Prevention Initiatives Research Articles

Abstract P236: Association Between Perceived Discrimination and Arterial Stiffness in Non-Hispanic Black Adults

Introduction: Racial discrimination is a chronic stressor that may contribute to cardiovascular disease (CVD) disparities in non-Hispanic Black (NHB) adults. Compared to non-Hispanic White adults, NHB adults experience greater perceived discrimination (PD), chronic perceived stress (PS), and burden of CVD risk. However, associations between PD, PS, and CVD risk, measured as arterial stiffness (AS), have not been tested in a population-based study of NHB adults in the US, limiting our understanding of whether and how CVD prevention initiatives should target PD and PS. Purpose: Determine the association between PD and AS, and whether this association is modified by biological sex and mediated by PS. Hypothesis: We hypothesized a direct association between PD and AS and that associations will be stronger in females and mediated by PS. Methods: Study sample included 594 NHB adults with complete data who participated in the Jackson Heart (JHS) and Atherosclerosis Risk in Communities (ARIC) studies’ shared cohort. PD (lifetime, everyday, and burden of lifetime discrimination) and PS were measured at JHS baseline (2000-2004). AS was measured at ARIC Visit 5 (2011-2013). PD and PS were coded as continuous variables. Effect modification was evaluated by including an interaction term between sex and PD in fully adjusted models. Mediation was assessed via the natural indirect effects from the CAUSALmed procedure. Models were adjusted for age, sex, body mass index (BMI), blood pressure medication, diabetes status, and mean arterial pressure (MAP). Results: Participants had a mean [95% confidence interval (95%CI)] age of 64.7 [64.3, 65.1] years, BMI of 30.1 [29.7, 30.6] kg/m 2 ; 69% (410 of 594) were female, 24% (143 of 594) had diabetes, and 70% (416 of 594) had hypertension. Mean [95%CI] total scores for everyday, lifetime, and burden of lifetime PD were 1.96 [1.89, 2.03], 2.97 [2.81, 3.14], and 2.28 [2.21, 2.34], respectively. Mean [95%CI] AS, measured as pulse wave velocity, was 12.42 [12.15, 12.70] m/s. A 1-unit increase in lifetime PD score was associated with a decrease in AS ( β =- 0.30 [-0.57, -0.02] m/s ). The association remained after adjusting for demographics and clinical characteristics ( β= -0.29 [-0.55, 0.02] m/s ), but was no longer statistically significant when including MAP ( β= -0.21 [-0.46, 0.05] m/s ). There were non-significant associations between everyday PD and burden of lifetime PD and AS. There was no evidence of effect modification by sex or mediation by PS. Conclusion: Higher lifetime PD, but not everyday PD or burden of lifetime PD, was associated with lower AS in crude models. However, the association was attenuated to non-significance when adjusted for MAP, suggesting the association between PD and AS may be pressure-dependent. Future studies characterizing PD’s role in CVD risk development in other geographical regions and NHB populations.

Cancer Registry in Bangladesh: Challenges and Opportunities

The Cancer Registry is a database created for collecting, managing, and storing information about people with cancer. Collaborative research, preventive, and treatment initiatives benefit nations with cancer registries. Several Asian countries have recently made their cancer registries. It is done by a designated Organization, such as the National Cancer Registry Programme (NCRP) in India and National Cancer Registry (CNCR) in China. Both countries decentralized their programs in different parts of their country. Bangladesh’s National Cancer Registry has not yet been established due to a lack of government policy, fund allocation, trained manpower, workforce, awareness, and readiness among health professionals.

Veterans Crisis Line Contacts After the 988 Suicide and Crisis Lifeline Rollout

IntroductionThis study identifies changes in Veterans Crisis Line (VCL) contact volume following the 988 National Suicide Prevention Hotline rollout, and examines changes in contact volume for self-identified Veterans. MethodsVCL's Medora database was analyzed from July 2018-June 2023, fitting linear interrupted time series models to forecast trends after the July 2022 rollout of the 988 Suicide Prevention Hotline. Data analysis was performed from 2023-2024. ResultsAfter the 988 rollout, average monthly VCL contact volume increased by 5,388 contacts (8.2%). The number of contacts self-identifying as Veterans increased by 2,739 (6.2%), while the percentage of self-identifying Veteran contacts who could be linked to VHA records declined by 3.8%. ConclusionsThe 988 rollout was associated with increased VCL contact volume and broad changes in the profile of users. This underscores the importance of crisis services in adapting to dynamic user needs and highlights the potential of national suicide prevention initiatives to reach diverse populations.

Bloodstream infections and multidrug resistant bacteria acquisition among burns patients in Australia and New Zealand: A registry-based study

IntroductionThis study interrogates infection related data in the Burns Registry of Australia and New Zealand (BRANZ), to examine associations of multi-drug resistant organisms (MDROs) and blood stream infection (BSI). MethodsData between July 2016 and June 2021 were analysed to determine prevalence, risk factors and outcomes associated with BSIs and MDROs: Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Pseudomonas spp. (CRP), and carbapenem-resistant Enterobacter (CRE). Data completeness and value for quality improvement activity were assessed. ResultsWe found a low incidence (3.4%) of the resistant organisms of interest, and no change over the study period. Fequency varied between services and increased with age and size of burn. MRSA was the commonest organism in all age groups. A positive BSI result occurred in 1.6% of patients (12.1% of cultures taken) at a median time of 10.2 days post injury. Free text identification of organisms was inconsistently documented. ConclusionsThe low rate and patterns of acquisition of MDROs of interest and BSIs is comparable with reports from countries with low incidence of massive burns. Wider adoption of a standardized laboratory reporting framework would help realise the potential of clinical quality registries to provide data which supports evidence based infection prevention initiatives.

Characterizing Patients Presenting on Hospital Admission With Central Line-Associated Bloodstream Infections: A Multicenter Study.

There are no systematic measures of central line-associated bloodstream infections (CLABSIs) in patients maintaining central venous catheters (CVCs) outside acute care hospitals. To clarify the burden of CLABSIs in these patients, we characterized patients with CLABSI present on hospital admission (POA). Retrospective cross-sectional analysis of patients with CLABSI-POA in 3 health systems covering 11 hospitals across Maryland, Washington DC, and Missouri from November 2020 to October 2021. CLABSI-POA was defined using an adaptation of the acute care CLABSI definition. Patient demographics, clinical characteristics, and outcomes were collected via record review. Cox proportional hazard analysis was used to assess factors associated with the all-cause mortality rate within 30 days. A total of 461 patients were identified as having CLABSI-POA. CVCs were most commonly maintained in home infusion therapy (32.8%) or oncology clinics (31.2%). Enterobacterales were the most common etiologic agent (29.2%). Recurrent CLABSIs occurred in a quarter of patients (25%). Eleven percent of patients died during the hospital admission. Among patients with CLABSI-POA, mortality risk increased with age (hazard ratio vs age <20 years by age group: 20-44 years, 11.2 [95% confidence interval, 1.46-86.22]; 45-64 years, 20.88 [2.84-153.58]; ≥65 years, 22.50 [2.98-169.93]) and lack of insurance (2.46 [1.08-5.59]), and it decreased with CVC removal (0.57 [.39-.84]). CLABSI-POA is associated with significant in-hospital mortality risk. Surveillance is required to understand the burden of CLABSI in the community to identify targets for CLABSI prevention initiatives outside acute care settings.

Understanding Knowledge, Attitude, and Practices towards Sickle Cell Disease among Adult Outpatients: Insights from Lira Regional Referral Hospital, Northern Uganda

This study investigates the knowledge, attitude, and practices (KAP) regarding sickle cell disease (SCD) among adult outpatients at Lira Regional Referral Hospital (LRRH) in Northern Uganda. Employing a descriptive cross-sectional qualitative approach, data were collected from 100 adult patients aged 18 years and above attending the general outpatient department (OPD) at LRRH. Results revealed a substantial level of awareness of SCD among respondents, predominantly sourced from healthcare facilities and media outlets. While many recognized SCD as hereditary, misconceptions regarding its etiology and symptoms were evident. Notably, there was a knowledge gap regarding the treatability of SCD. Attitudes towards marrying individuals with SCD were predominantly negative, reflecting concerns about genetic transmission. However, there was a positive inclination towards premarital SCD testing. Regarding practices, reliance on medical facilities for SCD treatment was predominant, with minimal engagement with alternative therapies. Recommendations include sustained awareness campaigns, integration of SCD prevention and control initiatives, and further research to elucidate regional SCD prevalence determinants. Efforts to enhance male involvement in SCD advocacy and capacity building among healthcare providers are advocated to optimize SCD management and prevention strategies within the community. Keywords: Knowledge, Attitude, Practices, Sickle Cell Disease, Outpatients

Preventing smoking initiation in adolescents living in vulnerable socioeconomic conditions: Study protocol of the KickAsh!-intervention.

Adolescents living in vulnerable socioeconomic conditions are confronted with tobacco-related health disparities. As school-based interventions appear to be less effective among these youngsters, other approaches are necessary. One promising avenue is youth social work settings that offer sport and recreational activities (SR-settings). SR-settings have been examined as a levering context for health promotion, but evidence regarding smoking prevention is currently lacking. This study describes the protocol of a non-randomised cluster controlled trial evaluating a smoking prevention intervention for adolescents. At least 24 SR-settings are needed for the intervention and control group. A mixed-method design will be used. Quantitative measures will be used to assess effectiveness, involving validated questionnaires on smoking initiation behaviour and influencing factors (i.e. attitude, self-efficacy, social influence and risk perception). In addition, feasibility will be assessed with regard to intervention fidelity, dose and reach. Data will be collected at baseline, three and nine months following the intervention. To gain deeper understanding on the impact and underlying processes of the intervention, we will conduct qualitative interviews with users (adolescents) and implementers (youth workers within the SR-settings) of the intervention. Conducting this trial will offer novel insights into the effectiveness of a smoking prevention intervention designed for adolescents living in vulnerable socioeconomic conditions. A mixed-method design will enable to measure impact, implementation and underlying processes of the intervention. Overall, this design will enhance our understanding on the suitability of SR-settings as contexts for smoking prevention initiatives targeting hard-to-reach youth. This trial is registered on Clinicaltrials.gov: NCT05920772.

Bad mothers vs good mothers of the nation: The dual faces of Tunisian women in terrorism and in preventing extremism

ABSTRACT This article seeks to critically examine how gender influences the interpretation and representation of women’s violence within the Tunisian public discourse. Far from being gender-neutral, the counterterrorism discourse perpetuates entrenched patriarchal hierarchies, amplifying imbalanced power dynamics within society. The study, utilizing tools from feminist critical discourse analysis, aims to shed light on how female involvement is depicted in public discussions on terrorism in Tunisia, and how this affects counterterrorism strategies and preventive measures in the post-revolutionary setting. This is achieved primarily by scrutinizing the discourse of jihād al-nikāḥ, and by exploring women’s roles in programmes aimed at preventing violent extremism (PVE). Emphasis is given to the depiction of women as mothers – viewed negatively when embracing political violence and positively when engaging in extremism prevention initiatives. While one narrative often paints women merely as victims or brainwashed entities, the PVE policies acknowledge women’s agency but instrumentalize it for security-oriented objectives.

Risk and Promotive Factors Related to Cannabis Use Among American Indian Adolescents.

Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing and targets for prevention initiatives. This study aimed to develop predictive models for the usage of cannabis using 22 salient risk and promotive factors. Models were developed using data from a cross-sectional study and further validated using data from a separate longitudinal study with three measurement occasions (baseline, 6-month follow-up, 1-year follow-up). Application of the model to longitudinal data showed an acceptable performance contemporaneously but waning prospective predictive utility over time. Despite the model's high specificity, the sensitivity was low, indicating an effective prediction of non-users but poor performance in correctly identifying users, particularly at the 1-year follow-up. This divergence can have significant implications. For example, a model that misclassifies future adolescent cannabis use could fail to provide necessary intervention for those at risk, leading to negative health and social consequences. Moreover, supplementary analysis points to the importance of considering change in risk and promotive factors over time.

Working Paper 50: Seedlings of hope: Addressing corruption linked to crimes that impact the environment in line with UNCAC Resolution 8/12

At the 8th session of the Conference of the States Parties to the United Nations Convention against Corruption (UNCAC), in December 2019, States parties adopted a resolution recognising the relationship between corruption and environmental crimes. &#x0D; Resolution 8/12 – Preventing and combating corruption as it relates to crimes that have an impact on the environment – is a landmark Resolution. With its 23 operative paragraphs (OPs), it underlies the importance of addressing corruption linked to crimes that have an impact on the environment. It urges States parties to prevent, investigate and prosecute corruption offences where they may be linked to crimes that have an impact on the environment. &#x0D; This Working Paper report presents a concise overview of prevention and enforcement actions, initiatives and measures implemented by UNCAC States parties between 2019 and 2023 to combat corruption as it pertains to crimes that have an impact on the environment. Section 2 focuses on prevention and Section 3 on enforcement actions.&#x0D; Section 4 underscores the valuable contributions made by non-state actors, in particular civil society, academia and the media in this collective endeavour.&#x0D; The conclusion includes a list of promising initiatives for corruption prevention and enforcement.

Tobacco use and its associated factors among middle and old-aged women in India using LASI wave-1 data.

Despite a global decline in tobacco use reported by the Global Adult Tobacco Survey (GATS), India stands out for its high number of tobacco users. While research in India often focuses on tobacco use among young adults, there's a notable lack of studies addressing tobacco use among middle and old-aged women. However, the national prevalence of tobacco use among middle and old-aged (45 years and above) women in India is 18.2%. Thus, this study seeks to identify the factors influencing tobacco consumption among middle and old-aged women in the country. The study has utilized secondary data from Longitudinal Aging Study in India (LASI) conducted in 2017-18. This study exclusively included a total of 38,180 middle and old-aged women who reported tobacco use. The analysis encompassed the utilization of Chi-square tests and Binary logistic regression to pinpoint the risk factors linked to tobacco use among middle and old-aged women. Our study reveals a heightened likelihood of tobacco use among middle and old-aged women residing in the northeastern region of India. The study underscores the imperative to direct targeted efforts toward middle and old-aged women who fall into specific categories, including those who are widowed, separated, or unmarried, individuals who consume alcohol, those with lower socioeconomic and educational standings, residents of rural areas, those living in solitude, individuals experiencing depressive symptoms, and those who self-report poor health. Given the heightened susceptibility of these demographic groups to tobacco use, it is crucial to prioritize tobacco prevention and cessation initiatives specifically tailored to their needs and circumstances.

Public knowledge of button battery ingestions: A social media based cross-sectional analysis

IntroductionButton battery (BB) ingestion injuries are a devastating and preventable event within the pediatric population. Efforts to reduce the prevalence of esophageal button battery ingestion injuries include primary preventative measures. It is integral to assess the public's baseline knowledge about BB injuries to tailor future primary prevention efforts. MethodsThis is a crowdsourcing survey-based study. Participants were notified through our institution's Twitter and Instagram accounts. ResultsThere were 930 completed survey responses from May to June 2022. The survey found that 87% (791/910) knew that swallowing a BB could cause injury and 71% knew that it could cause death (642/905). Eight-five percent of respondents did not know what signs and symptoms to look for after BB ingestion, only 30% (99/340) of healthcare professionals felt they would know. Only 10.1% (94/930) of participants knew to give children over 12 months old honey after suspected BB ingestion. Thirty-four percent (311/930) knew that complications could still occur even after BB were removed. Seventy-seven percent (719/930) knew that a dead BB could cause injury but only 17% knew the correct way to dispose of a dead button battery (158/930). Only 8% (72/930) of participants were knew that wrapping dead BB in tape could potentially prevent injury. ConclusionThe current study reveals gaps in the public's understanding of BB injury including: the presentation of BB injuries; the delayed harm of BB impactions; management and mitigation strategies, and BB disposal methods. This survey provided imperative insights to help guide future education and primary prevention initiatives. Level of evidence3.

Integrating Fall Prevention Strategies into EMS Services to Reduce Falls and Associated Healthcare Costs for Older Adults.

The purpose of this study is to detail the implementation of fall prevention initiatives through emergency medical services (EMS) and associated outcomes. Paramedics with MedStar Mobile Healthcare utilized the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall prevention model to screen and direct intervention through 9-1-1 emergency response, High Utilization Group (HUG), and 30-day Hospital Readmission Avoidance (HRA) programs. Outcomes from 9-1-1 calls measured the number of older adults screened for falls and identified risk factors. The HUG and HRA programs measured change in quality of life with EuroQol-5D, referral service utilization, falls, emergent healthcare utilization, and hospital readmission data. Analysis included costs associated with reduced healthcare usage. Emergency paramedics provided fall risk screening for 50.5% (n=45,090) of adults aged 65 and older and 59.3% were at risk of falls, with 48.1% taking medications known to increase the risk of falls. Services provided through the HUG and HRA programs, along with additional needed referral services, resulted in a 37.2% reduction in fall-related 9-1-1 calls and a 29.5% increase in overall health status related to quality of life. Analysis of the HUG program revealed potential savings of over $1 million with a per-patient enrolled savings of $19,053. The HRA program demonstrated a 16.4% hospital readmission rate, in comparison to a regional average of 30.2%, and a cost-savings of $4.95 million or $15,618 per enrolled patient. Implementation of the STEADI model into EMS services provides an effective and cost-saving model for addressing fall prevention for older adults, provides meaningful and impactful improvement for older adults, and could serve as a model for other EMS programs.

Impact of social factors responsible for Juvenile delinquency - A literature review.

Juvenile delinquency appears to be the most widespread social issue in comparison to other social issues. Social factors and conditions have a significant impact on the prevalence of delinquency. Individuals who engage in criminal behavior before reaching the age of 18 are commonly referred to as juvenile offenders. The aim of this study is to comprehensively elucidate the research and work carried out on juvenile offenders, with a specific focus on the critical role played by social factors in all facets of juvenile delinquency. Additionally, this research seeks to investigate the social roots and influences that contribute to the criminal behavior of young offenders. This article uses a literature review methodology to analyze research on social factors influencing juvenile delinquency. It synthesizes and evaluates prior findings to understand the complex interplay between social factors and young individuals' involvement in delinquent behaviors. The study analyzed 80 articles from reputable online databases, focusing on juvenile delinquency, offenders, crime, and social factors. Out of the 80 articles, 53 were cited, meeting inclusion criteria, including publication within 2000-2023, rigorous peer-review, and reputable database indexing. As per the findings of the research, it has been observed that children who grow up in households that exhibit affection, hospitality, and encouragement are comparatively less susceptible to the manifestation of societal maladies. Children who have experienced parental abandonment are at heightened risk of developing delinquent behaviors. The presence of negative family dynamics and associations with delinquent peers are widely recognized as significant contributors to the development of drug abuse behavior. It is imperative for policymakers and preventive initiatives to have a comprehensive understanding of this complex relationship. Therefore, this literature review presented a distinct overview of the influence of social factors on juvenile offenders in India.

Predictors of non-fatal suicide attempts among Veterans Health Administration (VHA) patients who experienced military sexual trauma.

Military sexual trauma (MST) has been identified as a risk factor for suicidal behavior. To inform suicide prevention efforts within the Veterans Health Administration (VHA), this study evaluates predictors of non-fatal suicide attempts (NFSAs) among VHA patients who experienced MST. For VHA patients in fiscal year (FY) 2019 who previously screened positive for a history of MST, documented NFSAs were assessed. Using multivariable logistic regression, demographic, clinical, and VHA care utilization predictors of NFSAs were assessed. Of the 212,215 VHA patients who screened positive for MST prior to FY 2019 and for whom complete race, service connection, and rurality information was available, 1742 (0.8%) had a documented NFSA in FY 2019. In multivariable logistic regression analyses, total physical and mental health morbidities were not associated with NFSA risk. Predictors of a documented NFSA included specific mental health diagnoses [adjusted odds ratio (aOR) range: 1.28-1.94], receipt of psychotropic medication prescriptions (aOR range: 1.23-2.69) and having a prior year emergency department visit (aOR = 1.32) or inpatient psychiatric admission (aOR = 2.15). Among VHA patients who experienced MST, specific mental health conditions may increase risk of NFSAs, even after adjustment for overall mental health morbidity. Additionally, indicators of severity of mental health difficulties such as receipt of psychotropic medication prescriptions and inpatient psychiatric admissions are also associated with increased risk above and beyond risk associated with diagnoses. Findings highlight targets for suicide prevention initiatives among this vulnerable group within VHA and may help identify patients who would benefit from additional support.

Measuring Motivations to Eat Palatable Foods: Adaptation and Psychometric Properties of the Italian Version of the Palatable Eating Motives Scale (PEMS-IT).

Gaining knowledge of the various reasons behind people's consumption of highly processed foods has the potential to enhance obesity prevention initiatives and open avenues to tailor treatment approaches for obesity and binge eating at a more personalized level. This contribution aimed to test the psychometric properties and factor structure of the Palatable Eating Motives Scale (PEMS-IT) in a community sample of Italian adults. A confirmatory factor analysis was performed to test the factor structure of the Italian version of the PEMS (PEMS-IT) on a total of 616 respondents. Furthermore, the reliability and convergent validity analysis of the tool were evaluated. The analysis confirmed the four-factor structure of PEMS-IT [(YBχ2 (164) = 537.901; p < 0.001, the CFI = 0.918, RMSEA = 0.072; 90%CI [0.065-0.078]; p(RMSEA < 0.05) < 0.001, and SRMR = 0.080] and satisfactory reliability on its subscales (Cronbach's α: 0.745-0.917). Positive correlations were also found with food addiction and binge-eating symptoms, compulsive eating behavior, and uncontrolled and emotional eating. The PEMS-IT appears to be an instrument with promising psychometric properties and potential applications in clinical settings. However, it also has some limitations, and future studies could focus on improving the semantic content of the elements to increase the overall utility and precision of the instrument.

Obstacles and facilitators to preventing fetal alcohol spectrum disorder: a qualitative study with general practitioners.

Fetal Alcohol Spectrum Disorders are the leading cause of non-genetic intellectual disability. The damage caused, although completely preventable, is irreversible and requires lifelong support. General Practitioners have an important role in the prevention of Fetal Alcohol Spectrum Disorders. However, evidence suggests that General Practitioners do not monitor systematically alcohol consumption among pregnant women. The aim of this study was to understand the barriers and motivations of General Practitioners in the prevention of Fetal Alcohol Spectrum Disorders on Reunion Island. A qualitative research study was conducted by conducting semi-structured individual interviews with general practitioners. Participants were selected by random or snowball sampling. General practitioners who worked only in unscheduled care services were excluded from this study. After the interviews were transcribed, a verbatim analysis was performed according to the principles of grounded theory. Twenty interviews were conducted by two researchers between November and December 2020. General practitioners expressed discomfort in addressing alcohol consumption and excessive drinking in women. They had inaccurate theoretical knowledge and a lack of practical experience with Fetal Alcohol Spectrum Disorders. They also showed little knowledge of the Fetal Alcohol Spectrum Disorders care pathway available on Reunion Island. Both patients and general practitioners expressed discomfort when discussing women's alcohol consumption. Conflicting government policies were highlighted as alcohol promotion campaigns overshadowed Fetal Alcohol Spectrum Disorders prevention initiatives. General practitioners should be open and non-judgmental in their interactions with women and couples, with a focus on early detection and short-term intervention. General practitioners should be better educated about Fetal Alcohol Spectrum Disorders and have a clearer understanding of the Fetal Alcohol Spectrum Disorders care pathway.

A framework for national-level prevention initiatives in Indian schools: A risk reduction approach

India's mental health policies predominantly prioritize treatment and rehabilitation. While acknowledging the significance of youth well-being, the initiatives undertaken are fragmented, lacking comprehensive data on reach and utilization. Mounting evidence supports the preventability of mental illnesses, highlighting the cost-effectiveness of prevention initiatives, particularly within school-based programs. This paper aims to delineate a preventive framework centered on schools, employing the six-step OrigAMI (Origins of Adult Mental Illnesses) model. This model targets modifiable risk factors to stop the development of mental illnesses. Each step of this model is dissected and examined within the context of the school environment, elucidating the unique and influential role that educational institutions can undertake in preventive initiatives in India. In the initial step, the paper identifies modifiable risk factors in children and adolescents that can be addressed within the school environment. The second and third steps involve pinpointing the target demographic and utilizing data from comprehensive reviews of mental health initiatives. The fourth and fifth steps delineate the workforce structure, advocating for task shifting to non-specialists, engaging school stakeholders and parents, and establishing a systematic workforce framework. The final step delves into policy implications, exploring the potential to reduce the prevalence of mental illness by focusing on risk factors with a high Population Attributable Fraction. This section also contrasts the proposed approach in terms of expenditure against the current budget allocations. The paper culminates with a recommendation to integrate these preventive programs into existing healthcare policies, positioning schools as central to these prevention efforts. The integration of prevention programs into healthcare policies aims to reduce prevalence rates and alleviate the burden on the healthcare system.

Development and validation of fall risk perception scale for patients with Parkinson's disease.

Perception assessment plays an important role in fall risk awareness and fall prevention. Parkinson's disease patients with motor dysfunction are at high risk of falling. Currently, no instrument has been explicitly crafted to assess the risk perception of fall in PD patients. The purpose of this study was to develop and validate the fall risk perception scale for PD patients (FRPS-PD), providing healthcare professionals with a effective assessment tool to enhance proactive fall prevention initiatives. Based on the Proactive Health theory and Risk Perception Attitude (RPA) Framework, the questionnaire was developed through literature review, semi-structure interview, expert consultation and pilot testing. A total of 428 patients with PD from Grade A tertiary hospitals in Shanghai, Hangzhou and Anhui from January 2023 to July 2023 were recruited. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and test-retest reliability analysis. A total of 16-items, 2-dimensions structure were identified, including 12 items of risk perception and 4 items of self-efficacy dimension. The cumulative variance of EFA model was 73.669%, further CFA showed that acceptable model fit (χ2/df = 2.226, RMSEA = 0.074, NF = 0.928, TLI = 0.951, CFI = 0.959, GFI = 0.887 and AGFI = 0.848). The content validity index was 0.956. The reliability of the scale was 0.952 using Cronbach's α coefficient method. The test-retest reliability was 0.944. The FRPS-PD is a valid and reliable measurement for evaluating fall risk perception level for individuals with PD in mainland China.

Mitigating Cyberbullying among Teens: The Crucial Role of Moral Education in School Curricula

The increasing prevalence of cyberbullying has become a distressing form of entertainment for bullies throughout history and today. Therefore, it is crucial to fully understand the complex dimensions of this issue. This analysis investigates the origins and growth of cyberbullying strategies, in tandem with the rapid advancement of communication technologies. The paper highlights the challenges of addressing cyberbullying due to its intricate nature, which is facilitated by devices like cell phones and social media platforms. Despite schools being centers for academic and moral development, cyberbullying continues to impact the emotional well-being of teenagers. The study promotes the implementation of thoughtful curricula that incorporate activities empowering teenagers to recognize and counter self-defeating ideas, ultimately reducing cyberbullying rates. The paper underscores the importance of researching the various forms of cyberbullying and discusses potential preventative initiatives, urging educators to design curricula that address the emotional and behavioral issues that contribute to cyberbullying. Keywords: Cyberbullying, Moral education, Teenagers, School curriculum, Emotional impacts, Preventative initiatives and Character education