Evidence-based Prevention Strategies Research Articles

Injuries, Risk Factors, and Prevention Strategies in Bicycle Motocross (BMX): A Scoping Review.

Bicycle motocross (BMX) has become increasingly popular since its inclusion in the 2008 Olympics, but it has some of the highest injury rates (IRs) in multisport studies. To support planning for tailored primary prevention, understanding gaps in BMX injury prevention is crucial. To examine the evidence on injury incidence, prevalence, risk factors, prevention strategies, and prevention implementation in BMX. Ovid MEDLINE, Embase, APA PsycInfo, CINAHL, and SPORTDiscus were searched systematically in June 2023. Articles including BMX and any injury as the main topic or subtopic were searched across multiple databases. A scoping review was designed following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Level 4. BMX injury incidences, prevalence, risk factors, prevention strategies, and prevention implementation were extracted. Two reviewers screened all studies and extracted data independently. Of the 1856 articles screened, 37 met inclusion criteria. Most studies used injury surveillance at elite competitions or emergency departments, and common injuries were contusions, lacerations, and fractures. IRs provided were based primarily on elite competition and were heterogeneous (eg, 2016 Olympics: 37.5 per 100 athletes; 2007 BMX World Championship: 11.7 per 100 athletes; 1989 BMX Euro Championship: 6.6 per 100 athletes). Only 1 study stratified IRs by BMX discipline (BMX freestyle: IR, 22.2 injuries per 100 athletes; BMX racing: IR, 27.1 per 100 athletes). Few prevention strategies have been evaluated, but reducing the number of riders per race could be helpful. Most BMX studies do not use recommended injury surveillance methodology. Studies based on emergency department data may underestimate minor injuries and do not adequately measure BMX exposures. Rigorous community-based prospective studies examining IRs for both BMX racing and freestyle, risk factors, and prevention strategies are needed to inform widespread evidence-based prevention strategies.

Assessing Older Adults' Readiness for Adopting Fall Prevention Recommendations Using the Transtheoretical Stages of Change.

Objectives: Reducing fall risk requires older adults (age 65+) to adopt effective prevention strategies. This study has three aims: 1) understand Stage of Change (SOC) for three fall prevention strategies; 2) determine strategies older adults' use; and 3) understand which characteristics relate to readiness to take action. Methods: A survey of 1063 older adults assessed fall risk, SOC, and use of fall prevention strategies. Data analysis included descriptive statistics and regression analysis. Results: The most common SOC for older adults by strategy was action for overall fall prevention (61%), contemplation for medication management (45%), and preparation and action for strength/balance (29% each). Believing falls are preventable was most strongly related to being in a Change stage (e.g., action, maintenance) for overall fall prevention (Risk Ratio: 1.4, 95% CI: 1.1, 1.7). Discussion: Health promotion can focus on increasing knowledge of evidence-based fall prevention strategies to encourage older adults to take action.

Effect of police expenditure on crime rate in India

Purpose This study aims to examine the relationship between law enforcement expenditures, economic indicators and various crime rates in India using data from the National Crime Records Bureau (NCRB) spanning from 2001 to 2021. Design/methodology/approach The study uses data sourced from the NCRB covering violent crimes, property crimes, economic crimes and total crimes under the Indian Penal Code across 27 states and 2 union territories in India. Crime rates per 100,000 people are calculated using projected population figures from the 2001 and 2011 censuses, adjusting for census periods and growth rates. Economic variables such as per capita real gross state domestic product (GSDP) and total police expenditure are obtained from state government sources, adjusted to constant prices. Pooled ordinary least squares analysis is conducted to explore the relationships between crime rates, conviction rate, economic factors and police expenditure over the three-time points: 2001, 2011 and 2021. Findings The study reveals a complex relationship between police expenditure and crime rates across different categories in India. Increased police expenditure is positively associated with higher reporting rates for violent and economic crimes, suggesting that enhanced law enforcement resources may improve crime detection and reporting. However, contrary to some expectations, higher police spending does not necessarily lead to a reduction in overall crime rates. Economic prosperity, measured by per capita GSDP, is found to reduce violent crime rates but is associated with an increase in property and economic crimes, likely due to the greater opportunities for such crimes in wealthier regions. Research limitations/implications The study’s reliance on state-level aggregate data and NCRB crime statistics, which are based on reported incidents, might not fully capture the true extent of criminal activity, particularly in regions with underreporting issues. In addition, the use of projected population data beyond 2001 and 2011 introduces some uncertainty into the analysis. Future research should explore district-level data to better understand regional variations in crime and incorporate social, cultural and innovative policing strategies to provide a more comprehensive analysis. Practical implications Policymakers should recognize the nuanced impacts of police expenditure and economic prosperity on crime rates. While increased law enforcement resources may enhance crime reporting, they do not guarantee a reduction in overall crime rates. Economic growth, while beneficial in reducing violent crimes, may inadvertently increase property and economic crimes due to greater opportunities for criminal activity. These insights suggest the need for targeted interventions that consider both economic factors and law enforcement strategies in crime prevention efforts. Originality/value This study contributes to the ongoing debate about the effectiveness of police expenditure in reducing crime by highlighting its limited impact on overall crime rates in India. The findings underscore the importance of understanding the diverse effects of economic prosperity on different crime types, offering valuable insights for policymakers aiming to design evidence-based crime prevention strategies that account for socioeconomic disparities and regional contexts.

Homicide-Suicides in Pakistan: An analysis of Newspaper reports of two years

Background and Objective: Our understanding of homicide-suicide (H-S), a rare yet tragic event, is sparse. While the phenomenon has been studied in the West for many years, only limited literature is available from Asia and none to our knowledge from Pakistan. There is evidence of complexity of the interaction between cultural, societal, and psychological mechanisms underlying this phenomenon; therefore, research findings from the Western countries cannot be directly applied in non-Western societies. Our objective was to study homicide-suicides in Pakistan, describe the characteristics of offenders and victims, determine the types of H-S, and examine possible motives and any events prior to the offense. Methods: In the absence of any official data on homicide-suicides, we used newspaper surveillance approach of four most widely circulated Pakistani newspapers (one Urdu and three English Daily) for two years (1st January 2019 to 31st December 2020). Each case was categorized using the modified Marzuk et al., Tardiff, and Hirsch’s classification of homicide-suicides. Descriptive statistics were used to analyze the data that was then compared with published literature. Results: There were 114 H-S incidents with 198 victims of homicide during the study period, reported in the newspapers. Familial H-S particularly filicide-suicide were predominant, followed by spousal/ consortial H-S. Forty-one (36%) H-S involved multiple victims. The perpetrators across all categories of H-S were predominantly male (67%); the victims were predominantly women and children. Firearms were used in most incidents. The primary motive for the majority of H-S cases was familial, financial, and social stressors. Conclusions: The study highlights several unique patterns (predominance of familicide, multiple victims including high proportion of children) and a series of vulnerabilities (incidents related mostly to familial/ financial and social stressors) that overlap each other and ultimately lead to this tragic end. There is need to increase our understanding and develop effective evidence-based prevention strategies for H-S in Pakistan. It is also very important to have a national surveillance network and national violent death reporting system in the country for studying H-S cases, and for evaluating the impact of prevention programs. doi: https://doi.org/10.12669/pjms.40.10.9812 How to cite this: Imran N, Ayub M, Haider II, Rafiq B, Tahir SM, Naveed S, et al. Homicide-Suicides in Pakistan: An analysis of Newspaper reports of two years. Pak J Med Sci. 2024;40(10):2196-2201. doi: https://doi.org/10.12669/pjms.40.10.9812 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects of different intensity resistance training on fat level, energy intake, and appetite among overweight and obese female college students

This study examines how different intensity resistance exercises impact fat, energy intake, and appetite regulation in overweight and obese female college students in Jiangsu Province, China. This study used a randomized controlled trial (RCT) design that investigates resistance training intensity-target result causation. The study determines the impact of High-Intensity Interval Training (HIIT) and Moderate-Intensity Resistance Training (MIRT) on body composition, fat level/body composition, and muscle mass them. In Jiangsu Province, China, 515 overweight and obese female college students aged 18–25 were sampled. Intervention groups were assigned randomly to campus recruits based on demographic and anthropometric. This study demonstrated significant correlations between resistance training intensity, body composition, diet, and appetite regulation in overweight and obese colleagues. MIRT and HIIT outperformed Control in weight loss and diet and used valid measures like DEXA (Dual-Energy X-ray Absorptiometry), blood tests and food diaries to regulate appetite hormones. Increased protein and muscle mass minimize resistance exercise intensity-metabolic consequences. The study analyzes these impacts to show how exercise intensity, food, and metabolic health are interconnected. These findings help build evidence-based obesity prevention and treatment strategies for this demographic. Healthcare providers, legislators, and university stakeholders use this study to tackle college student obesity. The results suggest that campus wellness initiatives should focus on resistance exercise and diet to combat obesity. This research promotes exercise science and health behavior change theory for cross-cultural lifestyle interventions.

Risk factors and characteristics of intraoperative pressure injuries caused by medical devices and adhesives: A case-control retrospective study

Background: Undesirable injuries during the intraoperative period, such as pressure injuries caused by improper positioning, medical devices, or adhesive tapes, can lead to patient harm and decreased satisfaction. This study aims to identify the risk factors of pressure injuries during the intraoperative period and the characteristics of these injuries. Methods: A retrospective case-control study was conducted at King Khaled University Hospital in Riyadh, Saudi Arabia. Data were collected from the hospital incident reporting system and electronic medical records for incidents reported from January 1, 2022 to December 31, 2022. Inclusion criteria consisted of all patients with a reported pressure injury, including pressure ulcers, medical adhesive-related skin injuries, or medical device-related pressure injuries, occurring at least once during surgery. Results: Among the 113 patients, 57 (50.44%) had intraoperative pressure injuries (cases), while 56 (49.56%) did not (controls). The most common locations for pressure injuries were the lips (33.33%). Most of these injuries were classified as Medical Adhesive-Related Skin Injury (61.40%). Stage 1 injuries were observed in 47 cases (82.46%), while Stage 2 injuries were observed in 10 cases (17.54%). Duration of surgery and device tightness were identified as significant risk factors (P < 0.001). Conclusion: This case-control study identified the duration of surgery and device tightness as significant risk factors for intraoperative pressure injuries. The findings emphasize the importance of implementing evidence-based prevention strategies. Healthcare professionals should prioritize staff education and training, while future research should focus on conducting prospective, multicenter studies and developing risk assessment tools and innovative medical devices.

A contemporary evaluation of the frequency & factors associated with overt stroke across the lifespan: A Ghanaian sickle cell disease registry analysis

BackgroundStroke is a devastating complication of Sickle Cell Disease (SCD) with significant mortality and substantial morbidity. The burden of prevalent stroke in SCD is highest in sub-Saharan Africa and estimated at 4.2 % to 6.4 % in the era where evidence-based prevention strategies such as use of hydroxyurea therapy and transcranial doppler ultrasound were not routine care. PurposeTo assess the contemporary frequency and factors associated with prevalent stroke across the lifespan in an SCD registry at the tertiary medical center in Ghana. MethodsThis is a cross-sectional study conducted at the Komfo Anokye Teaching Hospital, a tertiary medical center in the middle belt of Ghana. The center has comprehensive Sickle Cell Clinics for children, adolescents, and adults with a patient registry established as part of the Sickle Pan-African Research Consortium (SPARCo)-Ghana study from 2017 to date. Data captured in the registry and analyzed for the present study include demographics, stroke status using the WHO criteria supplemented by the Questionnaire for Verifying Stroke Free Status (QVSFS), use of hydroxyurea, and complete blood count. Logistic regression modeling was utilized to assess factors associated with stroke. ResultsAmong a registry cohort of 4115 individuals with confirmed SCD, 35 (0.85 %, 95 % CI: 0.59–1.18 %) had overt or clinically confirmed stroke. The frequency of stroke differed significantly across the lifespan being 0.38 % (95 % CI: 0.12–0.64 %) among children <10 years, 1.23 % (95 % CI: 0.73–1.94 %) among adolescents aged 10 to 17 years, and 1.44 % (95 % CI: 0.66–2.71 %) among adults 18 years or more, p = 0.007. In adjusted analysis, each 10-year increase in age was associated with odds ratio, OR (95 % CI) of 1.90 (1.42–2.54) and hydroxyurea use, OR of 6.09 (2.65–13.99). The association between hydroxyurea and stroke observed in this cross-sectional study is not causal. ConclusionApproximately 1 in 120 SCD patients in this large Ghanaian cohort had clinically overt stroke. The gradual uptake of hydroxyurea therapy into routine care for SCD in this resource-limited setting, may partly explain the lower frequency of stroke.

Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Policy Statement.

Reading together often with infants and young children strengthens their relationships with parents/caregivers at a critical time in child development, stimulating brain circuitry and early attachment. A positive parenting practice, shared reading helps build the foundation for healthy social-emotional, cognitive, language, and literacy development, setting the stage for school readiness and providing enduring benefits across the life course. Pediatric physicians and advanced care providers have a unique opportunity to encourage parents/caregivers to establish routines and enjoy conversations around books and stories with their children beginning in infancy. Research has demonstrated that parents read and children learn when pediatricians offer literacy promotion as a practical and evidence-based primary prevention strategy in primary care practice to support early brain and child development. This supports families with a strengths-based approach, shaping a child's life trajectory and helping mitigate stress and adverse experiences. The American Academy of Pediatrics (AAP) recommends that pediatricians encourage shared reading beginning at birth and continuing at least through kindergarten as a strategy for supporting parents/caregivers, enhancing foundational relationships, promoting positive language-rich interactions, and helping families create a nurturing and stimulating home environment. The integration of literacy promotion into pediatric resident education is crucial to achieve that goal and thus is also essential. The AAP supports advocacy toward establishing public and private funding for diverse high-quality, developmentally appropriate children's books in the languages preferred by the family to be provided at pediatric health supervision visits to all children, but especially to children living in underresourced communities. This statement is supported by multiple AAP policies and implementation resources, including the accompanying "Literacy Promotion: An Essential Component of Primary Care Pediatric Practice: Technical Report."

Venous Thromboembolism Incidence, Risk Factors, and Prophylaxis in Burn Patients: a National Trauma Database Study.

Comprehensive studies on the incidence, risk factors, and prophylactic measures related to venous thromboembolism (VTE) are lacking in burn care. This study characterizes VTE risk and existing prevention measures to improve and inform overall patient care in the field of burn care on a national scale. The US National Trauma Data Bank (NTDB) was queried from 2007 to 2021 to identify burn-injured patients. Descriptive statistics and multivariate regression analyses were used to explore the association between demographic/clinical characteristics and VTE risk as well as compare various VTE chemoprophylaxis types. There were 326,614 burn-injured patients included for analysis; 5,642 (1.7%) experienced a VTE event during their hospitalization. Patients with VTE were significantly older, had greater BMIs and %TBSA, and were more likely to be male (p<0.001). History of smoking, hypertension or myocardial infarction, and/or substance use disorder were significant predictors of VTE (p<0.001). Patients who received low molecular weight heparin (LMWH) were less likely to have VTE compared to patients treated with heparin when controlling for other VTE risk factors (OR: .564 95% CI .523-.607, p<0.001). Longer time to VTE chemoprophylaxis (>6 hours) initiation was significantly associated with VTE (OR=1.04 95% CI 1.03=1.07, p<0.001). This study sheds light on risk factors and chemoprophylaxis in VTE to help guide clinical practice when implementing prevention strategies in burn patients. This knowledge can be leveraged to refine risk stratification models, inform evidence-based prevention strategies, and ultimately enhance the quality of care for burn patients at risk of VTE.

Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): Study Protocol for a National Implementation Trial.

Globally, women 15-24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men's sexually violent behavior (Odds Ratio [OR] = 0.71, 95%CI 0.50-1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00-2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed. We will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater 1) pre- and post-implementation engagement with university leaders and faculty, and 2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time-series design includes 1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; 2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes, 3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities), and 4) time diaries and cost tracking to assess cost effectiveness of the two implementation-strategies bundles. This project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual-violence-prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale. NCT06443541. Retrospectively registered with clinicaltrials.gov.

Cervical Cancer Screening Barriers and Facilitators for Sexual and Gender Minority People: A Community-Engaged Feasibility Approach

The purposes of this study were to identify barriers and facilitators to cervical cancer screening (CCS) among sexual and gender minority (SGM) people and to determine strategies to facilitate increased CCS among these populations. Between August 2021 and December 2022, 33 semistructured, in-depth qualitative interviews were conducted with SGM adults in Kentucky. Interview transcripts were analyzed using inductive content analysis to identify patterns and themes. Barriers to CCS included negative experiences with CCS, negative associations with CCS, and healthcare providers’ lack of SGM population awareness. Facilitators of CCS included positive CCS experiences related to healthcare providers and positive CCS experiences related to healthcare settings. Recommended strategies to increase CCS were SGM population-targeted CCS encouragement and cervical cancer self-screening. Healthcare provider and healthcare system barriers and facilitators have a disproportionate influence on SGM individuals’ CCS behaviors. CCS must be normalized in the SGM community and presented and promoted specifically to SGM populations. Human papillomavirus self-sampling acceptability for SGM populations should be explored. There is a critical need for piloting culturally tailored, innovative interventions supported by healthcare providers, healthcare systems, and SGM community partners, underpinned with acceptable, accessible, and evidence-based cervical cancer prevention strategies for SGM populations.

Prevalence of Peptic Ulcer Disease and its Associated Factors in Jeddah Saudi Arabia

Introduction: Peptic ulcer disease's (PUD) global significance, emphasizing its health burdens and associations with factors like Helicobacter pylori infection and lifestyle habits. The need for comprehensive approaches to prevention and management. Despite global research, there's a gap in understanding PUD in Jeddah, Saudi Arabia, necessitating this study to inform healthcare policies and interventions in the region. The study aims to investigate PUD prevalence, associated factors, healthcare-seeking behavior, and knowledge levels in Jeddah's population to provide insights for public health strategies and clinical practices. MethodologyThis cross-sectional study investigated the prevalence of peptic ulcer disease (PUD) and its associated factors in Jeddah, Saudi Arabia, using a validated questionnaire covered demographic details, knowledge, psychosocial aspects, symptoms, healthcare-seeking behavior, and medical history. It was translated into Arabic, culturally adapted, and validated through expert review and pilot testing. A sample size of 561 participants was determined using an online sample calculator, targeting a 95% confidence level. Ethical approval was obtained from the Institutional Research Review Board (IRRB-02-03092023). Data was collected through an online survey using convenience sampling and analyzed with SPSS and Excel, employing both descriptive and inferential statistical methods. ResultThe survey in Jeddah, Saudi Arabia, examined peptic ulcer disease (PUD) prevalence and associated factors. Demographic analysis showed 561 participants, almost evenly split by gender (269 males, 292 females), with varying ages and educational backgrounds. Symptoms like abdominal pain were prevalent (398 respondents), as were lifestyle factors such as spicy food consumption (456 respondents) and stress (496 respondents). The study revealed a high PUD prevalence, with 463 respondents (82.53%) reporting a history of the disease, primarily gastric ulcers (256 cases, 45.63%) and duodenal ulcers (207 cases, 36.89%). Treatment mainly involved outpatient antibiotic use (419 respondents, 74.68%), while 44 respondents (7.84%) required hospitalization. Reported well-being levels ranged from 1 to 10, with various satisfaction levels among respondents. ConclusionsThe study highlighted a substantial prevalence of PUD, primarily gastric ulcers, among participants. The findings advocate for tailored interventions, including education, screening, and treatment optimization, to alleviate the PUD burden and enhance healthcare outcomes. The study offers crucial insights into PUD epidemiology, guiding evidence-based prevention and management strategies.

Prevention and Management of Infectious Complications in Retrograde Intrarenal Surgery: A Comprehensive Review.

Retrograde intrarenal surgery (RIRS) is a minimally invasive procedure increasingly used to treat renal stones and other intrarenal pathologies due to its reduced risk of complications, shorter recovery time, and lower postoperative pain compared to more invasive surgical techniques. However, despite its advantages, RIRS is associated with a significant risk of infectious complications, ranging from simple urinary tract infections (UTIs) to severe systemic infections such as urosepsis, which can lead to increased morbidity, prolonged hospitalization, and, in severe cases, mortality. This review aims to summarize the current knowledge on preventing and managing infectious complications associated with RIRS. By exploring the pathophysiology of these infections, identifying patient and procedural risk factors, and evaluating evidence-based strategies for prevention and management, this review provides comprehensive insights into minimizing infection risks in RIRS. A thorough literature review was conducted, examining studies and clinical trials that address the incidence, risk factors, prevention strategies, and management protocols for infections in RIRS. This review also assesses current guidelines from professional organizations and recent infection control technologies and practices advancements. The review identifies multiple risk factors contributing to infections in RIRS, including patient-specific factors such as comorbidities and procedural factors like the duration of surgery and use of instrumentation. Effective prevention strategies include preoperative antibiotic prophylaxis, stringent aseptic techniques during surgery, and careful postoperative monitoring. The review also highlights the importance of a multidisciplinary approach involving urologists, infectious disease specialists, and microbiologists in managing complex cases of infection. Infectious complications remain a significant concern in RIRS, necessitating a comprehensive approach to prevention and management. By adhering to evidence-based guidelines and utilizing a multidisciplinary strategy, healthcare professionals can significantly reduce the incidence of infections, thereby improving patient outcomes and the overall safety of RIRS. Future research should focus on advancing infection control technologies and developing novel prophylactic and therapeutic approaches to further enhance the safety and effectiveness of RIRS.

Strategies for Implementing GlobalConsent to Prevent Sexual Violence in University Men (SCALE): study protocol for a national implementation trial

BackgroundGlobally, women 15–24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men’s sexually violent behavior (odds ratio [OR] = 0.71, 95%CI 0.50–1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00–2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed.MethodsWe will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater (1) pre- and post-implementation engagement with university leaders and faculty and (2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time series design includes (1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; (2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes; (3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities); and (4) time diaries and cost tracking to assess cost-effectiveness of the two implementation-strategies bundles.DiscussionThis project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual violence prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale.Trial registrationNCT06443541. Retrospectively registered with ClinicalTrials.gov. Registered on June 05, 2024.

Secular Trends in Preterm Birth Rates: Uncovering the Primary Challenge for Perinatal Medicine in Greece.

Preterm labour is a serious pregnancy complication that is the primary cause of infant mortality, with detrimental impacts on the offspring and the mother in the short as well as the long term. This study aims to comprehensively present the time trends of national preterm birth rates (PBRs) in Greece. Official national data regarding live births in Greece were acquired from the Hellenic Statistical Authority, and the annual total PBRand rates for gestational age groups were computed per 100 total live births spanning from 1980 to 2022. Time trends were analyzed through joinpoint regression analysis, and annual percent changes (APC) and average annual percent change (AAPC) were calculated with a 95% confidence interval (95% CI). Following a steady decline from 4.66% in 1980 to a historic low of 2.77% in 1991 with an APC of -5.1 (-6.2 to -4.2), the PBR exhibited a dramatic increase during 1991-2011 with an APC of 7.3 (6.9 to 7.8). Subsequently, between 2011 and 2022, the rise in PBR was attenuated, showing a slight statistically non-significant upward trend (APC = 0.5, 95% CI: -0.6 to 1.5). This led to a historical high of 12.07% in 2018, 4.4 times higher than that in 1991, and eventually, the PBR reached 11.90% in 2022. From 1991 to 2022, there were sharper increases in the rates of moderate (32-33 weeks) and late (34-36 weeks) preterm births, with AAPCs of 4.9 (3.5-6.4) and 5.8 (5.3-6.3), respectively. In contrast, the rates of extremely (<28 weeks) and very (28-31 weeks) preterm births saw slower growth, with AAPCs of 2.2 (1.7-2.7) and 0.7 (0.5-1.0), respectively. The PBR in Greece more than quadrupled during 1991-2022, mainly due to increases in moderate and late preterm births. Although its rise has markedly decelerated since 2011, amidst the country's economic recession, the PBR is alarmingly higher than those in all other European and developed nations. More than one in nine neonates is born prematurely in the Greek population, posing challenges in implementing evidence-based prevention strategies and perinatal care.

Trends in the prevalence of HIV, HCV, and co-infection and associated factors among young people who inject drugs (PWID) in Catalonia (2008–2019)

ABSTRACT People who inject drugs (PWID) face a significantly increased risk of blood-borne virus (BBV) infections, including HIV and hepatitis C virus (HCV), as well as co-infections. To better understand this issue, bio-behavioral surveillance studies were conducted among PWID attending harm reduction facilities in Catalonia, forming part of the comprehensive Integrated HIV/STI Surveillance System since 2008. The goal of this study was to describe the prevalence of HIV, HCV, and HIV-HCV coinfection and associated socio-demographic and behavioural factors among young PWID in Catalonia by gender and to examine trends over time, from 2008 to 2019. We first estimated the prevalence of HIV, HCV, and their co-infection and sample characteristics, and then, we calculated prevalence ratios (PR) and adjusted prevalence ratios (aPR) to identify the variables associated with HIV infection, HCV infection, and HIV-HCV co-infection. We found that the overall prevalence of HIV, HCV and HIV-HCV co-infection in 2019 was 20.1%, 66.2%, and 16.8%, respectively. In multivariable analysis, we found that being female (aPR: 1.55, 95% CI: 1.05–2.30), age (aPR: 1.09, 95% CI: 1.04–1.14), having born outside of Spain (aPR: 1.67, 95% CI: 1.19–2.34), homelessness (aPR: 1.90, 95% CI: 1.34–2.68), daily injection (aPR: 1.46, 95% CI: 1.04–2.04), sharing needles (aPR: 1.93, 95% CI: 1.32–2.82), involvement in sex work (aPR: 1.82, 95% CI: 1.09–3.03), and imprisonment (aPR: 2.54, 95% CI: 1.75–3.67) was associated with increased prevalence of HIV and HCV co-infection, while being a new injector (aPR: 0.64, 95% CI: 0.43–0.93) was associated with decreased prevalence. Overall, this research provides valuable insights into the risks and determinants of HIV and HCV co-infection among young PWID. The study’s findings contribute to the existing body of knowledge on blood-borne virus transmission in this population, informing evidence-based strategies for prevention and harm reduction.

Communicating the science of suicide prevention: A call to action for psychologists.

Suicide is a major public health concern within the United States, and prevention efforts are essential for decreasing the suicide rate. Researchers and clinicians have knowledge and effective treatments for preventing suicide; however, their impact is limited to those with access to services. Science Communication (SciComm) is an effective tool that can be integrated into the field of suicide prevention and can bridge the gap between scientific findings and the general population. SciComm can help disseminate evidence-based strategies for suicide prevention, dispel misinformation on suicide, and normalize help-seeking. In this article, we propose specific, tangible ways that SciComm can be integrated into graduate school programs, mentorship, career advancement requirements and can help enact systemic change within the field of suicide prevention. Additionally, we discuss why it is important that the field of suicide prevention, specifically, adopts a SciComm framework. Embracing SciComm can help the field of suicide prevention to have a broader impact and can help to reduce rates of suicide.

Veteran suicide prevention learning collaborative: implementation strategy and processes.

The majority of Veterans who died by suicide in 2021 had not recently used Veterans Health Administration (VA) services. A public health approach to Veteran suicide prevention has been prioritized as part of the VA National Strategy for Preventing Veteran Suicide. Aligned with this approach, VA's Patient Safety Center of Inquiry-Suicide Prevention Collaborative piloted a Veteran suicide prevention learning collaborative with both clinical and non-clinical community agencies that serve Veterans. The VA COmmunity LeArning CollaboraTive (CO-ACT) uses a quality improvement framework and facilitative process to support community organizational implementation of evidence-based and best practice suicide prevention strategies to achieve this goal. This paper details the structure of CO-ACT and processes by which it is implemented. This includes the CO-ACT toolkit, an organizational self-assessment, a summary of recommendations, creation of a blueprint for change, selection of suicide prevention program components, and an action plan to guide organizations in implementing suicideprevention practices. CO-ACT pilot outcomes are reported in a previous publication.

Patient First Strategies for Reducing Inequities in HAI Prevention

Background: Inequities in healthcare-associated infections (HAI) incidence and prevention measures are critically important to understand (Chen,2021). While evaluations are beginning to characterize these disparities by infection type (Gettler, 2023), our work expands this by characterizing disparities by prevention strategies. By better understanding how evidence-based prevention strategies are implemented at the patient level, infection preventionists and hospital epidemiologists can better design strategies that provide equitable care to all patients. Methods: Beginning January 2023, gender, race, ethnicity, spoken language, and age group fields were added to daily chlorhexidine gluconate (CHG) treatment and C. difficile test order compliance data captured via electronic medical record. In July 2023, fields on recorded race, ethnicity, and gender were added to well-established foley and vascular access real-time peer audit tools that are used by infection preventionists (IPs). Each prevention strategy variable was summarized by demographic variables and differences in compliance were measured using chi-square tests. Results: 899 vascular audits and 420 foley audits were completed by IPs between July – December 2023. In 2023, there were 114,066 opportunities for CHG Treatment and 1,991 C. difficile test orders. Missing data varied by metric but ranged from 0-60%. Statistically significant differences by race were found in 3 of 8 components (i.e., intact seal, secured catheter and absence of dependent loop) in the foley audit (p &lt; 0 .01) and compliance with C. difficile test ordering (p &lt; 0 .01). No differences in race were found in vascular access audits or CHG treatment. No differences in gender or ethnicity were noted in foley, vascular access audits, CHG treatment compliance, or C. difficile testing. Differences in gender and age were found in CHG treatment compliance (p &lt; 0 .001). Conclusions: By focusing more on patient level process measures rather than only presenting stratified outcomes data, we can identify targeted opportunities for improvement in health equity before our patients develop an HAI. Further evaluations should also focus on assessing the clinical relevance of statistical findings to better inform intervention strategies. Separately, efforts are needed to improve completeness and integrity of demographic data in the electronic medical record.

Progress of researches on mechanisms of acupuncture for secondary prevention of ischemic stroke.

Ischemic stroke (IS) is one of the main causes inducing death and disability in adults. Because of the high recurrence rate of IS, prevention of recurrence is of great significance to this population, for which the evidence-based and effective secondary prevention strategy is an important means, and acupuncture intervention has a positive effect on its risk factors. In the present article, we reviewed the progress of researches on the mechanisms of acupuncture underlying prevention of IS relapse from the perspective of its main risk factors, namely 1) hypertension (preventing and controlling the adverse effects caused by the imbalance of blood pressure level, vascular and other tissue structures, endocrine factors and central nervous system activities in patients with hypertension after IS), 2) hypercholesterolemia (lowering serum total cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C) and raising high-density lipoprotein cholesterol), 3) diabetes (regulating the secretion function of adipose tissue, activating the insulin signal transduction pathway, protecting the function of pancreatic β cells, and regulating the central nervous system functions to participate in the secondary prevention of IS), 4) smoking (relieving the symptoms of smoking cessation and reducing the smoker's dependence on smoking by changing the internal environment, lowering the level of blood endorphin and regulating the excitability of central nervous system), 5) sleep apnea syndrome (regulating local muscle function and the excitability of the nervous system, but also affecting some organic changes as reducing tonsil swelling) and 6) obesity (lowering blood glucose and lipid, increasing the ratio of brown/white fat, reducing leptin resistance, and suppressing appetite to induce body weight loss, or directly regulate the changes of fat tissue, etc). Results shows that the acupuncture's regulatory mechanism for IS risk factors is closely related to the neuroendocrine system, and simultaneously involves multiple targets of multiple risk factors. Due to its good efficacy and safety, acupuncture therapy is of great value for clinical promotion as an important intervention for secondary prevention.