Effective Preventive Interventions Research Articles

Plating after tumor curettage in human femora does not efficiently improve torsional stability ex vivo

BackgroundSurgical treatments of benign primary bone tumors of the femur face the challenge of limiting tissue damage and contamination while providing sufficient stabilization to avoid fracture. While no clear treatment guidelines exist, surgical treatment commonly consists of femoral fenestration and curettage with optional filling and plating of the defect. Mono- or bicortical plating of distal femoral defects aim to reduce fracture risk and have been shown to increase axial stability. However, it remains unclear whether plating increases torsional stability of the affected femur. Questions/purposesThis biomechanical study aimed to determine how much additional stability can be achieved by mono- or bicortical plating of femoral defects after fenestration. The following hypotheses were investigated: 1. Preventive plating of distal femur bone defects enhances torsional stability when compared to femoral fenestration alone. 2. A condition close to the intact (nonpathological) bone can be achieved by bone plating. 3. Defect shape influences torsional stability. Patients and methodsThiel embalmed human femora (n = 24) were left intact or subjected to the following surgical treatments (A) defect creation via fenestration, (B) defect with short monocortical plating, (C) defect with long bicortical plating. All femora were torsion tested in midstance position using pre-cycling and testing until failure. Quantitative computed tomography pre and post testing allowed bone mineral density calculation and crack path analysis. Finite element analysis provided insight into defect shape variations. ResultsTorsion experiments showed no relevant enhancement of torsional stability due to mono- or bicortical plating. There were no significant differences in maximum torque between unplated and plated femora with defect (defect: 35.38 ± 7.53 Nm, monocortical plating: 37.77 ± 9.82 Nm, bicortical plating: 50.27 ± 9.72 Nm, p > 0.05). Maximum torque for all treatment groups was significantly lower compared to intact femora (155–200 Nm, p < 0.001). Cracks originated predominantly from the proximal posterior corner of the defect and intersected with screw holes in plated femora. The influence of variations of the defect corner shapes had no significant influence on maximum torque and angle. ConclusionThis biomechanical study shows that mono- or bicortical plating is not an effective preventive treatment against torsional failure of femora with distal defects as the resulting maximum torque was drastically reduced compared to intact femora. Thus, the initial hypotheses have to be rejected. As habitual loading of the femur includes a combination of axial and torsional loading, the observed lack of prevention against torsional failure might help to explain the occurrence of fractures despite plating. Future research towards ameliorating clinical outcome should address the role of defect filling with bone cement or bone grafts regarding the improvement of torsional stability after primary bone tumor treatment in the femur.

Prevalence of diarrhoea and treatment-seeking practices among children

Estimating the proportion of children with diarrhoea and those who are taken in as inpatients or outpatients is important for policy planning, resource allocation, and to evaluate the effectiveness of diarrhoea prevention and control interventions. We aimed to estimate the proportion of children <2 years of age with diarrhoea, explore their treatment-seeking practices, and identify factors associated with both diarrhoea and treatment seeking. We designed a longitudinal study based on a sample of children <2 years of age in the Birhan field site from September 2018 to September 2019. The study site collected data on child mortality and morbidity and treatment-seeking practice for those with a history of illness every three months. Mothers/caregivers were asked about signs or symptoms of illnesses for a two-week period prior to each study visit. We estimated the proportion of children <2 years of age with diarrhoea and treatment-seeking practices for each of the four rounds of data collection and identified associated factors through bivariable and multivariable logistic regression. We enrolled 4678 children <2 years of age. The proportion of children with diarrhoea was the highest from 11 September 2018 to 9 December 2018 (4.47%; 95% confidence interval (CI) = 3.70-5.35) and the lowest from 10 December 2018 to 9 March 2019 (2.48%; 95% CI = 1.90-3.19). Children from households with chlorinated drinking water had a 50% (adjusted odds ratio (aOR) = 0.50; 95% CI = 0.28-0.88) lower odds of developing diarrhoea compared to those who did not. Among 339 children with diarrhoea, 275 (81.12%; 95% CI = 76.54-85.15) were taken to health facilities for treatment. Female children had lower odds of being taken to health facilities for treatment (aOR = 0.37; 95% CI = 0.17-0.80) compared to males. While the proportion of children with diarrhoea in our study was lower than that observed in prior research conducted in Ethiopia, treatment-seeking practices were higher. Female children and children from the poorest families had lower odds of treatment. We recommend more studies to explore gender-based and socioeconomic differences affecting treatment-seeking practices.

Primary prevention of type 2 diabetes in the EU: A systematic review of interventional studies

Abstract Background The GBD 2019 study revealed that type 2 diabetes caused over 109.000 deaths and accounted for 5.3 million Disability Adjusted Life Years in the EU, with an estimated annual cost of EUR 300 billion in 2014. Interventions for primary prevention are pivotal in preventing diabetes, providing a structured approach to implementing lifestyle modifications or community-based programs. The objective of this study was to demonstrate the effectiveness of primary prevention interventions to prevent or delay the onset of type 2 diabetes in the EU member states. Methods A systematic review on six databases was conducted for relevant interventional studies carried out in the EU-28. The main outcome of the studies was determined by changes in the incidence of type 2 diabetes. Results The search yielded 18.885 records, of which 18 met the eligibility criteria. The following studies reported significant incidence reduction in the intervention groups: The Finnish Diabetes Prevention Study by individualised lifestyle intervention (HR: 0.614, 95%CI: 0.478-0.789), the Spanish CORDIOPREV Study through increased plant protein intake (HR: 0.64, 95%CI: 0.43-0.96), the Spanish PreDE trial by promoting healthy diet and physical exercise (RR: 0.68, 95%CI: 0.47-0.99), the Norfolk Diabetes Prevention Study with intensive diet-exercise counselling (OR: 0.57, 95%CI: 0.38-0.87), the Spanish PREDIMED and PREDIMED-Reus trials by mediterranean diet supplemented with extra virgin olive oil or mixed nuts (HR: 0.60, 95%CI: 0.43-0.85; HR: 0.49, 95%CI: 0.25-0.97; HR: 0.48, 95%CI: 0.24-0.96), and the Dutch SLIM Study with advices on diet and physical activity (RR: 0.53, 95%CI: 0.29-0.97). Conclusions Significantly decreasing the incidence of diabetes is feasible within primary healthcare settings through intensive lifestyle interventions targeting individuals at high risk. Therefore, it would be beneficial to incorporate these findings into the European guidelines for preventing type 2 diabetes. Key messages • Primary care plays an important role in the prevention of type 2 diabetes. • Well-defined primary lifestyle interventions are capable of slowing the progression from prediabetes to diabetes.

Developing an Evidence-Based Primary Cancer Prevention Repository: insights from the PIECES project

Abstract Introduction Up to 40% of cancer cases could be avoided through effective primary prevention. However, cancer prevention tends to be fragmented across Europe, leading to geographical health differences. The dissemination and scale-up of effective primary cancer prevention interventions may address this. Although effective cancer prevention programs exist, finding them and their materials (especially regarding implementation) can be challenging. Repositories of evidence-based interventions provide insight into “what is out there” and can support dissemination within and across national borders. The PIECES project aims to develop and disseminate a repository of evidence-based primary cancer prevention programs adaptable to European contexts, with information to aid adaptation and implementation across countries. Methods The development of the PIECES repository has been informed by established repositories such as NCI’s Evidence-Based Cancer Control Programs. The project team developed a scoring sheet with a selection of items that could be included in the repository. All participants rated each item on relevance and applicability and provided comments and suggestions. A final framework, including a set of minimal requirement items, was agreed upon during three online consensus building meetings. Results We created a repository of evidence-based primary cancer prevention interventions targeting modifiable risk factors suitable for implementation in European healthcare settings. This 22-item repository provides information about an intervention’s logic model, implementation practices, and appraisal of published evidence of effectiveness. Conclusions This repository is innovative as it includes practical information and tools to facilitate implementation. While initially built to serve the PIECES project, the repository is designed to be a valuable tool for European policymakers, researchers, and implementers. Lessons learned from this process will inform future developers. Key messages • A comprehensive cancer prevention intervention repository avoids “reinventing the wheel” and allows for more efficient use of existing interventions by building upon the best available evidence. • The ongoing efforts of the PIECES project represent a significant contribution to reduce cancer prevention disparities and to facilitate the adoption of evidence-based interventions in Europe.

The Critical Role of the 4th “P”: Addressing the Impact of “Otherness” on Human Trafficking Prevention Efforts

ABSTRACT Prevention is the key to reducing human trafficking prevalence, and awareness-raising campaigns are the most common form of trafficking intervention; however, there is little evidence that these activities translate to actions that prevent human trafficking. The “otherness” issue – the belief that human trafficking is a problem for “other” communities but not a problem within one’s own community – has been identified as a potential barrier to effective human trafficking prevention interventions. In this article, we unpack the “otherness” issue and build on Todres (2009) “otherness-aware” framework to develop a theoretical model for understanding otherness within the context of human trafficking prevention interventions. Drawing on evidence from public health, we discuss the community mobilization intervention framework, which is centered on partnership and community engagement, as a potentially useful strategy for addressing the “otherness” issue and improving the effectiveness of human trafficking prevention interventions. We conclude that meaningful partnership with communities is a key to developing contextually relevant, community-empowering approaches to prevent human trafficking. This article has implications for achieving UN Sustainable Development Goal (SDG) 16, which aims to support inclusive communities through targets such as reducing violence, ending human trafficking and amplifying developing countries’ participation in global decision-making.

Adaptation of an evidence-based, preventive intervention to promote mental health in Hispanic adolescents: eHealth Familias Unidas Mental Health.

Youth internalizing symptoms (i.e., depression and anxiety), suicide ideation and attempts have been rising in recent years, including among Hispanics. Disparities in mental healthcare are concerning and require intervention, ideally prevention or early intervention. Familias Unidas is a culturally-syntonic, family-centered intervention effective in reducing youth drug use and sexual risk, with evidence of unanticipated effects on internalizing symptoms. This paper describes the systematic process used to adapt the eHealth version of the Familias Unidas intervention to more directly address internalizing symptoms and suicide risk in preparation for an effectiveness-implementation hybrid trial for youth with elevated internalizing symptoms, a history of suicide ideation/attempts, or poor parent-youth communication. The resulting eHealth Familias Unidas Mental Health intervention is described. Guided by a 4-phase framework, the steps in the adaptation process involved: assessment of the community and intervention delivery setting (pediatric primary care clinics); integration of previous intervention research, including intervention mechanisms of action; and expert and community consultation via focus groups. Focus group analyses showed that youth and parents perceived that the intervention was helpful. Their feedback was categorized into themes that were used to directly target mental health by addressing technology use, parent mental health, and social support. Effective and scalable preventive interventions are needed to address mental health disparities. The systematic adaptation process described in this paper is an efficient approach to expanding interventions while maintaining known, empirical and theoretical mechanisms of action. Findings from the ongoing effectiveness-implementation trial will be critical.

The application effect of preventive nursing intervention in patients with traumatic flail chest: A retrospective study.

This retrospective study explores the intervention effect of preventive nursing on participants with traumatic flail chest caused by multiple rib fractures. In this study, 92 patients with multiple rib fractures from a certain hospital from July 2020 to June 2022 were chosen as the research subjects. They were divided into research group and a control group according to different nursing methods. The control group received routine care. The research group received preventive care on the basis of the control group. Then, questionnaire survey was collected to evaluate the quality of life, pain degree, psychological state, complications, and lung function recovery of patients before and after nursing. In the quality of life score, before nursing, the scores of the research group and the control group were between 52 and 69, and the difference among the participants in the experiment did not possess statistical significance (P > .05). After nursing, the scores of the research group were markedly superior to the control group, and all scores possessed statistical significance (P < .05). In the pain score, the pain scores of the research group and the control group before preventive nursing were 7.87 ± 0.86 and 7.68 ± 0.75, respectively, and the difference among the participants in the experiment did not possess statistical significance (P > .05). After 6 months of nursing, the pain scores of the participants in the experiment were 2.84 ± 0.69 and 3.04 ± 0.72, respectively. The difference among the participants in the experiment possessed statistical significance (P < .05). In the Hamilton Anxiety Scale, the psychological state scores of the experimental group and the control group before intervention nursing were 52.87 ± 4.97 and 51.74 ± 4.56, respectively, and the scores after intervention nursing were 22.68 ± 4.69 and 36.87 ± 5.21, respectively. The difference among the participants in the experiment possessed statistical significance (P < .05). Preventive nursing interventions can improve long-term quality of life, significantly alleviate postoperative pain, decrease the incidence of postoperative complications, as well as enhance nursing satisfaction in patients with traumatic flail chest.

Patterns of care contacts in the final year of life among opioid overdose fatalities in southern Sweden: a latent class analysis

BackgroundUnderstanding the heterogeneity of opioid overdose fatalities is critical to developing effective preventive interventions. This study examines patterns of care contacts among people who subsequently died from opioid overdose. The aim was to identify distinct groups of deceased individuals, based on their contacts with different care agencies in their last year of life.MethodsA retrospective registry study was conducted in Skåne, Southern Sweden. All recorded opioid overdose fatalities during the study period were included, n = 191. Latent class analysis was used to identify patterns of care contacts in the last year of life.ResultsThree distinct classes were identified: “Few care contacts,” with limited interaction with any services; “Social service contacts,” comprising individuals who predominantly had contacts with the social services and, to a lesser extent, with prison and probation services; and “Numerous care contacts,” with extensive contacts with both healthcare and social services. The “few care contacts” class comprises about half of the population. This is an important finding, since this group has not been clearly visible in previous research. The analysis indicates significant gaps in service provision, particularly regarding substance use treatment and mental health support.ConclusionsUsing a person-centred approach, this article offers a novel way of analysing care contacts among people who subsequently died from opioid overdose. The identification of distinct groups, particularly a large group of people with minimal contact with the community care system, highlights the need for more targeted outreach and support work. Developing targeted interventions in emergency and inpatient care settings may provide an opportunity to reach the group with few care contacts.

Zoom to the Virtual Room: The Shift to Remote Early Childhood Observational Assessments.

The COVID-19 pandemic has led prevention researchers to increasingly use remote observational procedures given social distancing directives associated with the pandemic. However, few studies have used remote observational procedures with children and their caregivers, with scant literature describing procedures with socioeconomically, racially, and ethnically diverse families. This manuscript describes processes to pivot to remote assessment of parent and child observations in the context of a longitudinal study examining the effects of a postpartum depression preventive intervention on responsive parenting and child self-regulation. We conducted remote assessments across three timepoints-42, 48, and 54 months-with 133 low-income and racially and ethnically diverse parent-child dyads. Details are provided on remote observation preparation and setup, as well as adaptation of observational assessments. Lessons learned are shared on the use of technology, scheduling considerations, parent's role as facilitator, maintaining child engagement, and cost considerations. We demonstrated excellent inter-rater reliability between independent coders on all assessments, suggesting the quality of remote assessments was conducive for analysis. Surveys with families completing a remote assessment found that most felt it was easy to participate in remote assessments and their child had a positive experience. Most parents preferred virtual visits if given an option for future assessments. Much prevention research utilizes observational measures that are less subject to bias. Our study demonstrated that research teams can effectively and reliably pivot to remote assessment with racially and ethnically diverse, low socioeconomic families, thereby providing guidance to other prevention researchers considering similar remote assessments with diverse samples.

Global Trends and Inequalities of Liver Complications Related to Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis From 1990 to 2021.

Metabolic dysfunction-associated steatotic liver disease is a significant driver of the increasing global burden of chronic liver disease. This study aimed to describe the temporal trends and inequalities of liver complications related to metabolic dysfunction-associated steatotic liver disease (LC-MASLD) by geographical region, age and sex during 1990-2021. Global Burden of Diseases Study 2021 data were analysed to assess LC-MASLD incidence, prevalence, mortality and disability-adjusted life years (DALYs). Temporal trends during 1990-2021 were measured by 'estimated annual percentage change' (EAPC). Inequalities of LC-MASLD burden across countries were evaluated by the slope index of inequality (SII) and the relative concentration index (RCI). During 1990-2021, LC-MASLD rose annually by 0.73% in incidence and prevalence, 0.19% in mortality and 0.16% in DALYs. In 2021, the Middle East and North Africa had the highest incidence and prevalence and Andean and Central Latin America had the highest mortality and DALY rates. While LC-MASLD incidence was earliest in the 15-19 age group, both prevalence and DALY rates peaked at 75-79 years for both sexes. Inequalities in mortality and DALYs by countries' socioeconomic development index increased during 1990-2021, demonstrated by a decline in SII from -0.09 to -0.56 per 100 000 for mortality and from 1.41 to -7.74 per 100 000 for DALYs. RCI demonstrated similar findings. The LC-MASLD burden is increasing globally, especially in economically disadvantaged countries, with widening disease inequalities during 1990-2021. Effective prevention and subregional interventions are crucial, with a specific focus on resource optimisation for disadvantaged populations.

Seroprevalence and risk factors for Lassa virus infection in South-West and North-Central Nigeria: a community-based cross-sectional study.

Understanding the level of exposure to Lassa virus (LASV) in at-risk communities allows for the administration of effective preventive interventions to mitigate epidemics of Lassa fever. We assessed the seroprevalence of LASV antibodies in rural and semiurban communities of two cosmopolitan cities in Nigeria with poorly understood Lassa epidemiology. A cross-sectional study was conducted in ten communities located in the Abuja Municipal Area Council (AMAC), Abuja, and Ikorodu Local Government Area (LGA), Lagos, from February 2nd to July 5th, 2022. Serum samples collected from participants were analyzed for IgG and IgM antibodies using a ReLASV® Pan-Lassa NP IgG/IgM enzyme-linked immunosorbent assay (ELISA) kit. A questionnaire administered to participants collected self-reported sociodemographic and LASV exposure information. Seroprevalence of LASV IgG/IgM was estimated overall, and by study site. Univariate and multivariate log-binomial models estimated unadjusted and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CI) for site-specific risk factors for LASV seropositivity. Grouped Least Absolute Shrinkage and Selection Operator (LASSO) was used for variable selection for multivariate analysis. A total of 628 participants with serum samples were included in the study. Most participants were female (434, 69%), married (459, 73%), and had a median age of 38 years (interquartile range 28-50). The overall seroprevalence was 27% (171/628), with a prevalence of 33% (126/376) in Abuja and 18% (45/252) in Lagos. Based on site-specific grouped LASSO selection, enrollment in the dry season (vs. wet; aPR, 95% CI: 1.73, 1.33-2.24), reported inconsistent washing of fruits and vegetables (aPR, 95% CI: 1.45, 1.10-1.92), and a positive malaria rapid test (aPR, 95% CI: 1.48, 1.09-2.00) were independently associated with LASV seropositivity in Abuja, whereas, only a self-reported history of rhinorrhea (PR, 95% CI: 2.21, 1.31-3.72) was independently associated with Lassa seropositivity in Lagos. The LASV seroprevalence was comparable to that in other areas in Nigeria. Our findings corroborate those from other studies on the importance of limiting human exposure to rodents and focusing on behavioral factors such as poor hygiene practices to reduce exposure to LASV.

Psychological Sequelae of Dog Bites in Children: A Review.

Although rare in the Western world, dog bites may be lethal or lead to physically severe outcomes. However, little attention is given to their psychological consequences. We aimed to review their psychological consequences in children 1-14 years of age, focusing on the prevalence and nature of psychological disorders, evaluating the impact on future mental health of children and their families, and assessing the effectiveness of preventive interventions and measures. On 23 May 2024, we investigated the PubMed, CINAHL, and PsycINFO/PsycARTICLES databases using ("dog bite" OR animal-induced OR animal-caused) AND (psychol* OR mental OR psychiatr* OR anxiety OR anxious OR depress* OR obsess* OR trauma* OR psychosis OR psychotic OR schizophren* OR schizoaffect*) filtered for ages 0-18 years. This resulted in 311 records, of which 50 were eligible. These included original research, case reports, patient surveys, and reviews/meta-analyses. Findings indicate that younger children are particularly vulnerable, often suffering head/neck bites, leading to severe injuries and psychological distress, with post-traumatic stress disorder (PTSD) being a common outcome. Symptoms such as nightmares, flashbacks, anxiety, and social withdrawal were frequently reported. Positive parental support and timely psychological interventions were found to mitigate these effects. Interdisciplinary approaches integrating education, cognitive restructuring, and behaviour modification are needed to effectively prevent and address the psychological impacts of dog bites. Summarising, dog bites in children result in substantial psychological sequelae, necessitating robust prevention and intervention strategies to improve their quality of life and reduce the risk of chronic mental conditions.

Person-focused interventions for fall risk assessment, fall prevention and fall injury prevention in long-term care facilities: a scoping review

ObjectiveFalls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries can result in functional impairment, disability and death. Older adults living in LTCFs are at greater risk...

Cascade effects of a parenting-focused program for divorced families on three health-related outcomes in emerging adulthood.

Using data from a 15-year longitudinal follow-up of a randomized controlled trial of a parenting-focused preventive intervention for divorced families (N = 240) with children aged 9-12, the current study examined alternative cascading pathways through which the intervention led to improvements in offspring's perceived health problems, BMI, and cigarette smoking in emerging adulthood. It was hypothesized that the program would lead to improvements in these health-related outcomes during emerging adulthood through progressive associations between program-induced changes in parenting and offspring outcomes, including mental health problems, substance use, and competencies. Intervention-induced improvements in positive parenting at posttest led to improvements in mental health problems in late childhood/early adolescence, which led to lower levels of mental health and substance use problems as well as higher levels of competencies in adolescence, which led to improvements in the health-related outcomes. Academic performance predicted all three health-related outcomes and other aspects of adolescent functioning showed different relations across outcomes. Results highlight the potential for intervention effects of preventive parenting interventions in childhood to cascade over time to affect health-related outcomes in emerging adulthood.

Prenatal Telepsychological Intervention for Preventing Anxiety: A Study Protocol.

Background: Anxiety is one of the most frequent disorders during the perinatal stage that is associated with adverse health effects in women and their babies. In spite of this, preventive interventions during this stage are scarce. A long-distance intervention carried out during pregnancy can be an effective and accessible resource to help improve women's emotional state. The objective of this study is to present and assess the effectiveness of a telepsychology cognitive-behavioral preventive intervention during pregnancy to manage anxiety. Methods: A random clinical trial will be carried out among pregnant women in Spain. The psychological intervention will take place via videoconference in seven weekly sessions, lasting one hour each, with groups of 6-8 pregnant women. Study outcomes will be collected via online questionnaires at five points in time: pre-intervention (baseline: t0), post-intervention (baseline: t1), follow-up at 1 month (t2), follow-up at 3 months (t3) and follow-up at 6 months (t4). The control group will receive usual pregnancy care (attendance at pregnancy follow-up consultations and information and answers to frequently asked questions provided by the midwife). Our primary hypothesis is that the intervention will decrease the frequency of women who present anxious symptomatology during pregnancy. The second objective is to analyze the effectiveness of this intervention to prevent depressive symptomatology during pregnancy, as well as postpartum anxiety and depressive symptomatology. The primary outcome measure is the difference in the mean anxiety score between the intervention and control groups assessed by the Edinburgh Depression Scale-Anxiety Subscale (EDS-3A), the State-Trait Anxiety Inventory (STAI) and Generalized Anxiety Disorder Screener (GAD-7) at the end of the intervention and at 1, 3 and 6 months postpartum. Generalized anxiety disorder (GAD) will be evaluated with the SCID clinical interview at the same time points. The secondary outcome will be determined by using the EPDS at the same time points. Conclusions: The results will determine whether a cognitive behavioral therapy applied via videoconference is well accepted by pregnant women, and if it is effective in preventing anxiety and emotional symptoms during the perinatal stage. If this intervention is an effective and useful resource among pregnant women, it can be implemented as a tool in Spanish healthcare.

Epidemiological and Histological Profile of Breast Cancer in the Ghrab Chrarda Bni Hsein Region, Morocco

Introduction Breast cancer is the most common cancer, accounting for 38.9% of all cancers diagnosed, it is also the most fatal among Moroccan women. The aims of this study were to draw up an epidemiological profile of breast cancer and to establish the link between patient characteristics and the histological types of cancer observed. Methods This was a retrospective study including 877 patients with histologically confirmed breast cancer. The study was conducted at the Reproductive Health Reference Center in the province of Kénitra (Morocco). It covered the period 2013 - 2018. Results The median age of patients at diagnosis was 50 years (Q1-Q3: 42 - 58 years). Most patients were aged 40 years or older (84.04%) and married (67.32%). They were nulliparous in 18.61% of cases. The average number of live children (LVC) was 3.5 LVC (Q1- Q3: 2 - 5 LVC). Approximately 10.22% of patients had a family history of invasive carcinoma (96.58%). The median tumour size was 25 mm (Q1 - Q3: 20 - 36 mm). The predominant histological type was invasive ductal carcinoma. The most common Scarff- Bloom-Richardson (SBR) grade was SBR II (63.64%). High histological grade correlated with large tumour size. Histological type showed a significant association with time to consultation (p&lt;0.05) and age at first pregnancy (p&lt;0.05). Conclusion All the contextual factors need to be taken into account to improve the assessment of the risk of developing breast cancer, and even of dying from it. Research, awareness-raising and ongoing education are essential if we are to develop more effective prevention strategies and treatments. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1129-1136

MIDWIFERY SERVICE MANAGERS’ READINESS FOR PREVENTION OF OBSTETRIC VIOLENCE IN NIGERIA: A COMMUNITY READINESS MODEL

Obstetric violence is a public health problem that needs to be prevented at all levels to improve maternal and newborn health outcomes. The midwifery service managers, as custodians of patient care in maternity centres are in a prime position to develop and implement effective obstetric violence prevention interventions. This study explored the midwifery service managers’ level of readiness for the prevention of Obstetric Violence in three maternity centres at three separate hospitals in Oyo State, Nigeria. Data was collected from six midwifery service managers as midwifery community leaders, using the adapted Community Readiness Model as a data collection tool. The Community Readiness Model scoring guide was used to score the six dimensions of community readiness. In addition, a thematic analysis was used to analyze the qualitative data from their views on each of the six dimensions of the Community Readiness Model. The findings revealed an overall level of readiness for the prevention of obstetric violence among midwifery service managers was at level five which is the preparatory level. This means that the community has a modest readiness for Obstetric violence prevention, and it would be easier to develop sustainable prevention interventions for obstetric violence. Understanding the midwifery service managers’ level of readiness for the prevention of obstetric violence is important for governments and other stakeholders intending to develop obstetric violence prevention interventions that are contextually appropriate and acceptable to communities.

Facilitators of and obstacles to practitioners’ adoption of harm reduction in cannabis use: a scoping review

Abstract Background Cannabis use can generate potential avoidable harms, hence the need for effective preventive measures and treatment. Studies show the efficacy of harm reduction (HR) in minimizing undesirable consequences associated with this use. Despite its proven efficacy, HR in cannabis use remains poorly applied by many health and social services (HSS) practitioners, especially with young people. However, knowledge regarding the underlying reasons for this is limited. To fill this gap, we aimed to identify facilitators of and obstacles to HSS practitioners’ adoption of HR in cannabis use across OECD countries. Methods We conducted a scoping review, guided by Arksey and O’Malley’s model. The search strategy, executed on health databases and in the grey literature, captured 1804 studies, of which 35 were retained. Data from these studies were extracted in summary sheets for qualitative and numerical analysis. Results Facilitators and obstacles were grouped into four themes: stakeholders’ characteristics (e.g., education, practice experience); clients’ characteristics (e.g., personal, medical); factors related to HR (e.g., perceived efficacy, misconceptions); factors related to the workplace (e.g., type of workplace). Data were also extracted to describe the populations recruited in the selected studies: type of population, clientele, workplace. Conclusion Several factors might facilitate or hinder HSS practitioners’ adoption of HR in cannabis use. Taking these into consideration when translating knowledge about HR can improve its acceptability and applicability. Future research and action should focus on this when addressing practitioners’ adoption of HR.

Self-reported sexually transmitted infections and associated risk factors among female university students.

The spread of sexually transmitted infections (STIs) is an ongoing public health challenge, and awareness of risk factors is essential for designing effective preventive interventions. This study aimed to assess self-reported STI occurrences and identify risk factors and sexual behaviors associated with STIs among female university students. This is a cross-sectional, online questionnaire study, including 384 female university students seeking contraceptive counseling at a gynecology clinic in Uppsala, Sweden, and reporting having had sex. Associated risk factors and behaviors were assessed by comparing those who reported STIs and those who did not. The mean age of participants was 22.8 years. Seventy-eight (20%) had contracted at least one STI, with seven (9%) experiencing multiple infections. Seventy-three (94%) reported first-date sexual activity without a condom among STI experienced. Chlamydia trachomatis was the most common STI pathogen (68% of all infections), followed by Herpes simplex virus (18%) and Mycoplasma genitalium (13%). Behavioral factors associated with self-reported STIs were first-date sexual activity without a condom, not using condom at first intercourse, younger age at first intercourse, a higher number of sexual partners overall and in the last 12 months, experience of anal sex, dating app usage, and regretting sexual activity after substance use (P < 0.003 for all). Condom use was low among the respondents, and STIs were common regardless of the high level of education in this group. Contraceptive counseling needs to highlight the importance of condom use in addition to contraceptive efficacy. It is also essential to consider the specific risk factors and behaviors prevalent among young adults to reduce the spread of STIs.

RISK FACTORS FOR SUBSTANCE USE AMONG MALE SECONDARY SCHOOL STUDENTS IN ADEN GOVERNORATE, YEMEN

Substance use among secondary school students is a growing concern with significant implications for public health. This study aimed to identify the risk factors associated with substance use in a community of secondary school students in Aden Governorate, Yemen. A cross-sectional study was conducted among secondary school students in Aden governorate, using a structured questionnaire to collect data on potential risk factors for substance use. The questionnaire included measures of Peer Pressure, Academic Performance (GPA), Parental Monitoring, as well as self-esteem towards drug use. The Self-esteem among secondary students was measured using Rosenberg's Self-Esteem Scale. Descriptive and inferential statistical analyses were performed to identify significant risk factors. A total of 280 male students from 10 secondary schools (both section) of Aden governorate participated in the study, with a mean age of 17.37± 1.42 years. Risk factors associated with substance use included peer pressure (OR=2.34, 95% CI: 1.56-3.42), poor academic performance (OR=1.87, 95% CI: 1.23-2.81), lack of parental supervision (OR=1.62, 95% CI: 1.09-2.37), and low self-esteem (OR=1.45, 95% CI: 1.01-2.11). The findings highlight the complex interplay of social, familial, and individual factors in contributing to substance use among secondary school students. These results can inform targeted interventions and preventive strategies to address the identified risk factors in the community. This study identified several key risk factors for substance use among secondary school students in the community. Understanding and addressing these risk factors is vital for the development of effective preventive interventions and support systems to mitigate the impact of substance use on the health and well-being of young individuals.