Odds Of Participation Research Articles

Advancing mammography uptake among vulnerable groups: a systematic review of intervention strategies

Abstract With over 2 million cases diagnosed annually, breast cancer is a leading cause of cancer-related disability and mortality. Despite global efforts to implement mammography screening programs, uptake rates vary widely across settings due to socioeconomic factors and accessibility challenges. To improve participation, targeted interventions addressing barriers faced by underserved groups are essential for promoting inclusive screening and early detection. As part of the ENTER project, which aims to address disparities in breast cancer screening participation among women with low socioeconomic status (SES) in Flanders, Belgium, we conducted a systematic review and meta-analysis on the effectiveness of interventions to enhance mammography uptake. To explore the differential impact of interventions on mammography uptake among vulnerable groups, including individuals with low SES, underinsured, with immigrant background or part of an ethnic minority, subgroup analyses were performed. 7 databases were searched, resulting in the inclusion of 54 out of 9,366 papers for analysis. 14 types of interventions were identified. The meta-analysis showed significant pooled effects of interventions that increased mammography uptake [OR 1.8 (95%CI 1.6-2.2)], particularly among vulnerable populations [OR 2.2 (95%CI 1.7-2.8)]. The most effective interventions were educational interventions [OR 3.03 (95%CI 2.2-4.9); in vulnerable groups OR 2.7 (95%CI 1.9-3.9)]. As expected, interventions adapted to linguistic needs and culturally sensitive approaches showed a significant effect among vulnerable target groups [OR 2.9 (95%CI 1.1-7.9) and OR 2.5 (95%CI 1.1-5.6), respectively]. Reminders were also highly effective [OR 1.8 (95%CI 1.5-2.1); in vulnerable groups OR 2.5 (95%CI 1.9-3.1)]. This review underscores the critical role of targeted interventions in augmenting screening mammography uptake, particularly among vulnerable populations, where odds of participation can increase by up to 2-3 times. Key messages • Interventions adapted to the linguistic needs of the target population and culturally sensitive approaches, aligned with values and beliefs of a specific community, can greatly enhance screening rates. • Considering costs, practicality and impact, reminder letters with culturally and linguistically adapted content emerged as the most promising option for implementation in the ENTER project.

Nourishing Farm to School Practice with Data to Inform Program Needs: An Evaluation of Participation among California Public Districts during the 2018-19 School Year

BackgroundThe US Department of Agriculture promotes farm to school (F2S) as an evidence-based approach to help school meals meet updated nutrition standards that promote health. California is a key agricultural state with strong support for F2S to promote local agriculture and equitable access to nutritious food for all students. ObjectiveExamine district characteristics associated with F2S participation among California public districts during the 2018-19 school year. DesignCross-sectional evaluation of 2019 US Department of Agriculture Farm to School Census data. Participants/settingCalifornia public districts responding to the 2019 US Department of Agriculture F2S Census (N = 572). Main outcome measureReported participation in F2S activities in 2018-19. Covariates included district size, annual per-pupil spending, urbanicity, racial/ethnic composition, and percent free and reduced-price meal eligibility. Statistical analysisDescriptive statistics (unweighted frequency and weighted percent) were reported for demographic characteristics. Weighted, multiple logistic regression assessed associations between demographic characteristics and F2S participation, reported as odds ratio (95% CI). ResultsNearly 78% of California respondents reported F2S participation. Top activities were serving local food in school lunch (73%) and breakfast (65%) and local food promotion at school (45.5%). The odds of participation among districts with enrollments ≥1000 were 1.79 (95% CI 1.15 to 2.79) times higher than smaller districts and 1.57 (95% CI 1.08 to 2.28) times higher in districts with lower annual per-pupil spending (≤$13 707). No significant differences were found by racial/ethnic composition, F2S participation eligibility, or urbanicity. ConclusionsDisparities in F2S participation exist for small districts and those with high annual per-pupil spending that may lack the advantages of economies of scale. Grant incentives and support networks for these groups are recommended along with increased monitoring focused on the quality of F2S engagement. Administration of a brief annual state F2S Census could support more timely monitoring and accountability to align with state goals and improve opportunities for data sharing and community engagement.

Public Views on Whether the Use of Pharmaceutical Neuroenhancements Should Be Allowed.

Some individuals are using drugs to try to enhance cognitive and social-affective functioning and asking physicians for off-label prescriptions for neuroenhancement (e.g., stimulants). Several medical societies released guidance on prescribing neuroenhancers, some of which refer to potential societal effects of neuroenhancement (e.g., distributive justice), besides risks and benefits to users. Which institutions (e.g., medical societies, government, universities) should make decisions on allowing neuroenhancement and whether they should consider potential societal effects are unclear. We examined whether and how much support for allowing pharmaceutical neuroenhancers was influenced by the institution and potential individual and societal effects of neuroenhancers. We conducted a discrete-choice experiment using a constructed representative sample of the US adult public. Multinomial logit models were used to analyze the data. Participants (n = 927) demographically resembled the US population. Risks of serious side effects (OR 0.20, CI 0.18-0.22) and a lack of benefits for users (OR 0.31, CI 0.26-0.38) had the largest negative effect on participants' support for allowing neuroenhancers. A risk of mild side effects had a moderate negative effect on participants' support for allowing neuroenhancers (OR 0.67, CI 0.62-0.74) and the prospect of more meaningful, long-lasting benefits for users a moderate positive effect (OR 1.74, CI 1.61-1.87). Positive or negative effects of neuroenhancers on the average well-being of people in society and on equality had moderate effects on participants' support for allowing neuroenhancers. For example, the odds of participants' support for allowing enhancers with a negative effect on societal well-being were around half (OR 0.45, CI 0.40-0.50) and the odds of allowing enhancers that worsen inequality were approximately 40% lower compared with enhancers without such effects (OR 0.62, CI 0.55-0.71). The odds of participants allowing neuroenhancers were slightly (10%) lower if enhancers reduced users' authenticity (OR 0.90, CI 0.84-0.97). The institution regulating neuroenhancers and neuroenhancers providing users with an unfair advantage did not affect participants' decisions. When presented with both individual and societal considerations, the public seems to support medical societies and other institutions making policy decisions about neuroenhancers based on risks and benefits for users, as well as, but to a lesser extent, effects on equality and societal well-being.

Patients' satisfaction with oral health care provided at the University Dental clinic in Tanzania: A cross-sectional analytical study.

Patients' satisfaction with health services is considered an essential element for hospital setup as it measures its performance and quality of care. Thus, evaluation of patients' satisfaction has become a basic concern of clinical practice. This study aimed to assess the satisfaction of patients with the oral health care provided at the University Dental Clinic in Tanzania. This analytical cross-sectional study targeted all adult patients who sought treatment at the Muhimbili University of Health and Allied Sciences (MUHAS) dental clinic, between December 2019 and August 2020. It utilized a Dental Satisfaction Questionnaire (DSQ) to collect relevant information for this study. A total of 302 patients participated in this study with male to female ratio of 1:1.54. Their mean age was 35.95 ± (SD = 14.19) years. The mean scores for various domains of satisfaction were; 9.42 ± 2.09 for pain management, 8.11 ± 2.84 for the quality of services, 16.08 ± 2.27 for the cost of service, 7.49 ± 1.94 for satisfaction with accessibility/convenience, and 8.93 ± 2.17 for satisfaction with access to care. The overall mean satisfaction score was 50.03 ± 6.53. Only the education level of the participant was significantly associated with overall satisfaction, with the odds of participants with an education level of less than college, being satisfied with dental service 38% more than those with a college education. Most of the participants had moderate overall satisfaction with the oral health care provided at the University dental clinic. The level of satisfaction was not determined by the sociodemographic characteristics of the participants. Patients with oral health problems and staff of the university dental clinic were consulted on the design, delivery, and reporting of the research.

Awareness, predictors and outcomes of drug alerts among people who access harm reduction services in British Columbia, Canada: findings from a 2021 cross-sectional survey

ObjectivesTo assess the awareness and predictors of seeing/hearing a drug alert in British Columbia (BC) and subsequent drug use behaviour after seeing/hearing an alert.MethodsThis study analysed the 2021 BC harm...

Relationship between depression, anxiety, stress, and SARS-CoV-2 infection: a longitudinal study.

We aimed to (1) describe the course of the emotional burden (i.e., depression, anxiety, and stress) in a general population sample during the coronavirus pandemic in 2020 and 2021 and (2) explore the association between emotional burden and a serologically proven infection with SARS-CoV-2. This longitudinal study involved a sample of community-dwelling persons aged ≥14 years from the general population of South Tyrol (Province of Bolzano-Bozen, Northern Italy). Data were collected at two stages over a 1-year period in 2020 and 2021. Persons were invited to participate in a survey on socio-demographic, health-related and psychosocial variables (e.g., age, chronic diseases, Depression Anxiety Stress Scale, DASS-21), as well as in the serological testing for of SARS-CoV-2-specific immunoglobulins. In 2020, 855 (23.8%) out of 3,600 persons participated; in 2021, 305 (35.7%) out of 855 were tested again. We observed a statistically significant decrease in mean DASS-21 scores for depression, stress, and total scores between 2020 and 2021, yet not for anxiety. Persons with a confirmed SARS-CoV-2-infection between the first and second data collection exhibited increased emotional burden compared to those without SARS-CoV-2-infection. The odds of participants with a self-reported diagnosis of mental disorder for future infection with SARS-CoV-2 was almost four times higher than that of participants without mental disorders (OR:3.75; 95%CI:1.79-7.83). Our findings support to the hypothesis of a psycho-neuroendocrine-immune interplay in COVID-19. Further research is necessary to explore the mechanisms underlying the interplay between mental health and SARS-CoV-2 infections.

Impact of the COVID-19 pandemic on breast cancer screening indicators in a Spanish population-based program: a cohort study.

To assess the effect of the COVID-19 pandemic on performance indicators in the population-based breast cancer screening program of Parc de Salut Mar (PSMAR), Barcelona, Spain. We conducted a before-and-after, study to evaluate participation, recall, false positives, the cancer detection rate, and cancer characteristics in our screening population from March 2020 to March 2021 compared with the four previous rounds (2012-2019). Using multilevel logistic regression models, we estimated the adjusted odds ratios (aORs) of each of the performance indicators for the COVID-19 period, controlling by type of screening (prevalent or incident), socioeconomic index, family history of breast cancer, and menopausal status. We analyzed 144,779 invitations from 47,571women. During the COVID-19 period, the odds of participation were lower in first-time invitees (aOR = 0.90 [95% CI = 0.84-0.96]) and in those who had previously participated regularly and irregularly (aOR = 0.63 [95% CI = 0.59-0.67] and aOR = 0.95 [95% CI = 0.86-1.05], respectively). Participation showed a modest increase in women not attending any of the previous rounds (aOR = 1.10 [95% CI = 1.01-1.20]). The recall rate decreased in both prevalent and incident screening (aOR = 0.74 [95% CI = 0.56-0.99] and aOR = 0.80 [95% CI = 0.68-0.95], respectively). False positives also decreased in both groups (prevalent aOR = 0.92 [95% CI = 0.66-1.28] and incident aOR = 0.72 [95% CI = 0.59-0.88]). No significant differences were observed in compliance with recall (OR = 1.26, 95% CI = 0.76-2.23), cancer detection rate (aOR = 0.91 [95% CI = 0.69-1.18]), or cancer stages. The COVID-19 pandemic negatively affected screening attendance, especially in previous participants and newcomers. We found a reduction in recall and false positives and no marked differences in cancer detection, indicating the robustness of the program. There is a need for further evaluations of interval cancers and potential diagnostic delays. This study has received funding by grants PI19/00007 and PI21/00058, funded by Instituto de Salud Carlos III (ISCIII) and cofunded by the European Union and Grant RD21/0016/0020 funded by Instituto de Salud Carlos III and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR).

The association between the hypertriglyceridaemia waist phenotype, cardiovascular risk factors and the metabolic syndrome in South African Asian-Indians

Background and aimsThe combination of high triglycerides and increased waist circumference (HTGW) has not been examined as a predictor of cardiometabolic abnormalities or the metabolic syndrome (MetS) in high-risk Asian populations. This study examines the so-called hypertriglyceridemia waist (HTGW) phenotype, (high serum triglycerides [Tg]) and increased waist circumference (WC) as a predictor of cardiometabolic abnormalities in a high-risk Asian population. MethodsData from the Phoenix Lifestyle Project, a cross-sectional study of 1349 South Asian Indians (15–65 years; 379 men; 970 women) in Durban, KwaZulu-Natal, were reclassified into different waist and Tg phenotypes using the demographic, anthropometric, and biochemical parameters. The HTGW phenotype was defined as WC ≥ 90 cm for men; ≥80 cm for women & TG ≥ 1.7 mmol/L. The MetS was determined using the harmonised criteria. Stepwise logistic regression was used to determine the strength of each phenotype as a predictor of the MetS. ResultsThe HTGW phenotype was recorded in 35.4% of participants, predominantly women (36.1%) and 8.2% smokers. Metabolic derangements and cardiovascular risk factors increased significantly in those with HTGW phenotype. After adjustment, multivariate logistic regression showed that the association between elevated total serum cholesterol, LDL, lowered HDL, diabetes and hypertension with HTGW persisted. The odds for participants with the HTGW phenotype developing the MetS was 19.7 (95% CI 13.9; 27.9). The degree of concordance between the HTGW was highest with the IDF and harmonised criteria for MetS. ConclusionThe HTGW phenotype was associated with a significantly higher risk of developing additional lipid derangements, hypertension, diabetes and the MetS.

Participants' Engagement With Telephone Support Interventions to Promote Healthy Feeding Practices and Obesity-Protective Behaviours for Infant Obesity Prevention.

BackgroundParticipant engagement with program interventions is vital to support intended behaviour changes and outcomes. The aim of this research was to investigate participant engagement with the Communicating Healthy Beginnings Advice by Telephone (CHAT) program, an early childhood obesity prevention program that included interventions for promoting healthy infant feeding practices and obesity-protective behaviours via telephone, and whether engagement with the telephone support program varied by participants’ sociodemographic characteristics.MethodsThis study used de-identified CHAT program data of participants who received the interventions via telephone. Data analysed included 1) participant engagement in telephone support from late pregnancy to 12 months of child's age, 2) demographic characteristics collected at late pregnancy and 3) intervention providers’ observations and notes (qualitative data) for 10 participants from each engagement group (low, medium, high) to explore issues discussed during telephone support.ResultsCall completion rate by participants was above sixty percent for all six stages of the telephone support program with more than half of the participants (57%) demonstrating high level of engagement. We found that participants’ country of birth, employment status and annual household income were predictors of engagement with the telephone support provided in the CHAT program. The odds of participants’ engagement with the telephone support program were 1.68 times higher for Australian born (95% CI 1.07 – 2.62), 1.63 times higher for participants who were employed (95% CI 1.01 – 2.66) and 1.63 times higher for participants with annual household income ≥AUD$80,000 (95% CI 1.02 – 2.60).ConclusionsParticipant engagement with the program interventions was good. Participants’ engagement with the telephone support program was significantly associated with certain socio-demographic characteristics. Australian born participants, and participants associated with higher household income and employment engaged significantly more with the telephone support provided in the CHAT program. Additionally, the program engaged more participants older than 30 years of age and those who spoke English at home. The program provided unintended personal benefits to some participants with high engagement level due to their various psychosocial needs such as domestic violence, mental health and sleep related issues. Although not an intended benefit of the intervention, psychosocial needs of participants were met which was a likely factor for mothers’ engagement with the program. This is an important factor that needs to be considered while implementing future programs or scale up of this program.

Special issue "The advance of solid tumor research in China": Participants with a family history of cancer have a higher participation rate in low-dose computed tomography for lung cancer screening.

We aimed to determine participation in low-dose computed tomography (LDCT) of individuals with a family history of common cancers in a population-based screening program to provide timely evidence in high-risk populations in China. The analysis was conducted using data from the Cancer Screening Program in Urban China (CanSPUC), which recruited 282 377 participants aged 40 to 74 years from eight cities in the Henan province. Using the CanSPUC risk score system, 55 428 participants were evaluated to have high risk for lung cancer and were recommended for LDCT. We calculated the overall and group-specific participation rates using family history of common cancers and compared differences in participation rates between different groups. Odds ratios (ORs) and 95% confidence intervals were derived by multivariable logistic regression. Of the 55 428 participants, 22 260 underwent LDCT (participation rate, 40.16%). Family history of lung, esophageal, stomach, liver and colorectal cancer was associated with increased participation in LDCT screening. The odds of participants with a family history of one, two, three and four or more cancer cases undergoing LDCT screening were 1.9, 2.7, 2.8 and 3.5 times, respectively, than those without a family history of cancer. Compared to those without a history of cancer, participation in LDCT gradually increased as the number of cancer cases in the family increased (P< .001). Our findings suggest that there is room for improvement in lung cancer screening given the relatively low participation rate. Lung cancer screening in populations with a family history of cancer may improve efficiency and cost-effectiveness; however, this requires further verification.

Anaemia Prevalence More Than Doubles in an Academic Year in a Cohort of Tertiary Students: A Repeated-Measure Study in Cape Coast, Ghana.

Background The stress of academic life may predispose young adults to poor dietary habits, which could potentially precipitate nutritional deficiencies, such as iron deficiency. This study evaluated factors predictive of optimal iron stores as well as changes in haematological parameters over the course of an academic year in a cohort of tertiary students. Materials and Methods The repeated-measure cohort study recruited 117 undergraduate students from September 2018 to May 2019. Venous blood samples were drawn for full blood count estimation, qualitative glucose-6-phosphate dehydrogenase (G6PD) status, haemoglobin variants, and blood group determination during the first 2 weeks of semester 1. However, anthropometric parameters as well as full blood counts were determined for each participant during the first week and last week of semesters 1 and 2. Additionally, semistructured questionnaires were used to capture sociodemographic data. Also, serum ferritin was estimated for each participant using enzyme-linked immunosorbent assay. Results Overall, 23.1% and 15.5% of participants inherited G6PD defect (G6PDd) or haemoglobin variants, respectively. However, group O (68/117; 58.1%) was the predominant ABO blood group and an overwhelming 90.6% (106/117) inherited Rh D antigen. The prevalence of anaemia increased from 20% at the beginning of the first semester to 45.1% at the latter part of the second semester. G6PDd participants had significantly higher median serum ferritin than G6PD normal participants (p = 0.003). Also, a significantly higher proportion of females were iron depleted (25% vs. 2.3%) or iron deficient (14.3% vs. 9.3%) compared to males. Moreover, being male, G6PD deficient, or 21–25 years was associated with increased odds of participants having optimal serum ferritin levels. Conclusion The progression of anaemia prevalence from mild to severe public health problem over the course of one academic year should urgently be addressed.

Disparities and trends in the participation of minorities, women, and the elderly in breast, colorectal, lung, and prostate cancer clinical trials.

This study was done to determine the representation of minorities, women, and the elderly in National Cancer Institute (NCI) clinical trials. This is an analysis in the NCI Clinical Data Update System. Patients were evaluated in breast, colorectal, lung, and prostate cancer trials from 2000 to 2019. Representation in a trial was determined by race/ethnicity, sex, and age. Secondarily, the change in trial participation by multivariable analysis by comparing years 2000 through 2004 to 2015 through 2019 was evaluated. The cohort included 242,720 participants: 197,320 Non-Hispanic White (81.3%), 21,190 Black (8.7%), 11,587 Hispanic (4.8%), and 6880 Asian/Pacific Islander (2.8%). Black and Hispanic patients were underrepresented for colorectal (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.50-0.67; P < .001 and OR, 0.74; 95% CI, 0.64-0.87; P < .001, respectively), lung (OR, 0.83; 95% CI, 0.76-0.91; P < .001 and 0.66; 95% CI, 0.57-0.77; P < .001, respectively), and prostate cancer trials (OR, 0.85; 95% CI, 0.79-0.92; P < .001 and OR, 0.58; 95% CI, 0.51-0.66; P < .001) between 2015 and 2019. The odds of participation in 2015 to 2019 increased among Black patients in breast (OR, 2.19; 95% CI, 2.07-%2.32; P < .001), lung (OR, 1.54; 95% CI, 1.38-1.73; P < .001), and prostate cancer trials (OR, 1.14; 95% CI, 1.04-1.26; P < .001). The odds of participation in a trial among Hispanic patients increased for breast (OR, 3.32; 95% CI, 3.09-3.56; P < .001), colorectal (OR, 2.46; 95% CI, 2.04-2.96; P < .001), lung (OR, 3.88; 95% CI, 3.20-4.69; P < .001), and prostate cancer (OR, 1.70; 95% CI, 1.42-2.04; P = .005). This study identified that Black and Hispanic patients remain underrepresented in trials, but in recent years, participation has increased. These findings indicate that minority participation has increased over time, but further efforts are needed.

P61.06 Participants With Family History of Cancer Have a Higher Participation Rate of Low-Dose Computed Tomography for Lung Cancer Screening

Family history of cancer is an important risk factor for lung cancer. Studies have shown that it may also affect the willingness to lung cancer screening. To describe the low-dose computed tomography (LDCT) participation rate with a history of common cancers in a population-based screening program. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 282,377 eligible participants aged 40-74 years from 8 cities in Henan province from 2013 to 2019. A total of 55,428 participants were evaluated to be high-risk for lung cancer by an established risk score system and were subsequently recommended for LDCT. In this study, we calculated the overall and group-specific participation rates by a family history of common cancers, as well as compared the differences in participation rates between different groups. Obtain odds ratios (ORs) and 95% CIs derived by multiple logistic regression model. Of 55,428 with high-risk for lung cancer, 22,260 subjects undertook LDCT (participation rate of 40.16%). We found that a family history of lung cancer, esophageal cancer, stomach cancer, liver cancer, and colorectal cancer were associated with increased participation in LDCT screening. The odds of participants with a family history of one cancer, two cancers, three cancers, and four or more cancers undertaking LDCT screening were 0.9-fold, 1.7-fold, 1.8-fold, and 2.5-fold higher than participants with no family history of cancer (OR: 1.88, 95% CI: 1.80-1.96; OR: 2.65, 95% CI: 2.51-2.79; OR: 2.83, 95% CI: 2.64-3.04; OR: 3.46, 95% CI: 3.15-3.79), respectively. Compared with those without a history of cancer, as the number of cancer family history increases, compliance gradually increases (P<0.001). There was room for improvement regarding lung cancer screening yield given the relatively low participation rate. Lung cancer screening in populations with a family history of cancer may be a choice.

Race, language, and neighborhood predict high-risk preterm Infant Follow Up Program participation.

ObjectivesInfant Follow Up Programs (IFUPs) provide developmental surveillance for preterm infants after hospital discharge but participation is variable. We hypothesized that infants born to Black mothers, non-English speaking mothers, and mothers who live in “Very Low” Child Opportunity Index (COI) neighborhoods would have decreased odds of IFUP participation.Study DesignThere were 477 infants eligible for IFUP between 1/1/2015–6/6/2017 from a single large academic Level III NICU. Primary outcome was at least one visit to IFUP. We used multivariable logistic regression to identify factors associated with IFUP participation.ResultTwo hundred infants (41.9%) participated in IFUP. Odds of participation was lower for Black compared to white race (aOR 0.43, p=0.03), “Very Low” COI compared to “Very High” (aOR 0.39, p=0.02) and primary non-English speaking (aOR 0.29, p=0.01).ConclusionWe identified disparities in IFUP participation. Further study is needed to understand underlying mechanisms to develop targeted interventions for reducing inequities.

Sports Injury Risks and Opportunity Costs: The Conspicuous Landscape of Handball among Tertiary Teachers’ Colleges in Zimbabwe

This study explored injury risks associated with sport participation among handball players in Zimbabwean Tertiary Institutions between 2016 and 2019. The study employed a descriptive, prospective cohort design anchored on quantitative methodology and informed by Positivism Philosophy. The population comprised technocrats (coaches, fitness trainers, physiotherapists, psychologists and players) from selected Zimbabwe Teachers’ Colleges Sports Association handball teams. Stratified random sampling was used to select the respondents. Questionnaire was used as data collection tool and IBM SPSS Statistic Version 23 was used for data analysis. Findings revealed critical knowledge-service gaps on sports medicine professionals regarding lack of players’ informational sources on pre-participation medical health-checks as evidence-based practices for addressing activity limitations and risks upon return-to-sport. Ego-oriented administration characteristic of pain-injury paradox environment prevailed with pre-mature ending of players’ rehabilitation routes. Well formulated guideline-inclined preventive injury risk management protocols resonating player-centered medicine approaches that could effectively abate epidemiologic opportunity injury risks and costs were non-existent. Furthermore, regularized in-service professional development clinics lacked. Players’ objective injury records, profiles and pre-participation medical examination health-checks should be considered as critical informational sources for fully resolving physiological defects prior to return-to competitive contexts. Formulation of guideline-inclined preventive injury risk management protocols entrenching player-centered medicine practices could effectively trim down epidemiologic opportunity injury risks and costs and improve the critical base for players’ odds of participation. Regularized in-service professional development trainings for sports medicine professionals through symposiums should inexorably be an esteemed epitomic pedestal delved towards improving their expert base levels in view of contemporary preventive and injury risk management dynamics in sports.

Impacts of Tooth Loss on OHRQoL in an Adult Population in Cape Town, South Africa.

(1) Background: Tooth loss is an important component of the global burden of oral disease, greatly reducing the quality of life of those affected. Tooth loss can also affect diet and subsequent incidences of lifestyle diseases, such as hypertension and metabolic syndromes. This study aimed to evaluate the oral health-related quality of life (OHRQoL) score using the oral impacts on daily performance (OIDP) index in relation to tooth loss patterns among adults. (2) Methods: From 2014 to 2016, a cross-sectional study was conducted on adults living in Bellville South, Cape Town, South Africa. The OHRQoL measure was used to evaluate the impact of tooth loss. (3) Results: A total of 1615 participants were included, and 143 (8.85%) had at least one impact (OIDP > 0). Males were less likely to experience at least one impact compared to the females, OR=0.6, 95% C.I.: 0.385 to 0.942, p = 0.026. Those participants who did not seek dental help due to financial constraints were 6.54 (4.49 to 9.54) times more likely to experience at least one impact, p < 0.001. (4) Conclusions: Tooth loss did not impact the OHRQoL of these subjects. There was no difference in the reported odds for participants experiencing at least one oral impact with the loss of their four anterior teeth, the loss of their posterior occlusal pairs, or the loss of their other teeth.

Female Youth Soccer Participation and Continued Engagement: Associations With Community Size, Community Density, and Relative Age.

Environmental context can impact youth engagement in sport and athlete development. Previous work has examined the population size of the birthplace of elite athletes; commonly known as the birthplace or community size effect. Community density has also been recognized as an important variable. Exact estimates for the ideal community characteristics and a thorough understanding of the underlying mechanisms has been somewhat elusive. Existing studies are cross-sectional in nature and there is evidence to suggest that significant variation exists within imposed categories. An athlete's birthdate position in a similar-age cohort can also impact development and has been associated with (dis)advantages resulting from subtle age differences (i.e., the relative age effect); it remains unknown if this variable is associated with population density. The objective of this study was to establish longitudinal participation trends among female youth soccer players in Ontario Canada, with consideration of community size, community density, and relative age. Within-category variation and associations between the variables were assessed. Registration entries at age 10 years (n = 9,826) and 16 years (n = 2,305) were isolated for analysis. Odds ratio analyses were conducted within each community size and density category for all 10 year old registrants; 95% confidence intervals were obtained. This procedure was repeated for all registrants at 16 years of age using the expected distribution at age 10 years to examine continued engagement. Findings suggest medium-sized communities (i.e., 10,000–249,999 inhabitants) provide the best odds of participation and continued engagement. Less densely populated communities (i.e., 50–<400 population/km2) appeared to be ideal for facilitating participation at age 10 years, but not for engagement at age 16 years. However, within-category variation was evident when each community was inspected individually. Consistent with previous attempts to find an association between community size and the relative age effect, there did not appear to be an association between community density and birth quartile distribution. Observations from this study show that community size and community density are truly unique and separate variables. Future studies should consider the underlying contributions to both low and high participation and continued engagement, while being mindful of within-category variation.

Knowledge and Behaviors Toward COVID-19 Among US Residents During the Early Days of the Pandemic: Cross-Sectional Online Questionnaire.

BackgroundThe early days of the coronavirus disease (COVID-19) pandemic in the United States brought uncertainty in the knowledge about COVID-19 and what to do about it. It is necessary to understand public knowledge and behaviors if we are to effectively address the pandemic.ObjectiveThe aim of this study is to test the hypothesis that knowledge about COVID-19 influences participation in different behaviors including self-reports of purchasing more goods than usual, attending large gatherings, and using medical masks.MethodsThis study was funded and approved by the Institutional Review Board on March 17, 2020. The cross-sectional online survey of 1034 US residents aged 18 years or older was conducted on March 17, 2020.ResultsFor every point increase in knowledge, the odds of participation in purchasing more goods (odds ratio [OR] 0.88, 95% CI 0.81-0.95), attending large gatherings (OR 0.87, 95% CI 0.81-0.93), and using medical masks (OR 0.56, 95% CI 0.50-0.62) decreased by 12%, 13%, and 44%, respectively. Gen X and millennial participants had 56% and 76% higher odds, respectively, of increased purchasing behavior compared to baby boomers. The results suggest that there is a politicization of response recommendations. Democrats had 30% lower odds of attending large gatherings (OR 0.70, 95% CI 0.50-0.97) and 48% lower odds of using medical masks (OR 0.52, 95% CI 0.34-0.78) compared to Republicans.ConclusionsThis survey is one of the first attempts to study determinants of knowledge and behaviors in response to the COVID-19 pandemic in the United States. A national, coordinated effort toward a pandemic response may ensure better compliance with behavioral recommendations to address this public health emergency.

Risks to pedestrians in traffic systems with unfamiliar driving rules: a virtual reality approach

In this study, a virtual-reality (VR) pedestrian simulation method was used to evaluate the risks to pedestrians crossing streets in a traffic system with driving rules that were unfamiliar to them. Pedestrians from mainland China (which has a right-side driving (RD) system) and Hong Kong (which has a left-side driving (LD) system) were studied. Significant differences were observed between pedestrians from the different locations in terms of the direction in which the pedestrians habitually first looked before crossing. When exposed to an unfamiliar driving rule (i.e., traffic coming from an inconsistent direction in terms of participants’ habitual driving system), the odds of participants from mainland China making an error in their looking behavior were 2.93 times those when exposed to a familiar driving rule. Road markings and traffic sound did not improve these participants’ looking behavior. The results also show a negative correlation between inattentive looking behavior and time to collision (significant at the 1% level), as these errors lead to a shorter time to collision and increased the risk to pedestrians. The results of this study confirmed the risks for pedestrians traveling to places with unfamiliar driving rules and confirmed the existence of habitual looking behavior, and therefore provide evidence of the need for future studies to improve this problem. These may help decision makers take the risks of pedestrians from different driving rules into consideration in future traffic policymaking or traffic-facility improvements. The use of a VR simulation-based approach in this study provided a safe and controllable way to trial interventions and potential improvements without risking injury to participants, and thus may also be used for similar future studies.

Effect of Crowd Voting on Participation in Crowdsourcing Contests

ABSTRACT While expert rating is still a dominant approach for selecting winners in contests for creative works, a few crowdsourcing platforms have recently used “crowd voting” for winner selection – that is, let users of the crowdsourcing community publicly vote for contest winners. We investigate how a contest’s reliance on crowd voting for winner selection, defined as the percentage of crowd-voted prizes to the total prize sum (in dollar amounts), affects contest participation. Drawing upon expectancy theory and tournament theory, we develop a theoretical understanding of this relationship. Using a novel dataset of contests employing both crowd voting and expert rating, we find that a contest’s reliance on crowd voting is positively associated with participation. Specifically, every 10% increase in the crowd-voting reliance can boost users’ odds of participation by about 7%. Moreover, crowd voting is more appealing to users whose expertise is not high and whose status in the crowdsourcing community is high.