Prevention Practices Research Articles

A Survey on Surgical Site Infections Prevention Guidelines Knowledge and Implementation Level of Trauma Centre Healthcare Professionals

Aims/Background Surgical site infections (SSIs) significantly influence patient safety and healthcare quality, particularly in low- and middle-income countries where the burden is most evident. This manuscript aims to evaluate the awareness and adherence to SSI prevention guidelines among healthcare providers at a tertiary trauma centre situated in Tirana, Albania. Methods This cross-sectional survey was conducted among practising surgeons, residents and nurses of Trauma University Hospital, Tirana. The questionnaire explores awareness, attitudes and practices towards SSI prevention in preoperative, perioperative and postoperative phases. Results The participants demonstrated a high level of patient education about SSI risks (91.9%), but lower adherence to individual prevention practices. Conclusion Despite adequate knowledge, there remains a significant gap in the implementation of SSI prevention guidelines. Strengthening continuous medical education is crucial to addressing systemic barriers, improving compliance with guidelines, and decreasing SSI rates.

Workplace-based prevention and management of knee pain: a systematic review.

Knee pain is highly prevalent and disabling among the general and working population. This systematic review explored the effectiveness of workplace-based interventions on knee pain among workers. A PICO-guided systematic search was performed in PubMed and Web of Science Core Collection for articles published from 2003 until January 2023. Eligible articles included randomized and non-randomized controlled trials assessing the effect of workplace-based interventions on knee pain among currently employed adult workers. The quality assessment and evidence synthesis adhered to the systematic review approach, which the Institute for Work & Health developed, and was focused on developing practical recommendations for stakeholders. Of the 13 identified studies, 11 medium- and high-quality studies were entered into the evidence synthesis. Importantly, none of the included studies specifically aimed at reducing of knee pain. Still, among the included studies, a strong level of evidence suggested no benefit of workplace-based physical exercise/activity intervention on knee pain. The level of evidence was deemed too uncertain to guide current policy/practices for ergonomic and multifaceted interventions. No intervention types were associated with negative effects on knee pain. The current evidence-base pertaining to workplace-based prevention and management of knee pain is insufficient to guide effective preventive workplace practice or policy development. Considering the global prevalence and health impact of knee pain, development and implementation of effective workplace interventions aimed at prevention and management of knee pain is needed.

A Narrative Review on the Conceptual and Methodological Advancements in Digital Disruption: A Way to Improved Quality of Services in Health Care

Background: The adoption and successful implementation of digital health solutions heavily depend on digital health literacy, which is particularly critical in the current COVID-19 era. Low levels of digital health literacy are associated with poor preventative practices, the spread of inaccurate information, vaccine hesitancy, and reduced subjective well-being. Thus, the aim of this review was to highlight areas of current scholarly interest and identify any gaps in the literature regarding conceptual and methodological advancements in digital disruption. Methods: The authors conducted a literature search using the databases Scopus, Embase, Web of Science, PubMed, and Google Scholar, focusing on papers released between 2003 and October 2023. The following keywords were used to conduct a thorough literature search: ((digital health OR digital disruption OR digital dental health)) AND (medical health OR telemedicine)), ((online doctor OR online consultation OR online health app)) AND (COVID-19 OR pandemic)). A total of 1,244 studies were screened, including duplicates and non- English research. After applying inclusion and exclusion criteria, 72 articles were selected for the review. Results: A total of 72 articles were included in this review. The studies discussed the potential reasons for disrupted access to healthcare, which is linked to avoidable hospital admissions. Delayed care due to disruptions can lead to disease progression, the exacerbation of existing conditions, and chronic ambulatory care-sensitive conditions. Digital health innovations were presented as solutions to enhance care, reduce clinical workload, and promote independent living. Conclusions: In conclusion, this narrative review provides a comprehensive overview of the conceptual and methodological advancements in digital technology related to healthcare. It demonstrates the potential of digital technology to revolutionize both medical and dental education.

ROLE OF MEDIA IN HEALTH AWARENESS DURING COVID-19 PANDEMIC

The COVID-19 pandemic highlighted the essential role of media in disseminating public health information, influencing health behaviors, and combating misinformation. This paper explores how media channels—traditional and digital—shaped public understanding and attitudes toward health guidance during the pandemic. It examines the successes and challenges faced by media in conveying accurate information, promoting preventive practices, and supporting vaccination campaigns. The analysis also addresses how misinformation spread through social media created obstacles for public health efforts. Finally, this paper offers recommendations on enhancing media strategies in future health crises to improve public health communication and outcomes.

CONHECIMENTOS SOBRE RASTREIO E DIAGNÓSTICO PRECOCE DE CÂNCER DE COLO UTERINO ENTRE AS MULHERES QUE FREQUENTAM UM AMBULATÓRIO DE UM CENTRO UNIVERSITÁRIO NA CIDADE DE PORTO VELHO – RO - BRASIL

Cervical cancer (CCU) is one of the most common types among women, making early diagnosis essential for better prognoses. It is characterized by slow progression, but it is amenable to screening and rapid detection, which can lead to effective treatment and a promising prognosis. Human papiloma virus (HPV) infection, especially by subtypes 16 and 18, is a necessary but not sufficient condition for the development of cervical cancer. The oncotic cytology test (Pap smear) aims to detect precursor lesions of CCU. This study investigated the level of knowledge about cervical cancer screening and early diagnosis among women attending an outpatient clinic at a University Center in Porto Velho, RO. A qualitative and descriptive approach was used through questionnaires to assess understanding of the preventive exam (Pap smear), risk factors, and preventive practices. The results showed: (i) high adherence to the cervical cancer preventive exam among participants; (ii) non-use of condoms (70%); (iii) educational actions on the preventive exam (60%); (iv) structural and personal barriers limiting access to the preventive exam; (v) 56.7% of participants had information about HPV; (vi) 83.3% of participants reported knowledge of cervical cancer; (vii) lack of knowledge about the frequency of the preventive exam in 55% of participants; (viii) 88.3% believe that early diagnosis improves prognosis and treatment success. The results of this study may help to develop effective educational interventions that encourage the preventive exam, contributing to reducing incidence and mortality rates associated with CCU, and improving women’s health in the region.

Co-Occurrence of Mycotoxins in the Diet and in the Milk of Dairy Cows from the Southeast Region of Brazil

Mycotoxins are toxic fungi secondary metabolites that develop on feedstuffs and can be transferred into milk, thus representing a public health risk. The objective of this study was to assess the co-occurrence of mycotoxins in the diet and in the milk of dairy cows from the southeast region of Brazil. Samples of total mixed ration (TMR, n = 70) and milk (n = 70) were collected in dairy farms and subjected to multi-mycotoxin analysis using liquid chromatography coupled to tandem mass spectrometry. The aflatoxins (AFs), ochratoxin A (OTA), and T-2 and HT-2 toxins were not detected in TMR samples. In contrast, fumonisins (FBs), zearalenone (ZEN), and deoxynivalenol (DON) were detected in 100, 93, and 24% of TMR samples at mean levels of 336.7 ± 36.98, 80.32 ± 16.06 µg/kg and 292.1 ± 85.68 µg/kg, respectively. Ninety-two percent of TMR samples exhibited co-occurring mycotoxins. In milk, 54% of samples (n = 38) had detectable levels of mycotoxin, while 43% (n = 30) contained two or more types of mycotoxins. DON, FB, and ZEN metabolites (α-zearalenol and β-zearalenol) were the most frequent mycotoxins detected in the milk samples analyzed, at mean concentrations of 0.562 ± 0.112, 2.135 ± 0.296 µg/kg, 2.472 ± 0.436 µg/kg, and 0.343 ± 0.062 µg/kg, respectively. However, none of the analyzed milk samples had levels higher than the maximum permitted limit for AFM1 in Brazil (0.5 µg/L). The results of this trial highlight the concern about the co-occurrence of multiple mycotoxins in TMR and in milk, due to the possible additive or synergistic effects of these compounds. The presence of co-occurring mycotoxins in milk underscores the need for stringent preventive practices to avoid mycotoxin contamination in the diet of dairy cows in Brazil.

Learning health system linchpins: information exchange and a common data model.

To demonstrate the potential for a centrally managed health information exchange standardized to a common data model (HIE-CDM) to facilitate semantic data flow needed to support a learning health system (LHS). The Rhode Island Quality Institute operates the Rhode Island (RI) statewide HIE, which aggregates RI health data for more than half of the state's population from 47 data partners. We standardized HIE data to the Observational Medical Outcomes Partnership (OMOP) CDM. Atherosclerotic cardiovascular disease (ASCVD) risk and primary prevention practices were selected to demonstrate LHS semantic data flow from 2013 to 2023. We calculated longitudinal 10-year ASCVD risk on 62,999 individuals. Nearly two-thirds had ASCVD risk factors from more than one data partner. This enabled granular tracking of individual ASCVD risk, primary prevention (ie, statin therapy), and incident disease. The population was on statins for fewer than half of the guideline-recommended days. We also found that individuals receiving care at Federally Qualified Health Centers were more likely to have unfavorable ASCVD risk profiles and more likely to be on statins. CDM transformation reduced data heterogeneity through a unified health record that adheres to defined terminologies per OMOP domain. We demonstrated the potential for an HIE-CDM to enable observational population health research. We also showed how to leverage existing health information technology infrastructure and health data best practices to break down LHS barriers. HIE-CDM facilitates knowledge curation and health system intervention development at the individual, health system, and population levels.

Understanding the future of dengue in Malaysia: Assessing knowledge, attitude, and homeowner practices in mitigating climate-driven risks

Introduction Dengue fever poses a significant public health threat, particularly in tropical regions like Malaysia. The rising incidence of dengue outbreaks challenges healthcare systems and highlights the urgent need for effective preventive measures. Climate change, with rising temperatures and shifting rainfall patterns, is expected to worsen the dengue situation in the coming years. Methods . This is a cross-sectional study conducted among adult residents of low-cost housing apartments in an urban poor community in Kuala Lumpur, Malaysia involving approximately 16,000 residents. A representative sample of 1,636 residents was calculated using the Krejcie and Morgan formula, and stratified random sampling was used to ensure proportional representation across the various floors of each PPR community apartment block. Data were collected using a structured questionnaire adapted from a validated Malay version. The questionnaire assessed respondents’ knowledge, attitudes, and practices (KAP) related to dengue prevention, categorising KAP scores as “Good” (≥80%) or “Poor” (<80%). Descriptive statistics summarized population characteristics and KAP scores, while logistic regression identified predictors of KAP levels, with significance set at p ≤ 0.05. Results In this community, 76.7% of participants exhibited poor knowledge and 83.1% had a negative attitude towards dengue, despite 66.7% demonstrating good preventive practices. The PPR location significantly predicts dengue knowledge, attitudes, and preventive practices, with p-values of less than 0.001 for all domains. Marital status also predicts dengue knowledge (p = 0.007) and preventive practices (p = 0.023), while prior infection with dengue is a predictor of preventive practices (p = 0.047). Conclusion Despite the community’s good dengue prevention practices, likely influenced by environmental expectations, there remains a critical need for education to sustain and strengthen these efforts, as climate change continues to worsen in the coming years. It is crucial to help residents grasp the relevance of these practices, so they can apply them more effectively as climate-driven risks intensify. Targeted interventions should de designed differently for each of the four PPR communities as their levels of knowledge, attitude and practices vary significantly, taking into account independent factors like marital status and prior dengue infection, which shape preventive behaviors.

The Effect of Internet-Based Cardiac Rehabilitation on Anxiety, Depression, and Quality of Life Among Patients With Ischemic Heart Disease

Background Internet-based cardiac rehabilitation (IBCR) is an innovative, alternative platform used in current practice for the secondary prevention of ischemic heart disease (IHD). The impact of IBCR on anxiety, depression, and quality of life (QoL) in patients with IHD remains inconclusive. Objective To explore the effect of IBCR on anxiety, depression, and QoL among patients with IHD. Methods Five databases (Embase, CINAHL, Medline, Cochrane, and Web of Science) and additional resources were searched to identify studies published between January 2014 and March 2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Critical Appraisal Skills Program checklist were used. Two reviewers independently assessed study quality, eligibility, and data extraction. RevMan (version 5.3) software was used for the meta-analysis. The protocol was registered in PROSPERO (CRD42023387666). Results Thirteen randomized controlled trials were included across 9 countries. A total of 2256 participants, with a mean age ranging from 55 to 63 years, the majority being men (73%), were identified. IBCR did not significantly reduce anxiety (P = .22) or depression (P = .44) or increase QoL (P = .21) compared with usual care. Intervention was delivered mainly via smartphones. Physical activities and risk factor management were mostly used, and behavioral changes less likely occurred. Hospital Anxiety and Depression Scale was mostly used. Conclusions IBCR was comparable to the effects of usual care in cardiac rehabilitation. Theory-driven interventions with larger and diverse sample sizes, and longer durations across different regions, are recommended for reliable findings.

Recognising and responding to the community needs of gay and bisexual men around mpox.

In May 2022, a global surge in mpox cases, typically endemic to Western and Central Africa, particularly affected gay, bisexual, and other men who have sex with men (gbMSM). This study examines gbMSM communities' experiences and perceptions around Ireland's public health response to the outbreak. A cross-sectional mixed-methods online survey was conducted. Qualitative data were analysed using reflexive thematic analysis informed by critical realism. A total of 163 gay and bisexual men took part in the survey. Participants accessed information from diverse sources, reporting varying levels of trustworthiness. Overall, participants were well-informed. Four themes were developed from the qualitative data: (1) Perceptions of the mpox response: divergence in urgency, priority, and care; (2) The mpox outbreak as a sign of otherness for gbMSM; (3) The potential for othering through mpox prevention practices; and (4) mpox, memory and fear. While community-led initiatives were effective, significant challenges included stigmatisation, discrimination, and mistrust towards public health institutions, influenced by institutionalised homophobia. The study underscores the need for inclusive, culturally sensitive, and transparent public health strategies. The mpox outbreak highlights the importance of robust community collaboration in public health interventions. Future strategies must ensure equitable access to information, vaccination, and care, and address broader structural inequalities to foster trust and engagement within affected communities.

Consensus on maturity-related injury risks and prevention in youth soccer: A Delphi study.

The aim of this study was to achieve consensus from leading sport and exercise science practitioners in professional soccer academies surrounding (i) motivations for maturity-related data collection (ii) maturity-related injury risk factors (iii) how maturity-related data informs injury prevention practices and (iv) the use of bio-banding as an alternative injury prevention strategy. The study adopted an iterative three round online Delphi method, where a series of statements were rated by expert panellists. Consensus agreement was set at ≥70% for all statements. Nine panellists participated in all three rounds (69% response rate). Consensus was achieved for a total of sixteen statements. Panellists agreed that the period during and 12-months post peak height velocity, muscle strength/flexibility imbalances and maturity status (% predicted adult height) as the most important maturity-related injury risk factors. Panellists also agreed that maturity-related data collection is important for injury prevention as well as physical and performance-related purposes, but not for recruitment or retain/release purposes. It was also evident that variability and misunderstanding of key language terms used within the growth and maturation literature exists. It was agreed that practitioners who are responsible for conducting maturational assessments require additional training/education to enhance their application, delivery and outcomes. The findings indicate that maturity-related data collection is part of a multidisciplinary process, dedicated towards the long-term development of players. Greater training and education are required along with increased dissemination of research findings surrounding the full uses for bio-banding. This study provides guidance on maturity-related injury risks and prevention in youth soccer for practitioners.

Bio-Politics and Cultural Rubric on the Prevention of Corruption of Village Funds in Wonogiri Regency

Corruption prevention in Indonesian villages is generally limited to the formal and informal dichotomy. To bridge this dichotomy, this research uses a bio-political approach and a cultural framework as a representation of the formal and informal. This research aims to explore bio-politics and cultural frameworks in preventing corruption in village funds in Sendang Village, Wonogiri. Using phenomenological qualitative research methods and triangulation, the results show that Sendang Village in Wonogiri has become a prime example of transparency and accountability prior to the recommendation from Transparency International Indonesia (TII) in 2023. Sendang Village also issued various regulations and utilized inherent and extrinsic village values to build massive corruption prevention practices. Despite the dynamics and issues arising from the simultaneous application of the bio-political and cultural frameworks, corruption prevention efforts in Sendang Village continue to be built consistently. The research has implications for bridging the dichotomy between formal and informal corruption prevention in the village. In addition, this research also provides an in-depth description and different perspectives in the research of corruption prevention at the village level.

Barriers and Facilitators to Cervical Cancer vaccination Among Young Females in Chennai: A Cross-Sectional KAP Study

Cervical cancer develops in the cervix, primarily caused by persistent infection with high-risk types of human papilloma virus (HPV). It is one of the most common cancers in women, especially in low- and middle-income countries. While most HPV infections resolve naturally, some persist and can lead to cervical cancer over time. Aim: This study aims to evaluate the knowledge, attitudes, and practices (KAP) of young women in Chennai regarding cervical cancer, screening, and prevention, and to identify barriers and facilitators influencing participation in screening programs. Methodology: A cross-sectional study was conducted from January to May 2024 among 222 young females, aged 13 and above.. A semi-structured questionnaire assessed their KAP towards cervical cancer. Responses were analyzed using descriptive statistics, and Bloom’s taxonomy was applied to categorize knowledge and attitude. Chi-square tests were used to determine statistical significance, with a p-value < 0.05. Results: Although 78.2% of participants were aware of cervical cancer, knowledge of preventive measures was low—only 25.2% knew about the HPV vaccine, and 44% understood the correct Pap test frequency. Attitudes toward screening were mostly positive, with 73.2% agreeing that free screening reduces cervical cancer risk. However, actual preventive practices were limited—only 9% had undergone a Pap smear, and 10% had received the HPV vaccine. Statistical analysis showed no significant differences in KAP between groups (p > 0.05), except for medical students, who demonstrated significantly higher knowledge levels. Conclusion: Despite positive attitudes toward cervical cancer screening, there were notable gaps in knowledge and preventive practices among young women in Chennai. The findings underscore the need for targeted educational interventions, particularly on HPV vaccination and routine screening, to bridge these gaps.

Preventive behaviors for COVID-19 in Chile: Lessons from a population follow-up for 2021 and 2022.

The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year. 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signed-rank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed. Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p < 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32). Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022.

Patients’ perspective and practices of heart failure recurrence prevention in Yancheng City

Effective self-management is essential for patients with heart failure, but many struggle with acquiring the necessary skills. Given the complexity of heart failure management and the importance of patient adherence to prescribed regimens, this study aims to investigate the knowledge, attitudes, and practices (KAP) concerning the prevention of heart failure recurrence among patients. A cross-sectional study was conducted at the Third People’s Hospital of Yancheng City from September 1, 2023, to December 31, 2023, employing a self-administered KAP questionnaire. The study included 421 heart failure patients, of whom 230 (54.6%) were male. Median scores for knowledge, attitudes, and practices were 12.00 [10.00, 13.00] (possible range: 1–18), 20.00 [19.00, 21.00] (possible range: 5–25), and 16.00 [15.00, 17.00] (possible range: 5–22), respectively. Pearson’s correlation analysis indicated a positive correlation between knowledge and attitude scores (r = 0.183, P < 0.001), as well as between knowledge and practice scores (r = 0.169, P < 0.001). A higher attitude score was significantly associated with a higher practice score (r = 0.245, P < 0.001), as supported by structural equation modelling. Multivariate logistic regression revealed that attitude score (OR = 1.238), suburban residence (OR = 2.524), monthly household income exceeding 5000 RMB (OR = 3.539), BMI less than 20 kg/m2 (OR = 2.155, P = 0.029), BMI between 20 and 24 kg/m2 (OR = 2.387), and BMI between 25 and 29 kg/m2 (OR = 4.063) were independently linked to proactive practices (all P < 0.05). Additionally, Structural Equation Modelling (SEM) elucidated the intricate relationship between sociodemographic factors and KAP dimensions. Despite positive attitudes and proactive prevention efforts, heart failure patients exhibit a knowledge gap. Tailored educational interventions by healthcare providers could effectively bridge this gap, leveraging patients’ positive attitudes and proactive behaviours to reinforce preventive measures.

Predictors of neonatal hypothermia within six hours of birth and exploring preventive practices among post-natal mothers in Kilimanjaro region: Explanatory sequential mixed method protocol.

Neonatal hypothermia is a worldwide problem that can lead to a high impact on neonatal health outcomes if appropriate thermal care measures are not implemented. Tackling neonatal hypothermia from the time of delivery with appropriate thermal care measures will increase neonatal survival and decrease complications related to hypothermia. The study aims to determine the predictors of neonatal hypothermia within six hours of birth and explore its preventive practices among postnatal mothers. This is a mixed-method sequential explanatory study. The first phase will be a quantitative study with a hospital-based analytical cross-sectional design. 325 neonates and their mothers will be randomly selected through a 4-stage sampling technique. The data will be collected using a structured questionnaire, checklist and documentary review. Descriptive and inferential statistics will be used to analyse the data. The second phase will be a descriptive qualitative study involving postnatal mothers who participated in a quantitative study. The data will be collected via in-depth interviews, and thematic analysis will be used to analyse the data. The findings of quantitative and qualitative studies will be triangulated in the discussion. This study will provide a wide understanding of neonatal hypothermia in the region which will help healthcare providers who are caring for neonates to be informed about the current situation, evaluate the care they provide, and find the best way to adhere to thermal care measures. Moreover, the practices of postnatal mothers will be known, which will help to develop tailored interactions to address this problem.

Evolution of WHO COVID-19 mask guidelines amid intense demands for rapid advice.

During a health emergency, there is an urgent need to rapidly develop guidelines that meet minimum quality standards, as exemplified by the development of WHO guidelines on mask use in health care and community settings during the COVID-19 pandemic. Between January 2020 and October 2023, WHO developed 21 guideline updates on the use of masks as part of infection prevention and control (IPC) practices. Guideline developers had to deal with an ever-growing volume of evidence of variable quality. Initially, indirect evidence drawn from other severe respiratory illnesses and established minimum requirements for IPC were used. As direct evidence began to emerge, WHO commissioned a living systematic review on mask use in June 2020, which formed the basis of evidence-to-decision making. As more evidence became available, additional considerations were incorporated into the process of recommendation formulation, including harms, acceptability, feasibility and resource use. Target populations for the mask guidelines expanded to include the general public, including children. A broad range of disciplines supported guideline development, including IPC, epidemiology, infectious diseases, occupational health, engineering, pneumology, paediatrics, and water, sanitation and hygiene, as well as civil society representatives. Additional expertise was engaged in the areas of ventilation and aerobiology to expand the range of perspectives regarding modes of transmission. Despite challenges, the experience of rapidly and regularly updating advice on mask use during an emergency health response has shown that it is possible to apply the minimum standards for ensuring the guideline methodology is trustworthy and transparent, with increasing rigor over time as evidence improves. Overall, the experience of developing guidelines during the COVID-19 pandemic underscores the importance of adapting to evolving evidence, incorporating diverse perspectives, and maintaining transparency to ensure a rigorous methodology and in return guideline trustworthiness and effectiveness.

A Cross Community Comparison of Muting in Conversations of Gendered Violence on Reddit

Gender-based violence (GBV) is an ongoing public health issue. Prevention practice and research on GBV contend with an incomplete understanding of its public health burden due to gender-exclusive definitions of GBV and inhibited survivor disclosure. Prior work in CSCW and HCI has explored sensitive disclosures and GBV conversations but excludes examination of conversation dynamics in surfacing knowledge of GBV. We used a mixed-methods approach to understand the phenomenon characterized by Muted Group Theory as a mechanism inhibiting disclosure in the context of GBV discussions on Reddit. Using an iterative process informed by literature of GBV research on cis-gender women, girls, trans, and non-binary populations, we developed comprehensive keywords to obtain, annotate, and analyze 298 posts and 10,369 comments about GBV across 7 subreddits. We found that muting faced by survivors offline, precluding reporting, is replicated on the Reddit platform. This study surfaced 5 categories of muting in discussions of GBV situated by variations in communication norms between dominant and non-dominant groups. These findings were supported by analysis of linguistic attributes that inform an Ensemble Classifier's detection of muting in conversations of GBV. The results offer that muting is a harmful occurrence in online disclosures of GBV that is mediated by existing moderation practices. This work contributes an expanded understanding of GBV conversations online, muting as a feature of those conversations, and an initial foray into detection to inform muting prevention.

Role for Lumbar Cerebrospinal Fluid Drainage in High-risk Thoracic Endovascular Aortic Repair: A Narrative Review.

Lumbar cerebrospinal fluid (CSF) drainage is one of the few preventative and therapeutic practices that may reduce spinal cord ischemia in high-risk thoracic endovascular aortic aneurysm repair (TEVAR). Although this is part of clinical guidelines in open thoracoabdominal aortic repair, there are no randomized controlled trials that provide convincing evidence on the protection conferred by CSF drainage in high-risk TEVAR patients. This gap in knowledge obfuscates clinical decision making given the risk of significant complications of CSF drain insertion and management. The current literature is inconclusive and provides conflicting results regarding the efficacy of, and complications from, CSF drainage in TEVAR. Filling the knowledge gap resulting from the limited current state of the literature warrants additional high-quality randomized controlled clinical trials that balance CSF drainage efficacy with potential complications in high-risk TEVAR patients.

Evaluation of Nurses’ attitudes, behaviors, and barriers toward pressure ulcer prevention in neonatal and pediatric intensive care units

IntroductionPressure ulcers are a significant concern in pediatric intensive care units, with prevalence rates ranging from 0.8% to 27%. They pose serious physical and psychological challenges, particularly in neonatal and pediatric intensive care units (NICU and PICU). This study explores nursing strategies, attitudes, and barriers toward pressure ulcer prevention in NICU and PICU settings.MethodsUsing a descriptive study design, data were collected from 80 nurses working in NICU and PICU through validated questionnaires, including a demographic profile and a pressure ulcer survey. Descriptive statistics were employed to calculate mean scores and percentages, while inferential statistics assessed associations between variables.ResultsThe study revealed specific nursing strategies, along with significant barriers and attitudes toward pressure ulcer prevention in NICU and PICU. The total attitude mean score was 3.57, with the highest positive response (mean = 4.29) for “most pressure sores can be avoided”, and the highest negative response (mean = 3.86) for “pressure sore prevention is a low priority for me”. Among participants, 72.5% conducted risk assessments on all patients, 60% had written prevention care plans, and 76.3% implemented preventive strategies. Barriers such as staff shortages and time constraints were reported by 76.2% of nurses. Multivariate analysis indicated that nurses with more than 10 years of qualification (OR = 3.67) and permanent staff with over 10 years of employment (OR = 4.31) were significantly more likely to engage in preventive practices. The use of a pressure ulcer grading tool (OR = 2.49, P &amp;lt; 0.05) and participation in formal training (OR = 3.14, P &amp;lt; 0.05) were also positively associated with preventive practices.DiscussionThese findings underscore the importance of structured assessment tools, ongoing education, and the need to foster positive attitudes among nurses to effectively reduce pressure ulcer prevalence and enhance patient outcomes in NICU and PICU settings.