Effective Prevention Programs Research Articles

Home-visiting Parenting Programs to Improve Mother-Infant Interactions at Early Ages: A Systematic Review.

Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children's behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

Explaining the barriers faced by veterinarians against preventing antimicrobial resistance: an innovative interdisciplinary qualitative study

BackgroundConsidering the significance of increased antimicrobial resistance (AMR) and its adverse effects on individual and social health and the important and effective role that veterinarians play in controlling this growing issue worldwide, it is essential to have effective preventive control programs. To this aim, the first step is to identify the factors behind the prevalence of AMR in Iran and the barriers veterinarians face to controlling this problem. Thus, the present study was conducted to explain the barriers veterinarians faced in the prevention of AMR from an Iranian veterinarian’s perspective.MethodsThe present research was done in three cities in Iran in 2021. The data were collected through in-depth interviews with 18 veterinarians selected through purposive and snowball sampling and analyzed using conventional qualitative content analysis.ResultsThe data analysis results were classified into 4 main categories and 44 subcategories. The former included: educational factors, administrative/legal factors, client-related factors, and veterinarian-related factors.ConclusionsThe increased AMR can be approached from multiple aspects. Considering the different factors that affect the increased AMR, it is necessary to consider them all through effective planning and policy-making at multi-level and multidisciplinary dimensions. There is special attention needed to scientific and practical interventions at the individual, interpersonal, social, and even political levels. At the same time, measures should be taken to rehabilitate and maintain the health of society to strengthen supervision and attract the full participation of interested organizations.

Epigenetics of conotruncal congenital heart disease: Protocol for a systematic review and meta-analysis.

Conotruncal congenital heart defects (CTD) are a subset of congenital heart diseases (CHD) that involve structural anomalies of the right, left, or both cardiac outflow tracts. CHD is caused by multifactorial inheritance and changes in the genes or chromosomes. Recently, CHD was found to be due to epigenetic alterations, which are a combination of genetic and other environmental factors. Epigenetics is the study of how a gene's function changes as a result of environmental and behavioral influences. These causative factors can indirectly cause CHD by altering the DNA through epigenetic modifications. This is a protocol for a systematic review and meta-analysis that aims to explore whether the strength of association between various epigenetic changes and CTD types varies by race. Furthermore, to determine and compare the changes in gene expression of each mutation. Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. A comprehensive pre-search has been developed in PubMed and PubMed's Medical Subject Headings (MeSH). The final search will be performed in June 2023 in PubMed, Embase, Scopus, Web of Science, Cochrane Library, CIANHL, and PsycInfo, without restrictions on publication years. The Covidence systematic review software will be used for blinded screening and selection. Conflicts will be resolved by a third, independent reviewer. The risk of bias in selected studies will be assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The data to be extracted will cover basic information on the included studies, study sample size, number of patients with various types of epigenetic changes, number of patients with various CTD types, measures of association and their 95% confidence interval between each epigenetic change and each CTD. The protocol has been registered with the International Prospero Register of Systematic Review (PROSPERO) [CRD42023377597]. To the best of our knowledge, this protocol outlines the first systematic review and meta-analysis of the epigenetics of CTD. There is a growing body of evidence on epigenetics and its indirect involvement in disease by altering the DNA through epigenetic modifications in the genes associated with the causative factors for CHD. We will conduct a comprehensive and systematic search for literature in the above-mentioned seven core biomedical databases. It is very important to identify population-specific risk factors for CHD, which will have significant creative, custom-made, and effective prevention programs for the future generation.

Stress and predictive psychosocial variables in Ecuadorian university teachers

ABSTRACT University professors are exposed to high levels of stress as a result of the multiple activities involved in their profession. The objective of this research is to explain how a sequence of psychosocial variables directly and indirectly influences stress. Method: A non-probabilistic and non-clinical sample of 480 professors from different Ecuadorian universities was surveyed online, and participation was anonymous. Sequential Canonical Analysis was used (SEQCA). This paper examined the following multivariate sequence: (1) resilience; (2) psychological inflexibility; (3) loneliness; (4) life engagement; and (5) stress. The model also considered the indirect influences of work-related variables including occupation, work-hours, and likelihood of losing a job. Results: The overall SEQCA was statistically significant (p < .0001) and accounted for 36% of the variance. Conclusions: Psychosocial variables predict stress more than work-related variables. The results will provide information for designing effective stress prevention programs.

“Allowing Space for Voice…All Our Voices”: Understanding Ho‘ouna Pono Implementation Through Educational Leadership Perspectives in Rural Hawai‘i Schools

Epidemiological research over the past two decades has highlighted substance use disparities that affect Native Hawaiian and Pacific Islander youth, and the lack of effective approaches to address such disparities (Okamoto et al. in Asian American Journal of Psychology 10(3):239–248, 2019). The Ho‘ouna Pono curriculum is a culturally grounded, teacher-implemented, video-enhanced substance use prevention program that has demonstrated efficacy in rural Hawaiʻi in a large-scale trial (Okamoto in Asian American Journal of Psychology 10(3):239–248, 2019). Despite its potential to ameliorate health disparities and address youth substance use, prevention programs such as Ho‘ouna Pono have been poorly disseminated and implemented across Hawaiʻi, raising the question: Why are effective prevention programs not used in communities that most need them? The present study used concept mapping to understand previously identified implementation barriers and develop implementation strategies for Ho‘ouna Pono. Seven Hawaiʻi Department of Education (HIDOE) educational leaders and administrators sorted Ho‘ouna Pono implementation barriers (e.g., “There is a lack of HIDOE funding to support prevention curricula”), named concepts, and rated barriers’ perceived impact and difficulty. Multidimensional scaling and cluster analysis yielded a five-cluster solution: (1) Kumu (Hawaiian word for teacher) Controlled, (2) School Level Buy-in, (3) Curriculum, (4) Student Attitudes + Mindsets (Family + Community), and (5) Policy. Participant ratings identified eight high-impact and low-difficulty barriers. Discussion revealed important intersections among barriers indicating the need for coordinated and cross-level implementation strategies to support Ho‘ouna Pono sustainment. Brainstormed implementation strategies using participants’ own language highlighted a need for participatory methods in school settings to bidirectionally share ways to best sustain substance use prevention programs.

Exploring the Interplay of Intergenerational Transmission, Structural Inequalities, and Relative Resources in Domestic Violence: Evidence From a Nationally Representative Dataset.

Domestic violence persists as a significant social challenge affecting a considerable number of women globally. Some scholars have ascribed the inclination toward domestic violence to a "cycle of violence" spanning generations, while others have pointed out structural inequalities. Feminist researchers contend that a comprehensive understanding necessitates exploration within the social and institutional realms of gender inequality. While each of these perspectives contributes significantly to comprehending domestic violence, individually, they might not unveil the complete causal narrative. This study endeavors to address this gap by proposing an integrated model to elucidate domestic violence in the context of Türkiye, examining (a) the correlation between growing up in a violent household and the susceptibility to domestic violence, (b) the interrelation between structural factors and the vulnerability to domestic violence, and (c) the connection between a woman's advantageous position in terms of the couple's relative resources and the likelihood of experiencing domestic violence. To achieve this objective, multivariate micro-level analyses were conducted using nationally representative data from the 2014 Research on Domestic Violence Against Women in Türkiye. The outcomes affirm the significance of all three approaches, highlighting the value of integrated methodologies for a more profound comprehension of the etiology of domestic violence. This insight is crucial for the development of effective prevention programs. Furthermore, the findings highlight intra-parental violence exposure as the most robust risk factor or predictor for subsequent involvement in violent intimate relationships. As the initial study in Türkiye encompasses early-life experiences, structural inequalities, and the relative resources of couples, this research is poised to contribute significantly to the existing body of literature on domestic violence.

Expanding the Question-Persuade-Refer (QPR) Evidence Base: Youth Suicide Prevention among the Mississippi Band of Choctaw Indians.

Youth suicide risks have been on the rise or persistently elevated for decades, and Native American communities are especially vulnerable. This study provides a promising framework for suicide prevention among underserved populations in the U.S., especially Native American communities in states lacking strong suicide prevention supports. Our investigation reports the evaluation results of the Question-Persuade-Refer (QPR) gatekeeper training program, a key component of the SAMHSA-funded Choctaw Youth Resilience Initiative (CYRI) implemented by the Mississippi Band of Choctaw Indians (MBCI). QPR trains adult gatekeepers to identify youth at risk of suicide and refer them to certified mental health service providers. Standardized QPR pre-test and post-test training surveys were administered at in-person trainings delivered to youth-serving MBCI organization leaders and staff. Statistical analyses of all survey items indicate that QPR gatekeeper trainings significantly enhanced the knowledge of prevention practices and risk identification skills for the MBCI trainees. The robust evidence of positive changes revealed in this study suggests that QPR can be an effective suicide prevention program for underserved minority communities, especially Native American populations in rural states where suicide is a persistent and leading cause of mortality.

A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns

The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.

Sex and gender differences in hepatitis C virus risk, prevention, and cascade of care in people who inject drugs: systematic review and meta-analysis

People who inject drugs (PWID) are a priority population in HCV elimination programming. Overcoming sex and gender disparities in HCV risk, prevention, and the cascade of care is likely to be important to achieving this goal, but these have not yet been comprehensively reviewed. Systematic review and meta-analysis. We searched Pubmed, EMBASE and the Cochrane Database of Systematic Reviews 1 January 2012-22 January 2024 for studies of any design reporting sex or gender differences among PWID in at least one of: sharing of needles and/or syringes, incarceration history, injection while incarcerated, participation in opioid agonist treatment or needle and syringe programs, HCV testing, spontaneous HCV clearance, direct-acting antiviral (DAA) treatment initiation or completion, and sustained virological response (SVR). Assessment of study quality was based on selected aspects of study design. Additional data were requested from study authors. Data were extracted in duplicate and meta-analysed using random effects models. PROSPERO registration CRD42022342806. 9533 studies were identified and 92 studies were included. Compared to men, women were at greater risk for receptive needle and syringe sharing (past 6-12 months: risk ratio (RR) 1.12; 95% confidence interval (CI) 1.01-1.23; <6 months: RR 1.38; 95% CI 1.09-1.76), less likely to be incarcerated (lifetime RR 0.64; 95% CI 0.57-0.73) more likely to be tested for HCV infection (lifetime RR 1.07; 95% CI 1.01, 1.14), more likely to spontaneously clear infection (RR1.58; 95% CI 1.40-1.79), less likely to initiate DAA treatment (0.84; 95% CI 0.78-0.90), and more likely to attain SVR after completing DAA treatment (RR 1.02; 95% CI 1.01-1.04). There are important differences in HCV risk and cascade of care indicators among people who inject drugs that may impact the effectiveness of prevention and treatment programming. Developing and assessing the effectiveness of gender-specific and gender-responsive HCV interventions should be a priority in elimination programming. Réseau SIDA-MI du Québec.

PRE- AND POST-NATAL METHODS FOR PREVENTING EARLY CHILDHOOD CARIES

In general, the world recognizes the lack of preventive measures against dental caries in children, as evidenced by itsprevalence and intensity with a signifi cant range of fl uctuations.The aim of the study. To describe modern approaches to the prevention of early childhood dental caries in children basedon the analysis of foreign and domestic literature.Materials and methods. The study used the bibliosemantic method and structural and logical analysis. The electronicdatabases PubMed, MEDLINE, Scopus, Web of Science and EMBASE were used to search modern scientifi c literature using the key words «early childhood caries», «macro and trace elements», «probiotics», «prenatal prevention», «postnatal prevention», «oral cavity microfl ora».Results and discussion. At this stage of caries development, the most eff ective prevention programs are those developedon the basis of methods to minimize the impact of risk factors for the development of the disease, such as microbial plaque,low resistance of dental tissues to demineralization, frequent consumption of carbohydrates. The practical implementation of comprehensive prevention programs is very diffi cult, as it should be carried out before the birth of a child and continue throughout life. Often the role of the dentist is to organize and monitor the program, while specifi c preventive measures can and should be implemented by health and education authorities, medical personnel, parents and educators. The greatest impact will be achieved through collaboration among specialists in various medical and non-medical fi elds.Conclusions. Based on the analysis of the literature, there is a great interest of the world’s leading scientists in the prevention of early childhood caries. However, the problems of developing adapted preventive measures taking into account etiologic factors remain relevant.

Peer and land-based approaches for fostering empowering and healthy relationships with Indigenous and northern young people in the Northwest Territories.

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.

Adaptation and qualitative evaluation of the BETTER intervention for chronic disease prevention and screening by public health nurses in low income neighbourhoods: views of community residents

BackgroundThe BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews.MethodsWe first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method.ResultsThirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals.ConclusionsResidents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention.Trial registration#NCT03052959, 10/02/2017.

Risk factors for suicidal ideations and suicide attempts among medical students

IntroductionMedical students are a high-risk population for having suicidal thoughts and behaviors. However, few studies have been fulfilled on this subject.ObjectivesThe objective of this study was to provide a systematic overview of risk factors for suicidal ideations (SI) and suicide attempts (SA) among medical students.Methods We set out to summarize the literature on the MEDLINE (via PUBMED) and Science Direct databases, regarding risk factors for SI and SA in medical students, using the key words : « medical student» ; « suicide attempt» ; « suicidal ideation », « risk ».Results Recent studies showed that poor mental health outcomes including depression, anxiety, burnout, comorbid mental illness, and stress presented the strongest risk for SI among medical students. In addition, SI was statistically significantly associated with alcohol use, Tobacco consumption, personal history of suicide attempt, female gender and poor social support.On the other hand, SA were significantly associated with the presence of a long-term illness, anxiety and depression. Conversely, stress, female gender, and alcohol use were not significant risk factors for SA among medical students.ConclusionsMedical students face a number of personal, environmental, and academic challenges that may put them at risk for SI and SA. Additional research on individual risk factors is needed to construct effective suicide prevention programs in medical schools.Disclosure of InterestNone Declared

Impact of oral health preventive program using specialized audio and tactile aids in visually impaired school children. A cross-sectional study.

The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children. 100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices. Independent 'T-test' was used for comparing mean ± SD values. Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months. The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Gastrointestinal parasite infections and associated factors in fighting bulls over 7 years of monitoring in Southern Thailand.

Indigenous beef cattle engaged in bullfighting in Southern Thailand represent a distinctive and valuable breed. Gastrointestinal (GI) parasites, which are recognized as important pathogens, have a negative impact on the overall health and physical performance of these fighting bulls. This study aimed to estimate the prevalence of GI parasitic infections and identify factors associated with these infections in a fighting bull population in Southern Thailand. Fecal samples (n = 4,244) from fighting bulls were submitted to the Laboratory and Diagnostic Centre of the Teaching Animal Hospital, Faculty of Veterinary Science, Rajamangala University of Technology Srivijaya. We examined the samples using simple flotation and centrifugal sedimentation methods. Individual animal profiles and demographic data were collected. The overall prevalence of GI parasitic infections was 93.2%. Nine GI parasites were identified as Paramphistome spp. [PP]. being the most prevalent (93.2%), and the highest annual prevalence occurred in 2019 (97.9%). The infection rates of various parasite species were significantly related to the years of study, geographic area, season, and age group (p < 0.05). The prevalence of parasitic infection was higher on the west coast (98.6%) than on the east coast (98.0%). PP, Eurytrema spp., Strongyles spp., and Buxtonella spp. infections differed significantly among the seven provinces of Southern Thailand (p < 0.05). The prevalence of GI parasitic infections was higher during the rainy season (98.5%) than during the summer (97.7%). Bulls aged 7.0-7.9 years and 8.0-8.9 years had the highest parasite infection rate (99.2%) compared with those aged 8.0-8.9. GI parasitic infections continue to be a significant health concern among fighting bulls in Southern Thailand. Regular epidemiological investigations are crucial for developing effective preventive programs and control strategies and providing basic knowledge for bull farmers.

Public health strategies for preventing youth substance use: A review of prevention programs and conceptual approaches

Substance use among youth is a significant public health concern with far-reaching implications for individual health and societal well-being. This review provides a comprehensive review of public health strategies aimed at preventing youth substance use, focusing on the examination of prevention programs and conceptual approaches. Prevention programs targeting youth substance use vary widely in their approaches, ranging from school-based interventions to community-wide initiatives. This review evaluates the effectiveness of different prevention programs, considering factors such as program structure, content, and duration. It highlights evidence-based programs that have demonstrated success in reducing substance use initiation and promoting healthy behaviors among youth. Moreover, the review discusses various conceptual approaches underpinning youth substance use prevention efforts. These approaches encompass socio-ecological models, which emphasize the influence of multiple levels of factors including individual, interpersonal, community, and societal influences on substance use behavior. Additionally, the socio-cultural perspective underscores the significance of cultural norms, beliefs, and values in shaping youth attitudes towards substance use. Furthermore, this review examines the role of policy interventions and regulatory measures in preventing youth substance use, emphasizing the importance of creating supportive environments and implementing evidence-informed policies to curb access to substances and minimize risk factors associated with youth substance use. In conclusion, effective prevention of youth substance use requires a multifaceted approach that integrates evidence-based programs, conceptual frameworks, and policy interventions. By addressing risk factors at various levels and promoting protective factors, public health strategies can play a pivotal role in reducing the prevalence of youth substance use and fostering healthier communities.

Using machine learning models to predict falls in hospitalised adults

BackgroundIdentifying patients at high risk of falling is crucial in implementing effective fall prevention programs. While the integration of information systems is becoming more widespread in the healthcare industry, it poses a significant challenge in analysing vast amounts of data to identify factors that could enhance patient safety. ObjectiveTo determine fall-associated factors and develop high-performance prediction tools for at-risk patients in acute and sub-acute care services in Australia. MethodsA retrospective study of 672,400 patients admitted to acute and sub-acute care services within a large metropolitan tertiary health service in Victoria, Australia, between January 1, 2019, and December 31, 2021. Data were obtained from four sources: the Department of Health Victorian Admitted Episodes Dataset, RiskManTM, electronic health records, and the health workforce dataset. Machine learning techniques, including Random Forest and Deep Neural Network models, were used to analyse the data, predict patient falls, and identify the most important risk factors for falls in this population. Model performance was evaluated using accuracy, F1-score, precision, recall, specificity, Matthew's correlation coefficient, and the area under the receiver operating characteristic curve (AUC). ResultsThe deep neural network and random forest models were highly accurate in predicting hospital patient falls. The deep neural network model achieved an accuracy of 0.988 and a specificity of 0.999, while the RF achieved an accuracy of 0.989 and a specificity of 1.000. The top 20 variables impacting falls were compared across both models, and 12 common factors were identified. These factors can be broadly classified into three categories: patient-related factors, staffing-related factors, and admission-related factors. Although not all factors are modifiable, they must be considered when planning fall prevention interventions. ConclusionThe study demonstrated machine learning's potential to predict falls and identify key risk factors. Further validation across diverse populations and settings is essential for broader applicability.

The effectiveness of school-based child sexual abuse prevention programmes among primary school-aged children: A systematic review

This systematic review provides a comprehensive overview of child sexual abuse prevalence globally, along with an examination of the effectiveness of school-based prevention education programmes for primary school-aged children. These prevention programmes utilise social cognitive learning theories to teach children the importance of identifying and responding to abusive situations. A total of 676 papers were evaluated with 13 Randomised Controlled Trial (RCT) or cluster RCT design studies identified as meeting the study's inclusion criteria. These studies were published in English between January 2000 and May 2022, and focus on outcomes of school-based prevention programmes designed for primary school-aged children (5–12 years old). To ensure a comprehensive and academically rigorous analysis, the following databases were included: Science Direct, Web of Science, Scopus, the American Psychiatric Association (APA) PsycINFO, Ovid Medline, and Embase. The studies reviewed aim to evaluate the effectiveness of various child sexual abuse prevention programmes in improving children's knowledge and recognition of, and response to potentially unsafe situations. In terms of outcomes and results, the interventions have significantly impacted knowledge, skills, confidence, and awareness in the short and long term. These studies used different intervention methods, including mobile applications, personal safety programmes, and protective behaviour programmes, delivered in various formats such as web-based, textbooks, and in-person sessions. This systematic review highlights the importance of child sexual abuse prevention programmes in schools and the need for further research.

A Cross-Sectional Study Looked into the Incidence of Early Missing Primary Teeth in Children Aged 6 to 12 in the Southern Iraqi City of Nasiriya

Objectives: One of the potential risk factors for poor dental arch length growth, which in turn affects the formation of permanent teeth, is the early loss of primary teeth, which is common in childhood dental disease. For the formation of permanent teeth, the dental arch must be the proper length. The length of the weak arc may cause crowding, preterm birth, or impaction of these teeth, which could harm the student's health and development throughout the course of their life. The purpose of this study was to determine the frequency of early primary tooth loss in students aged 6 to 12 years old. Materials and Methods: 259 students made up the study group, 135 boys and 124 girls. An expert examiner performed the dental examination in an environment with enough artificial light. The age of the patient and the number of lost teeth were recorded. Data analysis was conducted using descriptive statistics, and based on the findings, Chi-square tests were conducted at a level of significance of 5% (P 0.05). Results: Boys lost their primary teeth at a rate of 49%, while girls of the same age lost their teeth at a slightly higher rate of 51%. The study also revealed that first molars (42.6%) are the dental arch's most often missing teeth. Conclusion: In the study group, there was a high prevalence of early loss of primary teeth, students could retain a healthy primary dentition and eventually avoid disruptions in the development of appropriate occlusion with the support of effective educational and preventive programs for oral health. Reducing malocclusion issues would be made possible with the early detection and treatment of the space issues brought on by the early loss of primary teeth.

Peer Influence and Factors Associated with Personal Network Size of Underage Drinkers Recruited Through Respondent-driven Sampling in Dibrugarh District of Assam, India

Personal networks significantly contributed to initiating risky behaviours among emerging youth. The study aimed to assess the personal network characteristics and factors associated with the personal network size of underage alcohol users. 200 underage drinkers were recruited through respondent-driven sampling in Dibrugarh, Assam using five seeds. Transition probability matrices and homophily indices were used to describe underage drinkers’ network characteristics and network patterns. The weighted logistic regression model was performed to observe the association. Personal network size differed significantly with respect to demographic profile and alcohol consumption patterns of the respondents. A higher proportion of participants used cannabis (77.0%), drank for more than 3 years (40.7%) and liked to drink with peers (51.1%). The affiliation pattern of educational status shows a trend of homophily and interaction between new and older underage drinkers. Students (OR 3.17, 95% CI 1.32, 7.62) who like to drink with peers (OR 3.45, 95% CI 1.24, 9.62) were found significantly associated with larger personal network size in weighted multiple binary logistic regression. The findings will be helpful to understand the network pattern of underage drinkers. The study highlighted the need for effective prevention and intervention programmes for this population and suggested further research in this area.