Prevention Project Research Articles

Epidemiological characteristics of human rabies cases reported by sites in China from 2006 to 2022

BackgroundRabies is an incessant public health threat in China. The Ministry of Health implemented the Central Payment for Rabies Prevention and Control Project to assist with rabies prevention and control in a few representative provinces in 2006.MethodsData on human rabies cases reported by the National Infectious Disease Reporting Information Management System and national surveillance sites from 2006 to 2022 were collected, and statistical and multivariate analyses were then used to assess the effectiveness of current prevention and control efforts.ResultsDuring 2006–2022, a total of 2025 human rabies cases were collected by the national surveillance sites, with incidence rates far above the national average, but the incidence rate was consistent with the national trend. Human rabies cases demonstrated a dual peak distribution in terms of exposure and onset dates, with the peak exposure dates falling mostly in the spring and summer and the peak onset dates occurring mostly in the summer and autumn. Three danger categories are shown by the geographical distribution: high, medium and low. Dogs had a high infection rate (86.93%), with own domesticated dogs accounting for the majority of infections. The rates of post-exposure prophylaxis are not constant. The median incubation period was 71 days.ConclusionsVarious measures and policies implemented by the government have played a key role in reducing the incidence of rabies. To effectively prevent and control the resurgence of epidemics and halt the spread of the virus among host animals, it is imperative to prioritize and implement a robust dog management system, accelerate research and development of animal vaccines and improve the level of post-exposure prophylaxis.

Preventing Child Sexual Abuse and the Use of Child Sexual Abuse Materials: Following up on the German Prevention Project Dunkelfeld

Sexual interest in minors (i.e., pedophilia and hebephilia) is considered a risk factor for Child Sexual Abuse (CSA) and the use of Child Sexual Abuse Material (CSAM). This study examined the long-term development of CSA, CSAM use, associated cognitions, and quality of life among self-referred, help-seeking individuals diagnosed with pedophilic or hebephilic disorder (PHD) outside the judicial system. Of the 110 eligible men who had undergone therapy for PHD due to psychological distress or risk of offending, 56 were available for follow-up assessment 1–11 years after treatment. Behavioral manifestations, offense-supportive cognitions, and quality of life were evaluated using interviews and psychometric measures. At follow-up, 7.7% of participants with a history of CSA had re-offended, whereas 89.1% of previous CSAM users reported recidivism, although with less severe material. No new CSA offenses occurred among those without prior CSA. Treatment led to increased cognitive victim empathy and reductions in CSA-supportive and CSAM-supportive attitudes, but only the latter improvement persisted through follow-up. Participants exhibited elevated CSA-supportive attitudes relative to community norms at all time points and diminished quality of life at follow-up. Pedophilic and hebephilic disorder carry a persistent risk of sexual offending, particularly regarding CSAM use. Therapeutic gains in offense-supportive cognitions may erode over time without ongoing care. A comprehensive public health approach encompassing early detection, prevention, and expanded treatment access that addresses both the risk of reoffending and overall well-being is crucial for reducing sexual victimization and improving mental health outcomes for individuals from this target group.

The National Cancer Aid monitoring (NCAM-online) of ultraviolet radiation risk and protection behavior: a population-based observational trend study with four annual online survey waves

BackgroundUltraviolet (UV) radiation is the most important risk factor for skin cancer development. Sunlight is the main source of UV radiation in the general population. In addition, tanning beds are a source of artificial UV radiation. Since the incidence of skin cancer is increasing worldwide, it is necessary to monitor UV-related risk behaviors such as intentional indoor and outdoor tanning, as well as sun protection behavior in the general population and specific subgroups and settings. This is the aim of the National Cancer Aid Monitoring online (NCAM-online), a continuation and further development of the NCAM.MethodsThe NCAM-online is a longitudinal trend study consisting of four annual survey waves. Each year, 4,000 individuals aged 16–65 years living in Germany will be surveyed using online questionnaires. Each year, intentional indoor and outdoor tanning will be assessed. In addition, varying specific topics regarding skin cancer prevention, such as the utilization of skin cancer screening, will be addressed in the questionnaires.DiscussionThe findings of the NCAM-online will provide an important basis for the German Cancer Aid and Working Group on Dermatologic Prevention (Arbeitsgemeinschaft Dermatologische Prävention, ADP) to develop targeted prevention campaigns and projects aimed at preventing skin cancer. The explorative nature of the NCAM-online allows for the identification of new potential starting points for prevention and education. In addition, the longitudinal design allows for a description of the trend in the prevalence of intentional tanning. For tanning bed use, representative trend data from 2012 are available for Germany, to which NCAM-online will add annual data until 2027.

Universal Prevention Strategies to Prevent Opioid Misuse on a U.S. College Campus.

Opioid misuse and risk of death due to overdose are critical public health issues and young adults are at risk. College campus communities are ideal settings for the prevention of opioid misuse among young adults due to high enrollment rates, the diversity and availability of resources within the campus community, and the range of risk and protective factors that can be targeted. This practitioner narrative describes a grant-funded three-year opioid misuse prevention project implemented on a U.S. college campus. In keeping with the focus of the grant, the project involved a range of universal prevention activities implemented across the campus community. Lessons learned regarding factors that facilitated implementation in this community context are discussed and may be useful for others interested in implementing prevention activities to help prevent opioid misuse among young adults in their campus communities. Additionally, a reflection on the project and the efficacy of universal prevention to prevent opioid misuse among college students are offered for consideration.

Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work

Objective: There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials (PHE), a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers’ strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; here we report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement.Methods: A sequential mixed-methods research study was used to assess and explore longer-term outcomes among a sample of PHE graduates working in community public health roles.Results: Some 46% of eligible PHE graduates (n=70) completed a skills survey at three timepoints: Pre-PHE, post-PHE, and 3-to-6 months post-PHE completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (Beginner → Proficient, p<0.005), despite a slight drop in self-perceived ability in the 3-6 months post-PHE completion. Qualitative interviews with respondents and focus groups with their supervisors suggest PHE completion benefits participants’ everyday work by developing strategic skills, and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health.Conclusions: Successful completion of PHE provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive facilitated, online asynchronous capacity building programs may be an effective tool.

Deficiency of Peptidylglycine-alpha-amidating Monooxygenase, a Cause of Sarcopenic Diabetes Mellitus.

Peptidylglycine-α-amidating monooxygenase (PAM) is a critical enzyme in the endocrine system responsible for activation, by amidation, of bioactive peptides. To define the clinical phenotype of carriers of genetic mutations associated with impaired PAM-amidating activity (PAM-AMA). We used genetic and phenotypic data from cohort studies: the Malmö Diet and Cancer (MDC; 1991-1996; reexamination in 2002-2012), the Malmö Preventive Project (MPP; 2002-2006), and the UK Biobank (UKB; 2012). Exome-wide association analysis was used to identify loss-of-function (LoF) variants associated with reduced PAM-AMA and subsequently used for association with the outcomes. This study included n∼4500 participants from a subcohort of the MDC (MDC-Cardiovascular cohort), n∼4500 from MPP, and n∼300,000 from UKB. Endocrine-metabolic traits suggested by prior literature, muscle mass, muscle function, and sarcopenia. Two LoF variants in the PAM gene, Ser539Trp (minor allele frequency: 0.7%) and Asp563Gly (5%), independently contributed to a decrease of 2.33 [95% confidence interval (CI): 2.52/2.15; P = 2.5E-140] and 0.98 (1.04/0.92; P = 1.12E-225) SD units of PAM-AMA, respectively. The cumulative effect of the LoF was associated with diabetes, reduced insulin secretion, and higher levels of GH and IGF-1. Moreover, carriers had reduced muscle mass and function, followed by a higher risk of sarcopenia. Indeed, the Ser539Trp mutation increased the risk of sarcopenia by 30% (odds ratio 1.31; 95% CI: 1.16/1.47; P = 9.8E-06), independently of age and diabetes. PAM-AMA genetic deficiency results in a prediabetic sarcopenic phenotype. Early identification of PAM LoF carriers would allow targeted exercise interventions and calls for novel therapies that restore enzymatic activity.

The Relevance of Hypersexuality and Impulsivity in Different Groups of Treatment-Seekers With and Without (Exclusive) Pedophilia.

Hypersexuality and impulsivity are regarded as risk factors for sexual offending against children. Studies exploring these factors in undetected men who offended or are at risk of offending are rare. This study aims to investigate hypersexuality and impulsivity in treatment-seeking men with and without a diagnosis of (exclusive) pedophilia who committed child sexual abuse (CSA), consumed child sexual abuse images (CSAI), or feel at risk of offending sexually. Data were obtained from three child abuse prevention projects in Bamberg, Germany. We employed self-report (BIS-11, HBI), objective measures (TSO), and risk assessment tools (STABLE-2007). We computed Bayesian ordinal logit and binomial generalized linear models to explore differences between groups and to predict lifetime CSA and CSAI. Hypersexuality scores were particularly pronounced in patients with exclusive and non-exclusive pedophilia. Patients without pedophilia scored similarly to nonclinical samples. Impulsivity measures did not consistently differ between groups. We could not predict lifetime CSA and CSAI using impulsivity and hypersexuality measures. Sexual rather than general impulsivity seems to be an issue in men with pedophilia. The motivation to offend in patients without pedophilia is discussed.

The Deposition by Raffaello Sanzio: New analytical insights on old cross sections for the characterisation of pictorial palette

In 2020, 500th anniversary of Raffaello Sanzio death, his Deposition (1507), -the altarpiece known also as the Pala Baglioni, today located at the Borghese Gallery in Rome-has been subjected to conservative revision and preventive conservation project. This included in-depth diagnostic campaigns through most modern non-invasive techniques, together with the analysis of old cross sections from the same Pala. These latters, prepared between 1966 and 1972, preserved in ICR laboratory of chemistry and testing materials archive, have been used to deepen the knowledge of Raffaello painting techniques. The use of such cross sections was fundamental to verify the original pictorial film and restoration re-paintings before the conservation intervention in the same years.In this paper, the results of analytical insights on Raffaello pictorial palette are presented. The information is obtained by the analysis of the old ICR stratigraphic sections, through the use of Scanning Electron Microscope with Energy Dispersive X-Ray analysis (SEM-EDX) and micro-Raman (632.8 nm), while Surface Enhanced Raman Scattering (SERS) analysis through colloidal paste has been tested for the identification of organic lake-pigments present in low concentration and for the successful recognition of copper resinate, whose SERS spectrum is here reported for the first time, according to our knowledge. This combined diagnostic approach has made it possible to recognize the pigments employed in the different pictorial layers, such species in traces and those from organic materials, responding to open questions arising previous non-invasive analyses and highlighting further aspects of the illustrious master refined painting technique.

Study on debris flow discharge characteristics of check dam spillway

After a check dam is filled with sediment, the debris flow will flow out from the spillway. Insufficient discharge capacity of the spillway can lead to debris flow scouring the dam's shoulder and foundation. Therefore, it is necessary to study the discharge capacity of the spillway. It is of great importance for further optimizing the structural design of the check dam. This article analyzes discharge characteristics of debris flow of a spillway through a series of flume experiments. According to the motion states, it can be divided into five stages: contact stage of the spillway, flushing and climbing stage, increasing and reflux stage, stable discharge stage, and final discharge stage. We analyzed the influencing factors of the discharge capacity, including the type of spillway, bulk density of debris flow, scale of debris flow, flume gradient, and effective opening width of the spillway. Furthermore, we derived a calculation formula of discharge for the spillway based on Bernoulli's principle. Finally, we considered the influence of the ratio of flow area and Froude number to the discharge coefficient and established a calculation method of discharge. Consequently, we compared the calculated results with the measured results and found them to be in good agreement. Our research results provide a quantitative calculation method for the design of spillways and energy dissipation and erosion prevention projects under check dams, which is beneficial for improving engineering value and for better serving disaster prevention and reduction efforts.

Association between the triglyceride-glucose (TyG) index and stroke risk in Chinese normal-weight adults: a population-based study

BackgroundIdentifying high-risk populations and promoting stroke prevention measures can be achieved through studies on stroke and its risk factors. As a new alternative indicator of insulin resistance (IR), the triglyceride glucose (TyG) index may potentially increase stroke risk. However, the evidence confirming this association is inadequate and inconsistent, possibly due to variations in stroke assessment criteria or characteristics of the study populations. This study aims to evaluate the association between the TyG index and stroke risk level among individuals with normal-weight.MethodsA total of 30,895 participants aged ≥ 40 years with normal-weight were enrolled in this study. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Normal-weight was described as a body mass index (BMI) of 18.5-<24.0 kg/m2. Stroke risk was assessed by the Stroke Risk Assessment Scale, developed by the China National Stroke Screening and Prevention Project. To evaluate the associations between the TyG index and stroke risk level, multivariate logistic regression models were employed.ResultsResults showed that when the TyG index was considered as a continuous variable, each one unit increase in the TyG index was associated with a significantly higher risk of stroke [Moderate-risk (OR, 2.15; 95% CI, 2.03–2.28; P<0.001); High-risk (OR, 3.83; 95% CI, 3.57–4.10; P<0.001)]. Compared with Q1 of the TyG index, Q4 was significantly associated with moderate stroke risk (OR, 2.73; 95% CI, 2.50–2.99; P<0.001) and high stroke risk (OR, 5.39; 95% CI, 4.83–6.01; P<0.001). The continuous TyG index was an important risk factor for high stroke risk in the metabolically obese, normal-weight (MONW) individuals (OR, 3.44;95% CI, 2.92–4.06; P < 0.001). In the MONW individuals, when Q1 was used as a reference, participants in Q4 (OR, 5.33; 95% CI, 4.19–6.78; P < 0.001) was significantly associated with high stroke risk. Subgroup analysis showed significant interaction in the age and sex subgroups in the overall population (Pinteraction <0.001).ConclusionThe risk of stroke is increased with the TyG index among Chinese adults of normal weight; hence, the index may be an important indicator for identifying high-risk stroke populations among individuals with normal body weight.

Impact of Hepatitis Delta Virus Infection on the Selection of Hepatitis B Surface Antigen Mutations.

The interaction of multiple viruses in one host is thought to enhance the development of mutations. However, the impact of hepatitis D virus (HDV) positivity on the development of unique hepatitis B virus (HBV) mutations among people living with human immunodeficiency virus (HIV) (PLWH) remains poorly understood in African countries, including Botswana. We used HBV sequences generated from the Botswana Combination Prevention Project (BCPP), which is the largest pair-matched cluster-randomized HIV trial in Botswana. Only participants with available HBV sequences (n = 55) were included in our study ([HIV/HBV-positive (n = 50) and HIV/HBV/HDV-positive (n = 5)]. Geno2pheno was used to determine HBV genotypes, and HBV surface region sequences (all subgenotype A1) were aligned in AliView for mutational analysis, while the impact of mutations was assessed using Phyre2. Our results identified 182 common mutations between the two groups. In the HIV/HBV/HDV cohort, only three mutations (L95W, W156Q, C221Y) were classified as deleterious, with only L95W being the most frequent. In the HIV/HBV cohort, four mutations (W199R, C221A, C221S, W223G) were also classified as deleterious. Our results demonstrate the presence of unique HBV mutations among the HIV/HBV/HDV-positive cohort. Functional characterization of these mutations is recommended to determine their effect on HDV.

Educational Strategy of The Primary Prevention of Domestic Violence: Contributions of Curricular Practices to the Strengthening of Citizenship

At a global level, quality education is fundamental to achieve social and gender justice, stability, and sustainable development worldwide. Therefore, the current school is faced with the need to find answers to these challenges, which can manifest themselves in multiple social violences. The investment in Portugal in an education for citizenship is based on the implementation of an educational policy that introduces, in an intentional and strategical manner, into the curriculum, fracturing themes in societies with the aim of its transformation. In this regard, the construction of the curriculum, as proposed by the Critical Theory, as a social practice, can constitute an educational strategy for the study and action on the problematic issue of primary prevention of domestic violence. The aim of this research is to understand to what extent the inclusion of the issue of domestic violence in curricular practices, in the context of citizenship education, contributes to the primary prevention of this social scourge. The methodological course of the research is based on a qualitative approach of exploratory nature, using a questionnaire with four open-ended questions. The study took place in two public schools, Primary and Secondary: one in the Oporto area and the other in the Lisbon area. The former has a Prevention Project against Domestic Violence in place; the second has no similar project. The data was obtained through the Google Forms tool. Eight participants were selected, four from each school, all teachers at the end of a schooling cycle, specifically: 4th year, 6th year, 9th year and 12th year. The study revealed that, in the school in the Oporto area, because it had a Violence Prevention Plan, there were curricular practices focused on this issue. The school in the Lisbon area, on the other hand, that does not have a Plan for the Prevention of Violence, has an absence of this issue in curricular practices, there being only awareness-raising on the subject.

Coverage of Two-Dose Preemptive Cholera Mass Vaccination Campaign in High-Priority Hotspots in Shashemene, Oromia Region, Ethiopia.

Cholera is a public health priority in Ethiopia. The Ethiopian National Cholera Plan elaborates a multi-year scheme of oral cholera vaccine (OCV) use. Aligned with this, a preemptive OCV campaign was conducted under our Ethiopia Cholera Control and Prevention project. Here, we present the OCV vaccination outcomes. Cholera high-priority hotspots in the Oromia Region, Shashemene Town (ST) and Shashemene Woreda (SW), were selected. Four kebelles (Abosto, Alelu, Arada, and Awasho) in ST and 4 clusters (Faji Gole, Harabate, Toga, and Chabi) in SW were study sites with OCV areas nested within. A total of 40 000 and 60 000 people in ST and SW, respectively, were targeted for a 2-dose OCV (Euvichol-Plus) campaign in 11-15 May (first round [R1]) and 27-31 May (second round [R2]) 2022. Daily administrative OCV coverage and a coverage survey in 277 randomly selected households were conducted. The administrative OCV coverage was high: 102.0% for R1 and 100.5% for R2 in ST and 99.1% (R1) and 100.0% (R1) in SW. The coverage survey showed 78.0% (95% confidence interval [CI]: 73.1-82.9) of household members with 2-dose OCV and 16.8% (95% CI: 12.4-21.3) with no OCV in ST; and 83.1% (95% CI: 79.6-86.5) with 2-dose OCV and 11.8% (95% CI: 8.8-14.8) with no OCV in SW. The 2-dose coverages in 1-4-, 5-14-, and ≥15-year age groups were 88.3% (95% CI: 70.6-96.1), 88.9% (95% CI: 82.1-95.7), and 71.3% (95% CI: 64.2-78.3), respectively, in ST and 78.2% (95% CI: 68.8-87.7), 91.0% (95% CI: 86.6-95.3), and 78.7% (95% CI: 73.2-84.1) in SW. High 2-dose OCV coverage was achieved. Cholera surveillance is needed to assess the vaccine impact and effectiveness.

W3 - Is the Whole Greater Than the Sum of Its Parts? Examining How Dosage of Intervention Components From the Sacramento Neighborhood Alcohol Prevention Project Affect Child Abuse and Neglect

W3 - Is the Whole Greater Than the Sum of Its Parts? Examining How Dosage of Intervention Components From the Sacramento Neighborhood Alcohol Prevention Project Affect Child Abuse and Neglect

Exploring intersectional approaches to waste through grassroots innovations in the U.K.

ABSTRACT Waste is an urgent global challenge. Patterns of excessive resource consumption and disposal are causing immense environmental and social damage. This paper argues that solutions to the waste crisis must be intersectional – addressing the ways in which multiple, overlapping forms of oppression are embedded in resource consumption and the generation of waste. Existing approaches to reducing waste in the U.K. and other Global North contexts have largely failed to take such an approach, but we identify grassroots innovations as a movement which may be well positioned to confront waste challenges in an intersectional way. Drawing on 19 interviews with practitioners and experts in the field of Grassroots Waste Innovations (GWIs), as well as analysis of select documents relating to key waste prevention projects, the article investigates the extent to which GWIs are taking an intersectional approach, and what this looks like. The research finds that GWIs are not generally understood in an intersectional way, but some compelling examples can be found. Framings, project design, and coalition-building emerge as key features of an intersectional approach. However, there are also some significant constraining factors. These include concerns that placing too much emphasis on multiple political causes will be off-putting to participants, lack of capacity, unhelpful funding structures, and the risk of tokenising people from marginalised groups in an attempt to increase diversity.

Determinants of HIV/AIDS treatment and care service quality in Woliso Town, Oromia, Ethiopia: in the case of HIV prevention and control project

ABSTRACT In Ethiopia, even though there is an effort to increase ART services, different challenges remain in the provision of HIV/AIDS treatment and care services, and little has been done to evaluate patient satisfaction levels. The purpose of this study is to assess the determinants of HIV/AIDS treatment and care service quality. A facility-based cross-sectional study was conducted during from October 2023 to November 2023 in Woliso Town. The total sample size was generated using a systematic random sampling method from the source population. The results of the study showed that client satisfaction with HIV/AIDS treatment and care service quality was 272 (81.4%) with 95% CI: 76.9–85.3%. Government employees were 67% less likely to be satisfied with HIV/AIDS treatment and care service quality (AOR = 0.33 95% CI: 0.11, 0.99) when compared to unemployed clients. The odds of client satisfaction were 6.72 times higher among study participants who do not have health insurance membership cards (AOR = 6.72 95% CI: 3.42, 13.91) compared to those who have health insurance membership cards. The odds of client satisfaction were 2.77 times higher among study participants who reported the availability of community referral for any social support (AOR = 2.77 95% CI: 1.12, 6.84) when compared to those who did not report. Those study participants for whom privacy was kept during the examination were 8.67 times higher to be satisfied (AOR = 8.67 95% CI: 2.53, 29.68) compared to those for whom privacy was not kept during the examination. In conclusion, the client satisfaction on HIV/AIDS treatment and care service quality was relatively high in the study area. Occupational status, health insurance membership cards, availability of community referral for any social support and keeping privacy during examination have significant associations with HIV/AIDS treatment and care service quality in terms of client satisfaction.

Experimental and numerical study on the damage evolution and acoustic emission multi-parameter responses of single flaw sandstone under uniaxial compression

Cracks are generally the weakest position in engineering rock mass. It is of great practical significance to study the influence of cracks on the fracture process of rock mass and the precursor criterion of failure for disaster prevention and mitigation projects. In this paper, particle flow program (PFC2D) is used to analyze the mechanical strength and damage evolution of fractured rock. The multi-parameter stage characteristics of acoustic emission (AE) and the difference of fracture precursor information of fractured rock mass under uniaxial compression (UC) are explored. The results are as follows: (1) The strength and modulus of elasticity of fractured rock samples are smaller than that of intact rock mass, and increase in quadratic function with the increase of fracture angle, and the strength of B-90 sample is closest to intact rock samples; (2) The PFC analysis shows that the cracks in the defective rock samples all originate from the tip of the prefabricated crack, and the crack initiation angle is basically in the range of 60°∼90°. The loading process mainly produces tensile damage, and the number of tensile cracks are far more than that of shear cracks. Compressive stress and tensile stress increase with the increase of load, but the force chain of failure surface is the smallest after complete failure of rock; (3) The acoustic emission ringing number, RA/AF value, b value and entropy value of sandstone have obvious stage characteristics, the main frequency signal is mainly low frequency signal, and large-scale cracks are mainly produced in the failure process. The sudden increase point of AE ringing times and RA/AF value accumulation curve can be used as critical failure point. The fluctuation of B value and entropy value reflects the instability of fracture development, and “cliff-like” descending point and ascending point can be regarded as the precursor of critical failure of rock; (4) The failure precursor of acoustic emission parameters of sandstone appears in the peak load period of 85 %–98 %. The order of response time of different parameters is: cumulative RA/AF value, cumulative event number, entropy value, B value. The response time of B-45 and B-15 is earlier, while that of B-60 and B-30 is later. The research results are expected to deepen the understanding of the relevant standards of damage evolution and failure precursors of defective rocks in engineering applications.

Unlocking HIV Prevention in Primary Care: Implementation of the Denver HIV Risk Score Tool in an Urban Michigan Primary Care Setting

Abstract The Unlocking HIV Prevention Project was designed and implemented to address missed opportunities to address HIV risks. The project's site noted a gap in the use of an HIV risk assessment tool during primary care visits. The purpose of this quality-improvement project was to determine whether the translation of the Denver HIV Risk Score tool into primary care visits would affect the number of individuals identified as at risk for HIV and increase preexposure prophylaxis (PrEP) prescription rates among adults seeking care at an urban Michigan primary care clinic. Data on PrEP prescriptions were collected from the electronic health record before and after implementation of the HIV risk assessment tool. Before implementing this screening tool, no patients were identified as at risk and no prescriptions for PrEP were written. After implementation, 16 patients were identified as at risk with seven prescriptions written. These data suggest that this tool has the potential to improve the identification of patients at risk for HIV who are candidates for PrEP prescribing in primary care.

Association between Internet Use and Locomotive Syndrome, Frailty, and Sarcopenia among Community-Dwelling Older Japanese Adults.

In the lives of those who are the target of community health nursing, it is important to collaborate with individuals and communities to improve their quality of life. Herein, we aimed to determine the association between Internet use among older individuals and locomotive syndrome (LS), frailty, and sarcopenia. In this cross-sectional study conducted between July 2022 and March 2023, we recruited 105 community-dwelling older Japanese adults who participated in a care prevention project called "Kayoi-no-ba". All participants were divided into Internet and non-Internet user groups according to the classification of a previous study. We assessed LS (standing test, two-step test, and five-question Geriatric Locomotive Function Scale), frailty (through the Questionnaire for Medical Checkup of Old-Old), and sarcopenia (grip strength, normal walking speed, and skeletal muscle mass index) and made group comparisons between Internet users and non-users. Binomial logistic regression analyses were performed with Internet use as the independent variable and sarcopenia or LS as the dependent variables. The Internet and non-Internet user groups had 69 and 36 participants, respectively. The Internet user group comprised 65.7% of all participants, which was similar to that reported in a previous study of the same age group. Between-group comparisons showed significant differences in sarcopenia and LS items, whereas adjusted binomial logistic analysis showed a significant association between sarcopenia and Internet use. In summary, among LS, frailty, and sarcopenia, sarcopenia showed the highest association with Internet use. Older adults without sarcopenia having good physical functions, such as grip strength, walking speed, and skeletal muscle index, more likely used the Internet; while older adults with sarcopenia were less likely to use the Internet. This implied that Internet use may be associated with physical function.

Gender differences in risk factors for ischemic stroke: a longitudinal cohort study in East China

ObjectivesEpidemiological studies of stroke and its risk factors can help develop strategies to prevent stroke. We aimed to explore the current gender-specific prevalence of stroke and associated risk factors.MethodsData were collected using a structured precoded questionnaire designed by the Stroke Screening and Prevention Programme of the National Health and Wellness Commission Stroke Prevention and Control Project Committee, between June 2020 and November 2021. A total of 7394 residents took part in the study, 187 of whom had a stroke. The baseline information of each participant was obtained and included in this study. The chi-square test and Kruskal-Wallis tests were used to examine the relationship between these indicators and stroke, and then multivariate logistic regression was used to construct the prediction scale between different genders.Resultsof 7394 participants,4571 (61.82%) were female. The overall prevalence of stroke patients in the study population was 2.53%, Multivariate analysis found that residence status (OR = 0.43, p = 0.002) 、HCY (OR = 0.962, p = 0.000)、Previous TIA (OR = 0.200, p = 0.002) 、Hypertension (OR = 0.33, p = 0.000) and Dyslipidemia (OR = 0.668, p = 0.028) were significant predictors of stroke. there are gender differences in the traditional risk factors for stroke, and women have more risk factors. ROC analysis confirmed the accuracy of the stroke risk model, and the AUC of the stroke risk model for the general population was 0.79 with p < 0.05. In the gender model, the female AUC was 0.796 (p < 0.05). and the male AUC was 0.786 with p < 0.05.ConclusionThe prevalence of stroke in adults aged 40 years and above is high in eastern China were high. management of risk factors can effectively prevent the occurrence of most strokes. more attention should be paid to gender differences associated with stroke.