the analysis of the driving mechanism of flood disaster resilience and management decision-making based on the fuzzy mathematical theory improved Bayesian belief network (BBN) is proposed. A case study was conducted in 15 state-owned farms under the jurisdiction of the Jiansanjiang Branch in Heilongjiang Province, China. The model predicts the resilience level with missing indicators. A diagnostic analysis of the correlation between indicators and resilience improvement and a sensitivity analysis of the dynamic evaluation of the importance of indicators are performed, and fuzzy decisions are made to quantify different decision-making schemes. The results show that when a single indicator is missing, the prediction accuracy exceeds 80%. However, the lack of economic indicators has a substantial impact on the results, and the accuracy is reduced to 63.3%, indicating that economic indicators are the key dimension affecting the evaluation of flood disaster resilience levels in the study area, which also provides a focus for previous data collection efforts. The diagnostic analysis constructs an index sequence to guide the improvement in resilience, in which the water surface rate and rainfall are the most direct driving forces affecting resilience. On this basis, the differences in the driving forces of each farm are further analyzed in detail. Sensitivity analysis shows that rainfall, per capita GDP, and the energy consumption of agricultural machinery are the indicators that occur most frequently among the top three sensitivity indicators of all farms. The 859 farm, Chuangye farm and Nongjiang farm are typical farms with a high sensitivity to rainfall and economic indicators. Fuzzy decision-making takes the comprehensive grade score of implementation motivation as a quantitative evaluation criterion, which provides guidance for decision-making based on the two dimensions of time and space.

Acceptability and accessibility of HIV testing and treatment among men who have sex with men in Botswana

Background: Although HIV testing and treatment are the cornerstones of a comprehensive prevention strategy, their acceptability and accessibility are complex within the healthcare system. Methods: We used Aday and Andersen’s conceptual framework of access to healthcare services to explore factors influencing acceptability and accessibility of HIV testing and treatment among men who have sex with men (MSM) in Botswana. A qualitative descriptive study was conducted, using purposive sampling to recruit 20 MSM. Semi-structured interviews were conducted in Setswana and English. All data were audio-recorded, transcribed, translated into English, where necessary, and analysed using thematic analysis. Findings: This study found that acceptance of HIV testing and treatment was largely positive among MSM. Motivators were the expansion of HIV services, free healthcare services and the perceived risk of contracting HIV. Although perceptions of accessibility to HIV testing and treatment were positive, there were some concerns about privacy and confidentiality, perceived barriers and fear of positive diagnosis, making MSM reluctant to access HIV testing and treatment. Conclusion: This study highlights the need for novel approaches to increase the acceptability and accessibility of HIV testing and treatment. Barriers to accessing HIV services should be addressed to achieve satisfactory health outcomes, and sustainable HIV prevention barriers to accessing HIV should be addressed among MSM.

Impact of screening on cervical cancer incidence and mortality in a Northern Brazilian city

Objective:To analyse the impact of screening actions on the incidence and mortality rates of cervical cancer (CC) in the city of Belém, Brazil.Methods:Based on the cancer registry data from 1998 to 2017, collected from the Belém Population-Based Cancer Registry, combined with local population data for the interval 1998–2017, CC incidence and mortality were calculated. The Segi world population 1960 was used for age-standardised incidence/mortality rates.Results:In the period analysed, there were 4,469 new cases and 1,660 deaths from CC. The median age at diagnosis of invasive cases was 51 years. The age-adjusted incidence rate decreased from 18.65/100,000 in 1998 to 11.79/100,000 in 2017, despite the increase observed in the first 5 years of the historical series, while there was stability in mortality rates in the same time lapse.Conclusion:CC is still one of the most common malignant tumours that threaten public health in northern Brazil. The trend of the disease depends on comprehensive prevention and control strategies regarding the local situation and age groups, with emphasis on the organisation of the screening programme and vaccination against human papillomavirus.

The proportion of chronic kidney disease and its associated factors among adult diabetic patients at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia

BackgroundChronic kidney disease is defined as a progressive loss of kidney function occurring over several months to years. Programs to detect chronic kidney disease, linked to comprehensive primary and secondary Prevention strategies are rare in our country. This study aimed to assess the proportion of chronic kidney disease and its associated factors among adult diabetic patients. MethodsAn institutional-based cross-sectional study design was used. Adult Diabetic Patients (≥18 years of age) coming to the medical outpatient clinic were considered as study participants and they were selected using a systematic random sampling technique. Data were checked for completeness, then entered into Epi Data 3.1, and exported to SPSS Version 24 for analysis. Descriptive statistics such as frequency, crosstab, and median were utilized. chronic kidney disease epidemiology collaboration equations for calculating estimated glomerular filtration rate Simple binary logistic regression was conducted to identify candidate variables for multiple binary logistic regression at a p-value of <0.2. Those variables whose P-value <0.05 in multiple binary logistic regression were considered as significantly associated variables with chronic kidney diseases. ResultA total of 329 individuals were participating in the study. Of which 199 (60.5%) were males. The median age of participants was 39 (IQR; 28: 56) years. Of the total participants, 125(38%) had no formal education. The proportion of chronic kidney disease was 16.7% (95% CI: 12.8%–21%), The study also found that older age (AOR = 3.02; 95%CI: 1.37, 6.69), pre-existing hypertension (AOR = 4.85; 95%CI: 2.07, 11.3), current systolic blood pressure ≥140mmHg (AOR = 6.33, 95%CI: 3.34, 11.99), and presence of Albuminuria (AOR = 2.98, 95%CI: 1.26, 7.09) were associated with chronic kidney disease. ConclusionsThe proportion of CKD among diabetic patients in Tibebe Ghion Specialized Hospital was relatively high as compared to other studies. Health care professionals should consider strict follow-up for older age patients, patients with co-morbidities like hypertension, and for those patients with Albuminuria.

Management of a Candida Auris Patient Across Two Healthcare Systems

BackgroundContaining Candida auris (C. auris) has proven to be especially challenging during the COVID-19 pandemic given the enormous constraints on Infection Prevention (IP) departments. Knowledge of the organism, appropriate identification methods, and infection prevention strategies are key to reducing the risk of transmission. Many IP departments have been unable to develop or maintain comprehensive admission screening protocols and have limited best practices available for managing C. auris patients in the acute care setting. We describe the first case of C. auris in the acute care setting in the state of Minnesota and outline the infection prevention strategies used by the two systems that provided care to this patient.MethodsUpon receipt of a preliminary positive C. auris result at Hospital One, the patient was placed into contact precautions. All patients that were identified as exposed were screened. A comprehensive infection prevention strategy was implemented in collaboration with the state health department and Hospital Two. The plan included transmission-based precautions, hand hygiene compliance, environmental cleaning and disinfection, and staff and patient education.ResultsA total of 48 patients were screened for C. auris at Hospital One and no additional positive results were identified. The patient was transferred to Hospital Two for progressive care needs and required an extensive hospital stay post-surgery. No additional screening was recommended by the state health department. Practical prevention strategies for high level disinfection and sterilization, environmental cleaning, patient transport and ambulation, and procedural protocols were developed. No additional C. auris colonization nor clinical isolates have been identified to date.ConclusionsThis case highlighted the importance of inter-facility communication and the need for an established screening protocol for C. auris to identify cases in a timely manner. The robust infection prevention strategies implemented by the two systems resulted in no known transmission to other patients or staff.

Finding and treating early-stage HIV infections: A cost-effectiveness analysis of the Sabes study in Lima, Peru

Sabes, a treatment-as-prevention intervention among men who have sex with men and transgender women in Lima, Peru, was developed to identify HIV during early primary infection (<3 months from acquisition) through monthly serologic assays and HIV RNA tests. Newly diagnosed individuals were rapidly linked to care and offered to initiate ART. In this study we sought to study the cost-effectiveness of Sabes compared to the standard of care (SOC) for HIV testing and initiation of treatment. We adapted a compartmental model of HIV transmission to evaluate the cost-effectiveness of the Sabes approach compared to the SOC using a government health care perspective, 20-year time horizon, and 3% annual discounting. We estimated the proportion of cases of HIV detected during early primary infection, reduction in HIV incidence and prevalence, incremental cost-effectiveness ratio (ICER), and net monetary benefit. We analyzed costs using data from the Sabes study, the Peruvian Ministry of Health, published literature, and expert consultation. The Sabes intervention is projected to identify 9294 early primary HIV infections in Lima, Peru over 20 years. The intervention costs $6,896 per early primary infection diagnosed and by 2038 is expected to decrease the fraction of early infections among prevalent infections by 62%. Sabes is expected to improve health, resulting in greater total discounted QALYs per person than the SOC (16·7 vs 16·4, respectively). Sabes had an ICER of $1431 (22% per capita GDP in Peru) per QALY compared to SOC. Our analysis suggests that in Lima, Peru the Sabes intervention could be a cost-effective approach to reduce the burden of HIV even under stringent cost-effectiveness criteria. This finding suggests that programs that use frequent HIV testing, rapid linkage to care and initiation of ART should be considered as part of a comprehensive HIV prevention strategy. National Institutes of Health.

Dental Caries Frequency &amp; its Determinants among Adults of District Kohat &amp; Nowshera Khyber Pakhtunkhwa Pakistan

The objective of this study was to assess the frequency and risk factors of dental caries among adults in District Kohat and Nowshera Khyber Pakhtunkhwa Pakistan. Methods: After taking ethical approval, a descriptive cross sectional study was conducted in District Kohat and Nowshera, in which a total of n=435 adults were assessed and examined for dental caries, from November 2021 to March 2022. A structured questionnaire was used to collect data regarding dental caries and its risk factors. Moreover, relevant tooth brushing, and dietary information was also collected. Data was analyzed by SPSS and results were presented in form of tables. Results: The results showed that 23.68% of adults had dental caries. Approximately, 57.70% of adults are of age between 30-60 years; 25.06% had monthly income less than 25000/PKR per month; 14.02% were illiterate, and 40.92% were overweight and obese. Moreover, 52.64% had compliance to daily tooth-brushing; 49.66% used fluoride tooth paste; 41.15% and 58.85% prefer sugar and sweet beverages respectively. Furthermore, 21.84% had poor oral hygiene; 14.94% had routine dental examinations; and 49.21% &amp; 32.41% prefer vegetables and fruits. Conclusions: Concluded that dental caries showed moderate prevalence among adults and revealed relationship with age; monthly income, body mass index, and literacy level. Moreover, frequency of tooth-brushing, fluoride tooth-paste, oral hygiene status and sweet preference showed association with dental caries and thus comprehensive preventive and health promotion strategies were needed to overcome dental caries among adults. Keywords: Dental Caries, Toothbrush, Fluoride, Monthly Income, Sugar, Sweet beverages, Nowshera

Expert Consensus on Obesity Prevention and Treatment in China

Obesity and related chronic diseases have become major public health problems in China and in the world. While a series of prevention and control policies and action plans have been implemented in China, obesity and related chronic diseases have not been effectively controlled yet. The Obesity Prevention and Control Section of the Chinese Nutrition Society facilitated the cooperation of 34 interdisciplinary leading experts in drafting this consensus based on the latest relevant guidelines and research results in China and from overseas. The consensus report aims to help guide the prevention and treatment of obesity in China, promote the participation of the whole society and contribute to 'Healthy China' national goals. This report includes seven chapters. It outlines the prevalence and main contributing factors of obesity, challenges, obesity screening and diagnosis, treatment, prevention and control during the whole life cycle, comprehensive prevention and control strategies involving the whole society, and recommendations for future work in China. This report will help promote obesity prevention and weight management efforts in China to be more scientific and effective.

High Risk of Early and Late Cardiovascular Events After Endovascular Aortic Aneurysm Repair

The objective of this population-based study was to analyze short- and long-term major adverse cardiovascular events (MACE) after endovascular repair of ruptured or nonruptured thoracic (TAA) and abdominal aortic aneurysms (AAA). Nationwide retrospective registry study including all patients who underwent endovascular repair (thoracic endovascular aortic repair, TEVAR; abdominal endovascular aneurysm repair, EVAR) for nonruptured/intact (iAAA/iTAA) or ruptured (rAAA/rTAA) abdominal or thoracic aneurysms between 2000 and 2018. The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction (MACE). There were 8,641 patients with TAA and AAA; 634 TEVAR procedures [iTAA 488; rTAA 146], and 8007 EVAR procedures [iAAA 7071; rAAA 936] were performed. MACE incidence at 90-day after TEVAR for iTAA was 10.2% and for rTAA 26.7% [HR 3.02, 95% CI 1.99-4.6]; MACE at 90-day after EVAR for iAAA was 3.7% and for rAAA 26.9% [HR 8.5, 95% CI: 7.16-10.11]. There was a higher cumulative incidence of MACE at 90-day after TEVAR for iTAA compared to EVAR for iAAA [HR 2.82, 95% CI 2.09-3.82] but no difference between the procedures after ruptured aneurysm repair. The median follow-up time was 3.28years [IQR 1.31-5.94]. There was no long-term difference in MACE between EVAR and TEVAR after ruptured [90days-5years: HR 1.14, 95% CI 0.76-1.71; 5-10years: HR 0.78, 95% CI 0.31-1.96] or intact [90days-5years: HR 1.19, 95% CI 0.97-1.46; 5-10years: HR 0.82, 95% CI 0.56-1.21] aneurysm repair. Female gender had higher long-term incidence of MACE after intact [HR 1.14, 95% CI 1.03-1.27] and ruptured [HR 1.36, 95% CI 1.12-1.65] endovascular aortic aneurysm treatment. After intact aneurysms repair; age [HR 1.05, 95% CI 1.04-1.05], history of angina pectoris [HR 1.19, 95% CI 1.08-1.32], heart failure [HR 1.90, 95% CI 1.69-2.13], and stroke [HR 1.33, 95% CI 1.15-1.53] were associated with MACE. This nationwide cohort study still demonstrated a high risk of early and late cardiovascular events after endovascular aortic repair. Comprehensive strategies for postoperative cardiovascular disease prevention may be needed here.

“Without support, victims do not report”: The Co‐creation of a workplace sexual harassment risk assessment survey tool

AbstractWorkplace sexual harassment (WSH) remains a common experience for many women worldwide. European policies and guidelines point to the need to establish comprehensive WSH prevention programs and strategies. One of the strategies contemplated is establishing risk assessment and monitoring systems to prevent and identify WSH situations. However, few WSH risk assessment tools are currently available to European organizations and companies. This article analyses the co‐creation process that has led to developing an evidence‐based risk assessment survey tool (ST) to prevent in a wide diversity of work contexts. This process has involved experts, survivors, activists, and other relevant stakeholders. The research has been carried out based on the communicative methodology through the implementation of qualitative fieldwork. Furthermore, an extensive review of scientific literature and international guidelines has been carried out. The established co‐creation process has led to the inclusion of the Isolating Gender Violence approach in a risk assessment ST to prevent WSH for the first time.