High Acceptance Research Articles

Networks of care for the modern adolescent.

At a time of increased demand for specialist mental health services, a more nuanced understanding of how adolescents navigate systems of care and support is essential. We mapped 'networks of care' to explore patterns of mental health help-seeking alongside the perceived helpfulness of support accessed. We examined data from 23 927 adolescents aged 11-18 years who participated in the 2023 OxWell Student Survey, an English school-based, repeated cross-sectional survey of mental health and wellbeing. Students self-reported past-year access to 18 types of support across informal (e.g. friends and family), semi-formal (e.g. school and charities), and formal (e.g. health and social care) domains, alongside how helpful they found the support. We used a network approach to explore interconnections between sources of support accessed and perceived helpfulness. One in four (27.0%, 6449/23927) adolescents reported past-year access to mental health support, of which 56.7% (3658/6449) reported accessing multiple types. Informal networks were the most commonly accessed (23.1%, 5523/23927), followed by semi-formal (9.7%, 2317/23927) and formal (6.8%, 1623/23927) supports. Informal sources had high acceptability, with around 80-90% reporting them as helpful, whereas child and adolescent mental health services (CAMHS), helplines, and online supports were perceived to be the least helpful. The networks also identified groups who might not be optimally served by current systems, including gender diverse adolescents and adolescents who found mental health support from their parents unhelpful. Adolescents are accessing mental health support across informal, semi-formal, and formal sources of care. Services can no longer be developed, delivered, or evaluated in isolation from these networks.

Coping and Emotional Development for Adolescents to Reduce Stress (CEDARS): pilot test of a school-based positive psychological intervention for adolescents

IntroductionThis study tested the feasibility and preliminary efficacy of Coping and Emotional Development for Adolescents to Reduce Stress (CEDARS) a positive psychological intervention (PPI), tailored for adolescents and administered in a classroom setting, in boosting CEDARS skill use and emotional well-being.MethodAdolescents (N = 102, 45% female) aged 13–15, in four physical education classes at the same school were randomly assigned by classroom to either receive the CEDARS intervention (n = 59) or engage in the usual class activities (n = 44). Participants completed self-report measures at three time points assessing use of intervention skills, positive and negative affect, depressive symptoms, and perceived stress.Results and conclusionGroups differed significantly on race with 57% of the intervention group compared to 75% of the control group identifying as Asian or Pacific Islander. Race-adjusted analyses revealed that both groups improved on intervention skill use, negative affect, depressive symptoms, and perceived stress. The group by time interaction was significant such that the CEDARS group increased skill use from pre- to post- intervention and this difference persisted at follow-up. Contrary to hypotheses, there were also significant group by time interactions indicating that the control group had a steeper decline in depression and perceived stress from pre- to post-intervention. Students reported high acceptability and feasibility and suggested key changes to increase engagement. The current study expands on the existing PPI literature focused on adolescents and highlights the need for larger and more diverse samples, as well as developmentally- and culturally-tailored interventions.

The acceptability of intimate partner violence screening and response among refugee women accessing Australian resettlement services.

Screening and response for intimate partner violence (IPV) is recommended for women in priority populations and is implemented in health services across diverse jurisdictions. Most women experiencing IPV strongly support screening, however this is untested with refugee women in resettlement contexts. Around one third of refugee women in Australia experience IPV and face multiple post-migration challenges. SAHAR (Safety and Health after Arrival) tested IPV screening using the ACTS tool, brief intervention, and referral with women accessing four settlement support services. Women attending sites during the study period were invited to participate in a three month follow up survey with participation by 321/375 women recruited (86%). Acceptability of IPV screening was assessed against (i) levels of comfort with the IPV screening questions and (ii) strength of agreement/disagreement with settlement services asking women about being frightened, controlled or hurt by their partners. Of participants who recalled the screening, 93% reported being very or moderately comfortable with being asked the questions (89% who had experienced IPV; 94% of those with no IPV identified). For all participants, 84% strongly or somewhat agreed with services asking the questions, with no significant difference in agreement between disclosing and non-disclosing groups. Those with no recall of the questions had lower overall agreement and higher disagreement than those who recalled the questions (88% and 10%). Acceptability was not associated with age, country of origin, household composition, time since arrival or number of prior service visits. Participants identified 'care shown by the worker', 'talking to someone in my own language', 'trust in the privacy of the service', and 'talking to a female worker' as the factors most important for encouraging discussion of IPV. High acceptance of IPV screening by refugee women supports consideration of implementation across settlement services, a key access point for refugee women with diverse needs.

Quality Evaluation and Shipping Export Potential of ‘Eliteggul’ Korean Melon (Cucumis melo var. makuwa) to Singapore Using MAP Technology

Korean melons (Cucumis melo var. makuwa), which have a short shelf life and are prone to browning, face challenges when exported over long-distance via maritime shipping. However, the high firmness and low suture browning rate of the ‘Eliteggul’ cultivar suggest its potential suitability for long-distance export. This study aimed to evaluate the export suitability of ‘Eliteggul’ by comparing it to the widely grown cultivar ‘Alchankkul’. Consumer preferences were assessed based on fragrance, sweetness, overall preference, appearance, and firmness. Both cultivars were grown and harvested in a commercial greenhouse in Seongju-gun, South Korea. After being treated with modified atmosphere film, the fruits were stored at 6 °C for 1 day, transported to Singapore in a shipping container at 7.4 °C for 13 days, and distributed at 22 °C for 3 days. After 14 days of storage, analysis in Singapore showed that ‘Eliteggul’ maintained a significantly higher firmness at 12.9 ± 0.3 kg·cm2 compared to ‘Alchankkul’, which showed firmness at 8.1 ± 0.4 kg·cm2. Additionally, ‘Eliteggul’ exhibited less browning on the white sutures at 1.3 ± 0.1, indicating better preservation of its quality than ‘Alchankkul’, at 2.0 ± 0.3. Even at 14 + 3 days, ‘Eliteggul’ maintained a firmness of 12.8 ± 0.2 kg·cm2, which was significantly higher than that of ‘Alchankkul’, which showed a firmness of 7.7 ± 0.5 kg·cm2. Consumer preference surveys (n = 78) conducted in the local market revealed that customers favored the fragrance and sweetness of ‘Alchankkul’. Correspondingly, an analysis of volatile organic compounds (VOCs) from melon juice using a Twister stir bar method showed that ‘Alchankkul’ had significantly higher levels of ethyl(methylthio)acetate, ethyl propanoate, and benzyl alcohol, known to contribute to a sweet flavor. Furthermore, a thermal desorption tube VOCs test indicated that hexyl acetate and 2-methylbutyl 2-methylbutyrate were also significantly higher in ‘Alchankkul’. Despite this result, there was no significant difference in the overall preference scores between the two cultivars. This study indicates that ‘Eliteggul’, with a superior firmness, reduced browning, and high consumer acceptance, is ideal for long-distance export, offering foundational data to bridge the research gap in export-oriented melons and support the broader distribution of Korean cultivars.

Evaluating Human-Robot Interactions to Support Healthy Aging-in-Place.

Declines in older adults' cognitive and physical health pose challenges to maintaining their independence. Robots can improve independent living and facilitate aging-in-place. Despite recent innovations in healthcare robotics, the use of robots has not advanced significantly among older adults. This review seeks to understand human-robot interactions in older adults, focusing on their experiences and perceptions of robots for independent living. We identified 17 studies that utilized qualitative methods to investigate older adults and/or their caregivers' experiences and perceptions of robots designed to help older adults improve independent living. Drawing on content analysis, we identified eight themes: usefulness, ease of use, safety, reliability, self-efficacy, satisfaction, emotional connection with the robot and reciprocity, and intention to use. The findings provide insights to improve existing robots and guide future research about designing robots with higher acceptance. This review may have implications for policymakers, practitioners, and researchers working with robotics to support healthy aging-in-place.

Cookies with Functional Ingredients: Effect of Adding Powdered Passion Fruit Albedo on the Physical-chemical Characteristics and Sensory Attributes of Cookies Sweetened with Xylitol

Introduction: This paper studied nutritionally enhanced cookies, especially those containing dietary fiber and other health-promoting active substances. The addition of Xylitol, which is used as a sweetener and preservative as an ingredient during cookie production to extend the shelf life of cookies, also plays an important role in ensuring food and nutritional safety. Aims: The aim of this study was to elaborate and evaluate the physical-chemical and sensorial characteristics of cookies enriched with powdered passion fruit albedo (Passiflora edulis f. flavicarpa) and sweetened with xylitol. Study Design: This research involved the development of cookie formulations with varying concentrations of powdered passion fruit albedo and subsequent evaluation of their proximate composition, texture, water activity, soluble solids, pH, pectin content, and sensory attributes. Place and Duration of Study: The study was conducted in Brazil over a period of several months, encompassing both the experimental development of the cookie formulations and the laboratory analyses. Methodology: The cookie samples were prepared with a control formulation and variations containing 3%, 6%, 9%, and 12% powdered passion fruit albedo, all sweetened with 10% xylitol. The cookies were assessed for proximate composition (moisture, lipids, proteins, fiber, ash, and carbohydrates), texture, water activity, soluble solids, pH, pectin content, and sensory characteristics. Results: The incorporation of powdered passion fruit albedo significantly influenced the characteristics of the cookies. Higher concentrations (6% to 12%) adversely affected texture and acceptability. The optimal concentration was found to be 3%, which resulted in cookies with increased moisture, protein, fiber, pectin, and ash content, reduced lipids, carbohydrates, and calories, improved texture, and higher acceptability (71.43%). Conclusion: Cookies sweetened with xylitol and enriched with 3% powdered passion fruit albedo presented the best balance of physical-chemical and sensory properties, making them a viable option for producing functional foods with improved nutritional benefits.

Integration of AI-Assisted in Digital Cervical Cytology Training: A Comparative Study.

This study aimed to investigate the supporting role of artificial intelligence (AI) in digital cervical cytology training. A total of 104 trainees completed both manual reading and AI-assisted reading tests following the AI-assisted digital training regimen. The interpretation scores and the testing time in different groups were compared. Also, the consistency, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of diagnoses were further analysed through the confusion matrix and inconsistency evaluation. The mean interpretation scores were significantly higher in the AI-assisted group compared with the manual reading group (81.97 ± 16.670 vs. 67.98 ± 21.469, p < 0.001), accompanied by a reduction in mean interpretation time (32.13 ± 11.740 min vs. 11.36 ± 4.782 min, p < 0.001). The proportion of trainees' results with complete consistence (Category O) were improved from 0.645 to 0.803 and the averaged pairwise κ scores were improved from 0.535 (moderate) to 0.731 (good) with AI assistance. The number of correct answers, accuracies, sensitivities, specificities, PPV, NPV and κ scores of most class-specific diagnoses (NILM, Fungi, HSV, LSIL, HSIL, AIS, AC) also improved with AI assistance. Moreover, 97.8% (89/91) of trainees reported substantial improvement in cervical cytology interpretation ability, and all participants (100%, 91/91) expressed a strong willingness to integrate AI-assisted diagnosis into their future practice. The utilisation of an AI-assisted digital cervical cytology training platform positively impacted trainee performance and received high satisfaction and acceptance among clinicians, suggesting its potential as a valuable adjunct to medical education.

RADHawk-an AI-based knowledge recommender to support precision education, improve reporting productivity, and reduce cognitive load.

Using artificial intelligence (AI) to augment knowledge is key to establishing precision education in modern radiology training. Our department has developed a novel AI-derived knowledge recommender, the first reported precision education program in radiology, RADHawk (RH), that augments the training of radiology residents and fellows by pushing personalized and relevant educational content in real-time and in context with the case being interpreted. To assess the impact on trainees of an AI-based knowledge recommender compared to traditional knowledge sourcing for radiology reporting through reporting time, quality, cognitive load, and learning experiences. A mixed methods prospective study allocated trainees to intervention and control groups, working with and without access to RH, respectively. Validated questionnaires and observed and graded simulated picture archiving and communication system (PACS)-based reporting at the start and end of a month's rotation assessed technology acceptance, case report quality, case report time and sourcing time, cognitive load, and attitudes toward modified learning strategies. Non-parametric regression analyses and Mann-Whitney tests were used to compare outcomes between groups, with significance set at P<0.05. The intervention group (n=28) demonstrated astatistically significant reduction in the case report time by -162s per case (95%CI -275.76s to -52.40s) (P-value = 0.002) and an increase of 14% (95%CI 8.1-19.8%) (P-value <0.001) in accuracy scores compared to the control group (n=29) at the end of the rotation. The intervention group also showed lower levels of mental demand (P=0.030) and experienced less effort (P=0.030) and frustration (P=0.030) while reporting. Additionally, >78% of the intervention group gave positive ratings on RH's effectiveness, increase in productivity, job usefulness, and ease of use. Eighty-nine percent of participants in the intervention group requested access to RH for their next rotation. This study demonstrates that RH, as the first reported AI-derived knowledge recommender for radiology education, significantly reduces reporting time and improves reporting accuracy while reducing overall workload and mental demand for radiology trainees. The high acceptance among trainees suggests its potential for supporting self-directed learning. Further testing of a larger external cohort will support more widespread implementation of RH for precision education.

Production of Functional White Bread Enriched with Various Dietary Fibers with High Consumer Acceptance.

Fiber-enriched breads are inferior to wheat flour (white) breads in terms of volume, taste, and textural characteristics. The aim of this study was to produce functional dietary fiber (DF)-enriched white bread (WB) with high consumer acceptance. Wheat fiber (WF) was added to wheat flour as an insoluble fiber source (5%); polydextrose and inulin were used as soluble fibers at three different concentrations (2, 4, and 6%) individually or in combination. Their effects on dough rheology (farinograph and extensograph properties) and bread properties (volume, baking loss, moisture, texture, color, sensory, and crumb-grain characteristics) were investigated. The addition of WF, polydextrose and inulin had significant effects on dough rheology and bread properties. Hardness, chewiness, cell density, and DF content of breads were generally increased, whereas volume yield, baking loss, moisture and porosity values decreased with increasing DF concentration. The bread with the highest DF content (PD6IN6) contained 7.1 times more DF than WB. According to the results of sensory analysis, except for the sample with 6% concentration of polydextrose and inulin, all the other breads had very high overall acceptance values. Although the breads produced in the study have a high fiber content, their important quality characteristics (moisture content, volume yield, cell density, color values and sensory properties) are similar to those of WB. As a result, the overall quality characteristics of bread made with different dietary fibers were maintained, and functional WB enriched with DF were produced with high consumer acceptance.

Personalized Smartphone-Enabled Assessment of Blood Pressure and Its Treatment During the SARS-CoV-2 COVID-19 Pandemic in Patients From the CURE-19 Study: Longitudinal Observational Study.

The use of digital interventions by patients for remote monitoring and management of health and disease is increasing. This observational study examined the feasibility, use, and safety of a digital smartphone app for routine monitoring of blood pressure (BP), medication, and symptoms of COVID-19 during the COVID-19 pandemic. The objective of this study was to deploy and test electronic data recording using a smartphone app developed for routine monitoring of BP in patients with primary hypertension. We tested the app for ease of data entry in BP management and tracking symptoms of new-onset COVID-19 to determine if participants found this app approach useful and sustainable. This remote, decentralized, 12-week, prospective, observational study was conducted in a community setting within the United States. Participants were approached and recruited from affiliated sites where they were enrolled in an ongoing remote decentralized study (CURE-19) of participants experiencing the COVID-19 pandemic. Potential participants were asked to complete a digital screener to determine eligibility and given informed consent forms to read and consent to using the Curebase digital platform. Following enrollment, participants downloaded the digital app to their smartphones for all data collection. Participants recorded daily BP, associated medication use, and emergent symptoms associated with SARS-CoV-2 infection. In addition, usability (adherence, acceptability, and user experience) was assessed using standard survey questions. Adverse events were collected based on participant self-report. Compliance and engagement were determined from user data entry rates. Feasibility and participant feedback were assessed upon study completion using the User Experience Questionnaire. Of the 389 participants who enrolled in and completed the study, 380 (98%) participants downloaded and entered BP routines in week 1. App engagement remained high; 239 (62.9%) of the 380 participants remained in the study for the full 12-week observation period, and 201 (84.1%) of the 239 participants entered full BP routines into the digital app 80% or more of the time. The smartphone app scored an overall positive evaluation as assessed by the User Experience Questionnaire and was benchmarked as "excellent" for domains of perspicuity, efficiency, and dependability and "above average" for domains of attractiveness and stimulation. Highly adherent participants with hypertension demonstrated well-controlled BP, with no significant changes in average systolic or diastolic BP between week 1 and week 12 (all P>.05). Participants were able to record BP medications and symptoms of SARS-CoV-2 infection. No adverse events attributable to the use of the smartphone app were reported during the observational period. The high retention, engagement and acceptability and positive feedback in this study demonstrates that routine monitoring of BP and medications using a smartphone app is feasible for patients with hypertension in a community setting. Remote monitoring of BP and data collection could be coupled with hypertensive medication in a combination product (drug+digital) for precision management of hypertension.

Preferences and Acceptability of Testing for Sexually Transmitted Infections in an HIV Pre-Exposure Prophylaxis clinic in Hanoi, Vietnam.

Men who have sex with men (MSM) using HIV Pre-Exposure Prophylaxis (PrEP) are a vulnerable population with a high prevalence of sexually transmitted infections (STIs). Self-collection of specimens could improve STI testing, yet implementation in low-resource settings is limited. The study aimed to assess the feasibility and acceptability of self-collection for STI testing and to understand STI testing preferences among PrEP clients in Hanoi, Vietnam. From January to December 2022 MSM aged 16 and older, participating in a clinic-based HIV PrEP program were enrolled. Participants self-collected pharyngeal, anal, and urine samples for Chlamydia trachomatis and Neisseria gonorrhoeae testing. Testing preferences were assessed through conjoint analysis using eight hypothetical testing profiles across five testing attributes; each profile was rated on a Likert scale (0-5) to create an impact score. Differences between attributes were assessed using a two-sided, one-sample t-test of the impact score. There were 529 participants enrolled; all were male. Specimens from three sites were provided by 97.9% (518/529). Mean satisfaction with self-collection was 4.3 (SD: 1.0), 99.4% reported they would perform again. In conjoint analysis, cost (free vs. $17USD) had the highest impact on testing preference (Impact Score: 25.2; p = <0.001). A one-week time to test result notification was preferred to 90 minutes (Impact Score: -0.8; p = 0.03). We found high acceptability of self-collection for STI testing among HIV PrEP clients in Vietnam. Cost was the most important factor affecting testing uptake. Expanding self-collection and lowering costs could improve STI testing in HIV PrEP programs.

An Image-Recognition Dietary Assessment App for Adolescents With Obesity: Pilot Randomized Controlled Trial.

Adolescence is a period of increased susceptibility to developing obesity-related health issues due to poor eating patterns and increased sedentary behaviors. Recommendations for pediatric obesity management include dietary assessments. However, adolescents often avoid food logging through traditional methods. The use of image-recognition dietary assessment apps in adolescents with obesity is not well studied. Eating for Wellness (E4W) is a mobile app that determines the nutritional content of meals from photos and incorporates nutritional goal setting. Nutritional data can be displayed for health care providers (HCPs) via the Clinician Portal, while the data are presented to the user in a manner that minimizes the focus on calorie counting. This study aims to evaluate the usability and feasibility of E4W, a mobile health app designed to improve dietary intake in adolescents with obesity attending an obesity clinic, using a phased approach. The overall study was conducted in 2 phases to refine and evaluate E4W. In Phase 1, usability was tested through 3 iterative cycles of patient interviews. A total of 14 patient participants, aged 12-18 years with a BMI≥97th percentile, were included. Participants performed standardized scenario-based tasks in E4W and provided feedback on the app. Two iterative cycles were conducted for HCPs (n=4). Refinements were made during each cycle based on issues encountered and feedback provided. In Phase 2, a pilot randomized controlled trial of 32 adolescents (16 adolescents enrolled in the experimental group for 1 month, and 16 controls enrolled for 1 month) was completed. Both groups met with their dietitian at baseline, midstudy, and 1 month following their baseline visit to discuss goals and eating patterns. The control group was instructed to take photos of all intake using their default phone camera, without access to E4W, while those in the experimental group received full access to E4W. The primary outcome was the feasibility of implementation. Secondary outcomes examined overall change in dietary intake and achievement of nutritional goals. Usability testing demonstrated that E4W and the Clinician Portal were easy to use, efficient, and well-liked by patients and HCPs. Feasibility testing revealed high patient acceptability scores. However, significant technical challenges were encountered. Although the use of E4W did not significantly impact patient engagement (control: mean 0.9, SD 0.7; experimental: mean 1.7, SD 1.9; P=.14), there were outliers in the experimental group with very high engagement and improved self-reported efficacy. Overall, there was no improvement in dietary intake, although assessment was hindered by poor adherence to traditional methods of food logging. E4W and the Clinician Portal were well-received by patients and HCPs. Further research is warranted and planned to determine if E4W can improve dietary intake and achievement of nutritional goals in adolescents with obesity. ClinicalTrials.gov NCT05548868; https://clinicaltrials.gov/study/NCT05548868.

Randomized controlled trial of a pilot PrEP linkage intervention for individuals leaving incarceration in a southern state: Design and baseline characteristics.

We report baseline characteristics of a pilot intervention, PrEP-Link, which uses a community health worker (CHW) model to provide navigation to PrEP, the daily HIV preventative medication, and other medical and social services upon release from incarceration. This pilot study uses a randomized controlled trial design. The control group receives enhanced standard of care, and the intervention receives enhanced standard of care plus personalized navigation services from the CHW for up to one year. PrEP-Link is modeled after the Transitions Clinic Program, where a CHW who has lived experience of incarceration builds close relationships with individuals and community partners. After COVID-19 restrictions prevented recruitment within local jails, recruitment for this study took place in local reentry centers which house individuals as they near completion of their jail or prison sentence. Data are collected at baseline, 6 months, and 12 months. Planning and reporting was guided by the CONSORT 2010 checklist. We enrolled 80 participants between September 2021 and April 2023. Thirty-nine participants were assigned to the control group and forty-one to the intervention group. Data collected at baseline included measures of PrEP usage, HIV risk, drug and alcohol use, healthcare usage, and history of incarceration. Analysis of baseline characteristics show comparability of both demographic and HIV-related risk factors between the two arms. At baseline, participants had high clinical indication for potential PrEP benefit, particularly with respect to self-reported intravenous drug use and condomless sex. Participants responded with high PrEP acceptability within both study arms. Participants reported low preventative healthcare utilization at baseline. Barriers to accessing PrEP among the study population are significant. Results of this pilot RTC will help inform CHW lead PrEP-linkage interventions for people leaving incarceration.

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

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

Young, deprived women are more at risk of testing positive for Chlamydia Trachomatis: results from a cross-sectional multicentre study in French Health Examination Centres.

ObjectivesChlamydia Trachomatis (CT) is the most sexually transmitted infection in France. This study aimed to assess the feasibility of systematic screening for CT among people attending a preventive health examination in Health Examination Centres (HECs) and to compare positive CT cases according to deprivation. DesignA cross-sectional multicentre study in thirteen HECs in France in January 2018. MethodsSelf-sampling CT screening was proposed among 18-25 years women and 18-30 years men, who were sexually active and without recent CT treatment. Related data and referred specimens were collected among attendees for the study, including deprivation and health status. CT positivity was estimated by genders. We explored association between CT infection and deprivation by univariate and multivariate modelling. ResultsThe CT screening was proposed to 1701 eligible young people. 90.1% [88.6-91.5] accepted and participated with 43.6% being women, 54.3% being deprived people. 75.4% [72.1-78.6] screened women performed self-taken vaginal swabs and others took urinary tests. Screening was conducted in 1486 people. Overall prevalence of CT infection was 4.7% [3.7%-5.9%], significantly higher for women than men (6.4% vs 3.4%, p=0.009). Among women, being deprived increased the likelihood of CT positivity (aOR 4.95; 95% CI 2.02 to 12.00) more than it did for men. ConclusionsIndividual deprivation was significantly associated with having a CT infection among women. The feasibility of CT screening in HECs was demonstrated, with a high acceptance, and led to the implementation of CT screening in all HECs. Promoting access to CT screening to deprived population might contribute to reduce social inequalities in health.

Advanced technology in fruit preservation: Effects of nanoscale charged water particles on storage quality and reactive oxygen species in blueberries

During the postharvest period, blueberries with a short shelf life due to microbial activity and an overload of reactive oxygen species (ROS) were still a major unresolved problem. In this study, the effect of nanoscale charged water particles (NCWP) treatment on the postharvest characteristics and ROS metabolism in blueberries (Vaccinium ashei Reade) were investigated. The results showed that NCWP treatment significantly inhibited microbial growth, maintained high firmness and commercial acceptability, and extended the storage period of blueberries. The nutrient of blueberries was retained and elevated after NCWP treatment, especially in the 6 d of NCWP-9 h treatment, the total phenol and anthocyanin content reached the peak at 565.1 mg/L and 5.26 mg/g, which contribute to the total antioxidant capacity of blueberries increased. SEM showed that NCWP-9 h treatment maintained the integrity of the cuticular wax of the blueberry peel, which indirectly decelerated the decline of blueberry firmness. The NCWP treatment significantly enhanced the antioxidant enzyme system of blueberry peel. On days 2, 4 and 6 after NCWP-9 h treatment, the CAT, SOD and APX activities were significantly different from the control group (P < 0. 05), with 585.09 ΔA/min/g, 79.34 U/g and 3.32 umol/min/g, respectively, which effectively scavenged the oxidative stress markers (H2O2, O2−) accumulated in the blueberry peels, and slowed down the aging and deteriorated of the blueberry process. This finding demonstrates that NCWP is an effective postharvest preservation method for blueberries and provides a viable strategy for quality maintenance in the postharvest fruit and vegetable sector.

A randomised controlled feasibility trial of Behavioural activation as a treatment for people with diabetes and depression: (DiaDeM feasibility trial).

There is a lack of evidence on effective treatments for depression in people with T2DM, particularly in Low and Middle-Income Countries (LMICs). This study aims to test the feasibility and acceptability of a culturally adapted Behavioural Activation (BA) intervention (DiaDeM) for people with depression and T2DM in two South Asian LMICs. A multicountry, individually randomised-controlled feasibility trial was conducted from March 2022 to November 2022. We recruited adults from diabetes healthcare facilities in Bangladesh and Pakistan with a diagnosis of depression and T2DM. Consenting individuals were randomised to either optimised usual care or the DiaDeM intervention, which comprised six BA sessions delivered by non-mental health facilitators over six to twelve weeks. Participants were followed up at three and six months post-randomisation. The feasibility and acceptability of recruitment and retention, intervention delivery, and data collection were assessed. A mixed-methods process evaluation was also performed to inform the main trial. The DiaDeM feasibility trial successfully recruited 128 participants, with 85 % retention at six months follow-up. The majority of participants engaged with the intervention, demonstrating good adherence to the Behavioural Activation (BA) sessions. Data completeness for key outcomes, including depression severity and HbA1c levels, was high across all time points (>90 %). The process evaluation showed high acceptability of the intervention, with participants reporting increased motivation and improved management of both T2DM and depression. Good recruitment and retention rates, completeness of data collection, and high acceptability of the intervention showed that it would be feasible to undertake a full-scale trial.

The Renewing Intimacy and SExuality Intervention for Female Cancer Survivors: A Feasibility Study.

This study examined the feasibility and acceptability of a three-session, psychological-based intervention to improve intimacy and sexuality outcomes among women with breast and gynaecologic cancer in Singapore. Patients from outpatient oncology clinics completed screeners for marital and sexual distress. Those who endorsed either marital or sexual distress were invited into the study, and were randomized to receive the intervention immediately or be waitlisted. Intervention feasibility (i.e., reach, adherence) and acceptability (i.e., satisfaction, cultural sensitivity, willingness to pay) and marital, sexual, and body image outcome changes were examined. 1101 patients completed the screener; 24% of patients with breast or gynaecologic cancer reported marital or sexual distress. Forty-six patients who were eligible participated in the study. The majority (88%) of participants who started the intervention completed all 3 sessions. All (100%) participants who completed the intervention reported satisfaction and the majority (97%) reported they would recommend the intervention to a friend. The majority of participants found the intervention to be culturally sensitive (93%) and reported being willing to pay either out of pocket or through their national medical MediSave account (76%). Outcome changes were in expected directions with small effect sizes (0.24-0.42). Several themes emerged from open-ended feedback on what participants found useful and how the intervention can be improved. Approximately one quarter of breast or gynaecologic cancer patient who are partnered in Singapore reported marital or sexual distress. Despite the low reach, we found good adherence and high acceptability of the psychological-based intervention. Our findings suggest there is room to improve awareness and delivery of sexuality-related care in an oncology setting. Number and date: NCT03420547, April 10, 2018.

Recent Advances in Orally Disintegrating Tablet: Properties, Formulation and Production

: Healthcare practitioners, patients, and consumers widely recognize the convenience as-sociated with administering oral tablets. The emergence of orally disintegrating tablets (ODTs) represents a significant advancement in solid dosage forms, facilitating more convenient oral de-livery while maintaining medication safety, effectiveness, and quality. The ODTs market is ex-pected to experience continuous growth in the coming years despite the internal challenges faced by commercial manufacturers. This paper initiates a comprehensive discussion of the properties of ODTs, including palatability and taste, drug content, disintegration, mechanical strength, mois-ture content, safety, and efficacy. The formulation factors that affect each of these qualities are also discussed. Additionally, this review delves into the processes of the production of ODTs, en-compassing the approaches and technologies from the mixing of active ingredients and recipients to the formation and packaging of ODTs. This review provides valuable insights into the ad-vancement in ODTs technology, aiming to equip researchers with the knowledge necessary to improve quality and optimize efficiency, ultimately receiving high acceptance from patients or consumers.

Perceptions of rural Australian adults with chronic kidney disease stages 3 and 4 about the role of dietary intervention in their health and access to dietetic care.

Dietary modification is an important component of chronic kidney disease (CKD) management. The aim of this study was to explore the perceptions of people with earlier-stage CKD living in rural Australia about the role of dietary intervention in their health and access to dietetic care. Semi-structured interviews were conducted with 14 people with stage 3-4 CKD living in a rural Australian health district. Interview questions were guided by the principles of the appreciative inquiry study methodology. The thematic analysis involved inductive coding of data, discussions of emerging themes between co-researchers as coding proceeded and thematic memoing to finalise the transformation of data into distinct themes. Three predominant themes were evident from the data. First, people with CKD expressed that 'Dietary change empowers' them in self-management. Second, 'Dietetics is valued' in achieving dietary change. Third, it was clear that nephrologists had a key role in determining service access through 'Awareness and advocacy' of renal dietetic services. People with CKD living in rural Australia desire early, specialised renal dietetic care. The unexpectedly high acceptability of less resource-intensive technology for dietetic intervention suggests that there is an opportunity for service reorientation. Access to dietetic care could be enhanced by building on the key role of nephrologists in dietetic referral, service awareness and perception of value.