Suicide is a public health problem influenced by a variety of biological, psychological, social, and environmental factors. Recognizing the warning signs at each stage is crucial for prevention and helping those at risk. In this context, body awareness, especially interoceptive body awareness, emerges as a potentially relevant and underexplored factor. In this study, binary logistic regression and linear regression analyses were used to examine the relationship between interoceptive body awareness and suicidal orientation in Colombian university students. In addition, the bootstrap technique was used to resample and estimate the distribution of the data. The results support the idea that greater interoceptive awareness may protect against suicidal orientation by improving emotional regulation. An inverse relationship was found between interoceptive awareness and suicidal ideation. These findings are consistent with previous literature on the importance of body awareness for emotional well-being. Further longitudinal research is needed to explore this relationship in depth.

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

Background: Facebook represents a new dimension for global information sharing. Suicidal behaviours and attempts are growingly reported on Facebook. This scoping review explores the various aspects of suicidal behaviours associated with Facebook, discussing the challenges and preventive measures. Methods: PubMed, Google Scholar, and Scopus were searched for related articles published in English up to October 2021, using different combinations of "Facebook" and "suicide". A group of consultant psychiatrists screened the records and read the full-text articles to extract relevant data. Results: Facebook impacts suicidal behaviours in different aspects. Announcing suicides through sharing notes or personal information, which can be helpful in prediction of suicide, and harmful since negatively affects audience. Live-streaming videos of suicide is another aspect, which questions the ability of Facebook to monitor shared contents that can negatively affect the audience. Helping bereaved families to share feelings and seek support online, commemorating the lost person by sharing their photos is another positive impact. Moreover, it can provide real-world details of everyday user behaviours, which are helpful to predict suicide risk, primarily through novel machine-learning techniques, and provide early warning and valuable help to prevent it. It can also provide a timeline of the user's activities and state of mind before suicide. Conclusions: Social media can detect suicidal tendencies, provide support for those seeking help, comfort family and friends with their grief, and provide insights via timelining the users' activities leading to their suicide. The lack of quantitative studies on evaluating preventative efforts on Facebook was one of the limitations. The creators' commitment and the users' social responsibility will be required to create a mentally healthy Facebook environment.

Suicide is a major public health concern in South Korea, and self-poisoning by pesticides is one of the common methods of suicide. Pesticide ban policies have been successful for suicide prevention; however, no studies have shown their effect according to occupational groups. The present study analyzed suicide and suicide by pesticide rates among South Korean workers age 15-64 in 2003-2017, their associations with occupational groups, and the impact of three major economic indices on these factors. Workers in the agriculture, forestry, and fishery industries have relative risks of 5.62 (95% CI: 5.54-5.69) for suicide overall and 25.49 (95% CI: 24.46-26.57) for suicide by pesticide. The real gross domestic product (RGDP) has a positive association with suicide overall only in the last five-year period investigated in this study, and the unemployment rate consistently has a positive association. The economic status and policy for suicide prevention affect suicide and suicide by pesticide rates differently among occupational groups and different time periods. Policy addressing suicidal risk for different occupational groups should be of concern in South Korea.

Background: General Practitioners (GP) have an important role in the prevention of suicidal behavior. The purpose of this study was to explore their views and experiences of identifying and assessing suicidal ideation. Methods: Ten GPs were recruited through convenience sampling, based on accessibility, interest and willingness to participate. In-depth interviews were carried out and results transcribed ver-batim. Aspects of experiences with suicidal patients emerged through the thematic analyses process. Results: The GPs described the varied clinical picture when patients presented in their office. How they identified depressive symptoms apart from originally somatic complaints, formed a trusting relationship and addressed suicide ideation. They described customized interventions as well as obstacles and factors that facilitated communication: time, own personal traits, pa-tient’s disclosure and organizational barriers. Conclusions: The levels of the suicidal process among patients in general practice vary greatly. GPs adjust their appraisals to profundity understand and intervene in order to prevent a crisis to escalate into subsequent suicidal behavior.

Suicide is a global public health concern that has enormous social and psychological 1 implications for individuals, families, and communities affected. While the rate of suicide in the 2 UK has remained steady over the years mainly due to the various approaches to detection and 3 management of suicidal ideation, it is still one of the main causes of mortality amongst people 4 between the age of 20 – 34 years. The recent global events such as the COVID-19 pandemic, global 5 warming, war, and various environmental catastrophes means that suicide and suicidal ideation 6 is expected to increase especially among younger people. Thus, evidence-based, population-wide 7 preventative approach will be needed to ameliorate the predicted increase in suicide. Also, to 8 understand the effects of some of the suicide prevention approaches, objective and universal risk 9 assessment approach is required. However, there is no universally accepted preventative approach 10 or tools of assessment. This review examines current advances in suicide prevention in the United 11 Kingdom. It examines the epidemiology, risk factors, as well as the strengths and limitations of 12 the various suicide risk assessment and prevention tools currently in use. We hope to obtain a 13 deeper understanding of how these approaches have evolved and their impact on enhancing mental 14 health and preventing suicide ideation in the UK. We present an in-depth review of existing suicide 15 prevention research and policies, while proposing areas for future research and improvement.16

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

Background: The incidences of COVID-19 related suicide among adolescents and youths have been reported across the world. There is no cumulative study focusing on nature, patterns, and causative factors that lead to the present investigation. Methods: A purposive sampling of google news between 15 February to 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37-suicide cases across 11 countries. Results: More male suicides were reported (21-cases, i.e., 56.76%), and the mean age of the total victims was 16.6±2.7 years (out of a total of 29-cases). About two-thirds of the suicides were from three countries named India (11-cases), United Kingdom (8-cases), and the USA (6-cases). Out of 23-student victims, 14 were school-going students. Hanging was the most common suicide method accounting in 51.4% of cases. The most common suicide causalities were related to mental sufferings such as depression, loneliness, psychological distress, etc., whereas either online schooling or overwhelming academic distress was placed as the second most risk factors followed by TikTok addiction-related psychological distress, and tested with COVID-19. Conclusion: The finding of the temporal distribution of suicides concerning lockdowns may help in exploring and evolving public measures to prevent/decrease pandemic-related suicides in young people.

Aim: To analyse recommended interventions for the safe and responsible dissemination of suicidal behaviour in the media. An umbrella review was conducted. Background: Suicide is a serious public health problem that leads to more than 700,000 deaths per year, which translates into one death every forty seconds. The media are channels of information that reflect the real world. Because of its active role in the construction of reality, the way in which the media report and expose suicidal behaviour has the capacity to influence the population in either a preventive or harmful way. Design: An umbrella review was carried out and the report was written according to the Preferred Reporting Items for Overviews of Reviews.

Suicidal behaviour remains difficult to predict and prevent, even for experienced mental health care professionals. The known distal risk factors for suicidal behaviour are not sufficiently specific to fully understand the complex dynamic processes that precede a suicide attempt. Real-time mobile monitoring data can be used to analyse proximal risk mechanisms within the suicidal process. At the same time smartphone-based safety planning and self-monitoring may enhance a patient’s self-management skills thereby increasing their capacity to respond to a suicidal crisis and to become more aware of crisis symptoms. The current paper describes the theoretical and conceptual rationale for the CASPAR study which applies an innovative approach to the study of suicidal processes. It uses basic science approaches to inform the implementation of an innovative suicide prevention intervention. We aim to develop and implement mobile safety plan in conjunction with real-time monitoring in order to both directly implement suicide prevention interventions and to study the ongoing dynamics of individual suicidal behaviour by applying network analysis.

This article will examine the ambivalence in the views of Jewish authorities towards suicide. There are Jewish rulings which forbid the taking of one's own life, including requested euthanasia. There are seemingly contrary rulings which tolerate and sometimes admire suicide, particularly under conditions of religious persecution. The article will attempt an overview of suicide rates in Jewish communities, indicating variations in different circumstances. The question of whether religiosity affects suicide will be raised and examined. These variations—and of course other factors—may offer some clues to the precursors of suicide, and the processes which may be involved. The causal and risk factors in self-harm among Jews will also be examined. The article then turns to post-suicide events, behaviours and attitudes in Jewish communities.

The connection between marital status and suicidal behavior has been poorly assessed in South Asia. We aimed to see the proportion of marital status in individuals in suicidal behavior in South Asian countries. We followed PRISMA guidelines and registered the protocol in advance (PROSPERO 2023 CRD42023399906). A systematic search was conducted in Medline, Embase, and PsycINFO. Meta-analyses were performed to pool the proportion of married individuals with suicidal behavior (total, suicide, and suicide attempt) in South Asian countries. Our search identified 47 studies for this review from six countries published from 1999 to 2022 with a sample size ranging from 27 to 89178. The proportion of married individuals was 55.4% (95% CI 50.1-60.5) for suicidal behavior, 52.7% (95% CI 44.5 – 60.7) for suicides, and 43.1 (95% CI 32.9 – 53.9) for suicide attempts. The proportion of married persons among suicide attempts varied significantly across countries (p=0.016) which was highest (61.8%; 95% CI: 57.2 – 66.2) in India, followed by Bangladesh (52.5%; 95% CI 41.8% - 62.9%) and Pakistan (45.1%; 95% CI 30.9 – 59.9). As the current study did not assess any cause-and-effect association, a cautious interpretation is warranted while considering married marital status as a risk factor.

Introduction: Around a million people are reported to die by suicide every year, and due to the stigma associated with the nature of the death, this figure is usually assumed to be an underestimate. Suicide may be prevented if prompt intervention is taken to mitigate risk. Machine learning and artificial intelligence-based modelling, such as natural language processing (NLP) and other text analytics approaches, has the potential to become a major technique for the detection, diagnosis, and treatment of people who are suffering from mental health issues. The primary aims of this research are to determine whether NLP techniques have been utilised in the field of suicide prevention, and if so, were they effective? What were their limitations? Methods: PubMed, EMBASE, MEDLINE, PsycInfo, and Global Health databases were searched for studies that reported use of NLP for suicide ideation or self-harm. Thematic analysis was used to synthesise and analyse the included studies. Findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, and the Mixed Methods Appraisal Tool (MMAT) was used in assessing paper quality. Result: The preliminary search of five databases generated 387 results. Removal of duplicates resulted in 158 potentially suitable studies. Twenty papers were finally included in this review. Discussion: Studies show that combining structured and unstructured data in NLP data modelling yielded more accurate results than utilizing either alone. Also, to reduce suicides, people with mental problems must be continuously and passively monitored. Further, NLP and other machine learning/artificial intelligence technologies can be used to address health inequities and electronic health records provide valuable data for creating suicide risk tools. Finally, Online, social media, and smartphone applications can be leverage in detecting people with suicide ideation. Conclusion: The use of artificial intelligence and machine learning opens new avenues for considerably guiding risk prediction and advancing suicide prevention frameworks. The review's analysis of the included research revealed that the use of NLP may result in low-cost and effective alternatives to existing resource-intensive methods of suicide prevention. To summarise, there is substantial evidence that NLP is useful in identifying people who have suicide ideation.

Background: The study aimed to assess the prevalence and correlates of suicidal ideation, plans and attempts among middle school students in Sierra Leone. Method: Data from 2,798 adolescents (15 years of median age) that responded to the cross-sectional “2017 Sierra Leone Global School-Based Student Health Survey (GSHS)” were analysed. Results: The prevalence of past 12-month suicidal ideation was 14.2%, suicide plans 16.0%, and suicide attempts 19.1%. In adjusted logistic regression analysis, worry-induced sleep disturbance (Adjusted Odds Ratio-AOR: 1.84, 95% Confidence Interval-CI: 1.32-2.57), bullied (AOR: 2.90, 95% CI: 1.77-4.74), trouble from alcohol use (AOR: 1.90, 95% CI: 1.03-3.50), and leisure-time sedentary behaviour (AOR: 2.42, 95% CI: 1.18-4.98) were associated with suicidal ideation. Bullied (AOR: 2.40, 95% CI: 1.46-3.95) and current cannabis use (AOR: 2.48, 95% CI: 1.51-4.09) were associated with suicide plans in the past 12 months. No close friends (AOR: 2.63, 95% CI: 1.46-4.72) loneliness (AOR: 1.69, 95% CI: 1.08-2.66), bullied (AOR: 2.33, 95% CI: 1.66-3.28), trouble from alcohol use (AOR: 4.01, 95% CI: 2.25-7.13) and current cannabis use (AOR: 2.93, 95% CI: 1.37-6.25) were positively and school attendance (AOR: 0.62, 95% CI: 0.42-0.92) negatively associated with suicide attempts in the past 12 months. Conclusion: Almost one in five students had made suicide attempts in the past 12 months and several associated variables were discovered that can assist in designing interventions.

Objective: Our goal is to develop an online questionnaire to survey the prevalence of suicidal behavior. Methods: We developed a questionnaire with 51 variables and proceeded with validations. Validations were performed using face validity, content validity, and construct validity. Reliability was performed by test-rest. Results: The face validity was 1.0 and the content validity was 0.91. The exploratory factor analysis got KMO = 0.86 and extracted one principal factor. The confirmatory factor analysis demonstrates RMSEA= 0.000 and CFI=1.000. The test-retest had an intraclass correlated coefficient of 0.98. Conclusion: The adequate development questionnaire was validated, and we have an instrument to survey suicide behaviors in the pandemic time.

Suicide remains a persistent global health challenge, resisting widespread prevention efforts. According to previous findings, toxoplasmosis is particularly associated with altered deci-sion-making, which could lead to risk-taking behavior thereby increasing the likelihood for sui-cidal behavior (SB). In addition, discussion about the role of microbiome in psychiatric disorders has emerged lately, which also makes it relevant to investigate its role in the context of SB. Therefore, the current review aimed to comprehensively summarize existing knowledge regard-ing the association between microbial pathogens and SB. We conducted a systematic search with keywords including suicide and Toxoplasma gondii (Suicid* AND Toxoplasm*) and microbiome (Microbiome AND Suicid*) throughout PubMed to retrieve the related studies up to 09.11.2023. Most results reported significant association between toxoplasmosis and SB, suggesting a higher likelihood of SB in the infected population. Regarding the microbiome, only very few studies in-vestigated an association between SB and alterations in microbiota. Based on those few studies, changes in the microbiome were significantly associated with SB. The cognitive aspects of deci-sion-making in T. gondii infected individuals with SB should be further investigated to unravel underlying mechanisms. Further sufficiently powered studies are needed to establish a link be-tween SB and gut microbiota.

Although suicide is a major public health issue worldwide, we understand little of the onset and development of suicidal behavior. Suicidal behavior is argued to be the end result of the complex interaction between psychological, social and biological factors. Epidemiological studies resulted in a range of risk factors for suicidal behavior, but we do not yet understand how their interaction increases the risk for suicidal behavior. A new approach called network analysis can help us better understand this process as it allows to visualize and quantify complex association between many different symptoms or risk factors. A network analysis of data contain information on suicidal patients can help us understand how risk factors interact and how their interaction is related to suicidal thoughts and behaviour. A network perspective has been successfully applied to the field of depression and psychosis, but not yet to the field of suicidology. In this theoretical article, I will introduce the concept of network analysis to the field of suicide prevention, and offer directions for future applications and studies.

Ketamine, a racemic mixture of esketamine (S-ketamine) and arketamine (R-ketamine), has re-ceived particular attention for its rapid antidepressant and antisuicidal effects. NMDA receptor inhibition has been indicated as one of the main mechanisms of action of the racemic mixture, but other pharmacological targets have also been proposed. This study aimed at exploring the possible multiple targets of ketamine enantiomers related to their antidepressant and antisuicidal effects. To this end, targets were predicted in SwissTargetPrediction software for each ketamine enan-tiomer. The targets related to depression and suicide were collected by GeneCards database. The intersections of targets were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Network pharmacology analysis was performed in GeneMania and Cy-toscape softwares. Molecular docking was used to predict the main targets of the network. The results indicated that esketamine and arketamine share some biological targets, particularly NMDA receptor and phosphodiesterases 3A, 7A and 5A, but have specific molecular targets. While esketamine is predicted to interact with the GABAergic system, arketamine may interact with macrophage migration inhibitory factor (MIF). Both ketamine enantiomers activate neuroplas-ticity-related signaling pathways and show addiction potential. Our results identified novel poorly explored molecular targets that may be related to the beneficial effects of esketamine and arketamine against depression and suicide.

Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men. COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide. This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.

Background: Currently, completed suicide, suicide ideation, suicide behavior, and suicide attempts are major public health problems worldwide. Major Depressive Disorder (MDD) is one of the most common mental disorders associated with an increased risk of suicide. Since the relationship between suicide and cholesterol levels is still controversial, in this study, we explore the association between SNPs rs754203 and rs4900442 of CYP46A1 with suicide risk in Mexican patients with major depressive disorder. Methods: We evaluated 188 unrelated suicide completers and compared them to 144 non-suicidal individuals (controls) and 126 MDD patients. Genotypes were analyzed using the Real Time-polymerase chain reaction method and two allele-specific probes to detect specific SNP targets. A chi-square test was used to identify a possible risk genotype or allele type for suicide. Results: Statistical analysis showed significant differences between completed suicide and controls in their allelic and genotypic frequencies in rs754203 SNP. The genotype G/G of CYP46A1 rs754203 was significantly associated with suicide. Also, the G allele was associated with an increased risk of suicide (OR= 1.370, 95% CI= 1.002-1.873). No differences in either genotype distribution or allele frequencies of CYP46A1 rs4900442 were observed. Conclusions: The results of the current study report the first association between G allele carriers (A/G + G/G) of rs754203 and increased risk for suicide, especially in males.

Every year around 800 000 people commit suicide, this represents one death every 40 seconds. In the search for possible biological biomarkers associated with suicide and/or psychiatric disorders, serum cholesterol levels have been extensively explored. Several studies have indicated that cholesterol and associated proteins, especially apolipoproteins (Apos), may play an important role in the diagnosis, prognosis, and susceptibility of suicide. Here, we describe the current knowledge and findings in the relationship between apolipoproteins and suicide.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

Suicide is defined as the action of harming oneself with the intention of dying. It is estimated that worldwide one suicide occurs every 40 seconds, making it a major health problem. Studies in families have suggested that suicide has a genetic component, around the world studies have been carried out in search of genetic variants associated with suicidal behavior, these variants could be useful as potential biomarkers to identify people at risk of suicide. In this area in Mexico, some studies of variants in genes related to neurotransmission and other important pathways have been carried out and a possible association of variants located in genes has been suggested: SLC6A4, SAT-1, TPH-2, ANKK1, GSHR, SCARA50, RGS10, STK33, COMT, and FKBP5. This systematic review shows the genetic studies on the Mexican population. This article contributes by compiling the existing information on genetic variants and genes associated with suicidal behavior, said variants in the future could be used as potential biomarkers to identify people at risk of suicide.

The aim of the study was to examine the prevalence of suicide thoughts and -attempts during the early stage of the COVID-19 outbreak and examine factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, mental health variables, pandemic-related concerns and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6 % reported suicide thoughts during the last month, while 0.2 % had attempted to commit suicide during the same period. Lower age (OR: 0.66, p < 0.001), daily alcohol use (OR: 3.29, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.38, p < 0.01), and having economic concerns related to the pandemic (OR: 2.51, p < 0.001) were associated with having suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.

The fight against suicide is highly challenging as it may be one of the most complex and at the same time most threatening among all psychiatric phenomena. In spite of its huge impact, and despite advances in neurobiology research, understanding and predicting suicide remains a major challenge for both researchers and clinicians. To be able to identify those patients who are likely to engage in suicidal behaviors and identify suicide risk in a reliable and timely manner, we need more specific, novel biological and genetic markers/indicators to develop better screening and diagnostic methods, and in the next step to utilize these molecules as intervention targets. One such potential novel approach is offered by our increasing understanding of the involvement of neuroinflammation based on multiple observations of increased proinflammatory states underlying various psychiatric disorders including suicidal behavior. The present paper overviews our existing understanding of the association between suicide and inflammation including peripheral and central biomarkers, genetic and genomic markers, and our current knowledge of intervention in suicide risk using treatments influencing inflammation, also overviewing the next steps to be taken and obstacles to be overcome before we can utilize cytokines in the treatment of suicidal behavior.

Introduction: Given increasing adult use of amphetamine and methylphenidate and their high misuse potential, we examined suspected suicide attempts and other intentional misuse and medical outcomes and their associations with co-used other substances among amphetamine and methylphenidate exposure cases age 50+.Methods: Using the 2015-2021 U.S. National Poison Data System (N=7,701 amphetamine and/or methylphenidate cases), we fit two generalized linear models for a Poisson distribution with log link function, with suspected suicide attempt versus intentional misuse and major medical effect/death versus other outcomes as the dependent variables. Results: Of all amphetamine/methylphenidate exposure cases, suspected suicide attempts and intentional misuse were 28.4% and 13.2%, respectively. Benzodiazepine use was associated with a higher likelihood but any illicit drug use was associated with a lower likelihood of suspected suicide attempts compared to intentional misuse. Type of stimulant involved (amphetamine or methylphenidate) was not significant. Co-use of antidepressants (IRR=1.43, 95% CI=1.16-1.76), prescription opioids (IRR=1.48, 95% CI=1.21-1.81), drugs for cardiovascular disease (IRR=1.51 95% CI=1.20-1.90), antipsychotics (IRR=1.26, 95% CI=1.02-1.55), or illicit drugs (IRR=2.40, 95% CI=1.82-3.15) was associated with a higher likelihood of major effect/death.Conclusions: Suspected suicide attempts or intentional misuse accounted for more than 40% of amphetamine or methylphenidate exposure cases age 50+. The higher likelihood of major effect/death in cases involving antidepressants, antipsychotics, and cardiovascular disease drugs also suggests confounding effects of comorbid mental and physical health problems. Careful monitoring of those who were prescribed amphetamine or methylphenidate and use other substances are needed.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to compare help-seeking among younger and older men who attended a therapeutic centre for men in a suicidal crisis. In this case series study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE-OM there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001) for both younger and older men. At initial assessment, younger men were less affected by entrapment (46% v 62%; p=.02), defeat (33% v 52%; p=.01), not engaging in new goals (38% v 47%; p=.02), and positive attitudes towards suicide (14% v 18%; p=.001) than older men. At discharge assessment, older men were significantly more likely to have an absence of positive future thinking (15% v 8%; p=0.03), have less social support (45% v 33%; p=.02) and feelings of entrapment (17% v 14%; p=.02) than younger men. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

Due to the continuing high suicide rates among young men, there is a need to understand help-seeking behaviour and engagement with tailored suicide prevention interventions. The aim of this study was to explore help-seeking behaviour and engagement for young men aged 18 to 30 years who attended a therapeutic centre for men in a suicidal crisis. In this prospective cohort study, data were collected from 546 men who were referred into a community-based therapeutic service in North West England. Of the 546 men, 337 (52%) received therapy; 161 (48%) were aged between 18 and 30 years (mean age 24 years, SD=3.4). One third (n=54; 34%) of the men were seen within 48 hours of their referral. Analyses included baseline differences, symptom trajectories for the CORE-34 Clinical Outcome Measure (CORE-OM) and engagement with the therapy. For the CORE 34 there was a clinically significant reduction in mean scores between assessment and discharge (p<0.001), with all outcomes demonstrating a large effect size. Future research needs to assess the long-term effects of help-seeking using a brief psychological intervention for young men in order to understand whether the effects of the therapy are sustainable over a period of time following discharge from the service.

Previous incidental findings of an increase of suicidal risk among subjects with low cholesterol levels have drawn attention to the role of lipids in suicidal behavior. To date, multiple lines of evidence acquired from clinical studies have confirmed an association between low cholesterol levels and suicidal behavior, but the involvement of dimensional traits including impulsivity and aggression in this association remains elusive. In this narrative review, we aimed to address and synthesize the literature regarding the involvement of lipids in the neurobiology of suicidal behavior and its underlying psychological substrates, impulsivity and aggression. An electronic database search was performed using different combinations of relevant keywords. Both preclinical and clinical studies matching the scope of this article were reviewed and filtered through an inspection of the abstracts to recruit the most suitable articles that contributed essential and substantial findings to the literature. Although subject characteristics and study designs vary across studies, current research has demonstrated that impulsivity and aggression might have shared neurobiologic substrates involved in altered serotonergic neurotransmission. Despite the association between low serum lipid levels and suicidal behavior being well documented, the involvement of lipid subtypes in the pathophysiology of impulsive and aggressive traits remains elusive. Further work is warranted to recognize the roles of lipids in neuronal membrane functions and serotonin metabolism, promote a greater appreciation of identifying biomarkers that could be used to determine at-risk individuals, and develop potential interventions to disrupt the pathogenesis of behavioral phenotypes of suicide.

Background: Suicide is a major health problem. The aim of this study was a comparative study of the causes and methods of completed suicide referred to legal Medicine Organization in Bushehr Province during the years 2006- 2015. Methods: This consideration has been done as a retrospective cross-sectional study; the data were collected by the check list. After coordination to the medico legal 343 cases of completed suicide lead to death over a ten year period from 2006 to 2015 were extracted and the data were analyses by SPSS software. Results: The rate of completed suicide was 2.43 and 1.12 suicides per 100,000 people in male and female, respectively. The mean age were 29.25 and 27.61 years in male and female, respectively p>0.05. A higher completed suicide rate was found among single people. The most common ways of a suicide among people who live in Bushehr were hanging out 184(53.6%), self-Immolation 83(24.2%) and firearms 37(10.8%). Motive of suicide was psychological disorders, Physical disease, Conflict with family and substance abuse. 43(12.5%) people smoking and 22(6.4%) people were both smoking and opioid. During the ten year period of studied, throughout the all years that frequency of hanging out has been higher than others. Conclusion: Due to the high incidence of completed suicide in young people and unmarried individuals also hanging out in male and self-burning in females are prevalent. So determination of preventive measures appears to be necessary. Social factors such as psychological disorders and family conflicts have a noticeable role from .Bushehr people.

Primary and secondary cardiovascular prevention is less effective than expected due to the concern about polymedication by professionals and the lack of patient adherence to medications prescribed in the medium and long term. Polypills have been presented as a possible solution. A comprehensive bibliographic review is presented about polypills as mechanisms for facilitating adherence and a proposed guide for the use of polypills for the prevention of cardiovascular risk. 41 articles were included, showing options for the polypill as a method of primary and secondary cardiovascular prevention.The polypill increases therapeutic adherence in the medium and long term, also increasing the therapeutic results compared to the administration of the various drugs separately. Based on the evidence, a flow diagram is proposed for the prescription of a polypill.Polypills increase the effectiveness and adherence of patients to primary and secondary cardiovascular prevention programs, without increasing the cost of the intervention. The use of a polypill in cardiovascular prevention can be effective as a prescription tool.

Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state to estimate the prevalence and strength of association between PRD and serious psychological distress, suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in Grades 6, 8, 10, and 12 within 129 school districts across Kentucky were examined to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed differences and established comparative strength of association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality. Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with increased likelihood of negative mental health outcomes, although the strength of these associations varied across subgroups and developmental levels. Implications for early intervention and prevention are discussed.

: Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide, and the leading cause of unnatural death in Spain. The use of clinical simulation has proven to be a beneficial tool in the training of nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions (b) identification of suicide motives (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to lack of prior exposure.

Background: Aluminum phosphide (AlP), also known as “rice tablet,” is widely used as an effective pesticide. However, AlP poisoning is a common cause of mortality in many countries, such as Iran. Unfortunately, there is no specific antidote for AlP toxicity to date. AlP releases phosphine gas when it is exposed to moisture and acid. Phosphine is a robust mitochondrial toxin that could significantly inhibit cellular energy metabolism. AlP poisoning is an emergency condition that needs instant and effective intervention. Dihydroxyacetone (DHA) is a simple saccharide used for several pharmacological as well as cosmetic purposes. Previously, we found that DHA could significantly prevent mitochondrial impairment induced by toxic agents such as cyanide and phosphine in various in vitro and in vivo experimental models.Methods: Hospitalized patients (n = 111) were evaluated for eligibility criteria. Among these patients, n = 35 cases were excluded due to incomplete data (n = 11) and suspicion of poisoning rather than AlP (n = 24). Meanwhile, n = 76 cases with confirmed AlP poisoning were included in the study. AlP-poisoned patients who did not receive DHA (n =18) were used as the control group.Patients (n = 58) received at least one dose of DHA (500 ml of 5% DHA solution w/v, i.v.) in addition to routine treatment of AlP poisoning. Arterial blood gas (ABG), blood pH, bicarbonate levels, and other vital signs and biochemical measurements were monitored. Moreover, the mortality rate and time of hospitalization were evaluated in both DHA-treated (n = 58) and AlP-poisoned patients without DHA administration (n = 18). Several biomarkers were assessed before (upon hospitalization) and after DHA treatment. The routine tests for AlP-poisoned patients in this study were the measurement of electrolytes (K+ and Na+), WBC, RBC, hemoglobin, INR, carbonate (HCO3), blood pH, PaCO2, and PaO2 and SGPT, SGOT, BUN, Cr. Results: Upon patients' admission, significant decreases in blood pH (acidosis), blood PaO₂, and HCO₃ levels were the hallmarks of AlP poisoning. It was found that DHA significantly alleviated biomarkers of AlP poisoning and tremendously enhanced patients’ survival rate compared to patients treated based on hospital routine AlP poisoning protocols (no DHA). No significant adverse effects were evident in DHA-treated patients in the current study.Interpretation: These data suggest that parenteral DHA is a novel and effective antidote against AlP poisoning.Trial registration: IR.SUMS.REC.1394.102

Since its initial outbreak in late 2019, the COVID-19 pandemic has profoundly affected the global community. In addition to the negative health consequences of contracting COVID-19, the implementation of strict quarantine and lockdown measures has also disrupted social networks and devastated the global economy. As a result, there is rising concern that the pandemic has taken a toll on the mental health of the general population. To better understand its impact, an increasing number of studies examined the effects of the pandemic on mental health and psychosocial implications of enforced quarantine and lockdown. In this article, we aim to review and summarize the findings from a variety of studies that have explored the psychosociological effects of the pandemic and its impact on the mental well-being of the general population. We will also examine how various demographic groups, such as the elderly and youth, can be more susceptible or resilient to the pandemic’s mental health effects. We hope to provide a broader understanding of the underlying causes of mental health issues triggered by the pandemic and provide recommendations that may be employed to address mental health issues in the population over the long-term.

Relatively little research attention has been paid to sex issues in late life suicidal behaviour. The aim was to compare clinical characteristics of women and men aged 70+ who were hospitalized after a suicide attempt. We hypothesized higher depression and anxiety scores in women, and we expected to find that men would more often attribute the attempt to health problems and compromised autonomy. Participants (56 women and 47 men, mean age 80) were interviewed by a psychologist. In addition to psychiatric and somatic health assessments, participants responded to an open-ended question concerning attributions of the attempt. There were no sex differences in depression and anxiety, but women were more likely to report that they found their situation hopeless (67.9% vs. 43.8%, p = 0.02). At least one serious physical disability was noted in 60.7% of the women and 53.2% of the men (p = 0.55). Proportions attributing their attempt to somatic illness did not differ (women, 14.5% vs. men 17.4%, p = 0.79), and similar proportions attributed the attempt to reduced autonomy (women, 21.8% vs. men, 26.1 %, p = 0.64). The unexpected lack of sex differences might be influenced by cultural context in which sex norms play a part.

SUDEP is a sudden death in a person with epilepsy, without evidence of a seizure before death. While its cause is still unclear, various factors have been linked to seizure onset and cardiopulmonary function. Studies have shown that although 91.3% of epilepsy patients want information on premature death, only 31% of them receive it. The numbers emphasize the need for open and sensitive communication by medical professionals. It is important to choose the appropriate moment for the conversation, avoiding periods of stress and ensuring emotional stability in the patient, as well as clear, appropriate and easy to comprehend information about SUDEP. To facilitate this, knowing the patient's level of knowledge is essential. Education on the warning signs of seizures and SUDEP can help take precautions and can decrease the incidence of the phenomenon itself. Effective epilepsy care requires a comprehensive plan, including medication adherence and lifestyle changes. Regular communication and collaboration between the patient, caregiver and health professionals are essential for the effective management of epilepsy, so just as epilepsy has a fluid, changeable course of disease and follow-up appointments are very important, the topic of SUDEP is not a one-time conversation either.

Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24-hour urine volume, which, under physiological conditions, approximately reflect daily fluid intake. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) but also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake at least at 2.5L /day to prevent stone formation, and even at 3.5-4L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate or magnesium content). Finally, some additional advices have to be given to avoid some beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes suicide mortality, suicide methods and years of potential life lost during 2005 and 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 200-2009 to 5.8 during 2014 and 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among the 20-24 years-old whereas in women the age most affected were the 15–19-year-old age group. The most used method for suicide was strangulation. The most frequent places of suicide occurrence were at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn winter (53% vs 47%). The rate of potential years of life lost statistically significantly increased from2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and to implement interventions in the population to decrease suicide mortality in Paraguay.

Objectives: The aim of our study was to evaluate patients after suicide attempts treated at the Department of Trauma Surgery for Children before and after the outbreak of the Covid-19 pandemic. Material and methods: Retrospective review of the medical database at equal time intervals of 24 months to identify patients treated before and after the COVID-19 was done. Thorough analysis including injury mechanism, medical procedures, history of previous mental disorders or suicidal behavior was performed. Furthermore, results were compared with the Polish police suicide statistics. Results: Based on our retrospective review we found 4 patients treated in our department before the pandemic and 10 patients treated after COVID-19 outbreak. The group before SARS-Cov-2 era consisted of three girls and one boy with a mean age of 14.97 (12.7-17.6). The group treated in the pandemic crisis consisted of 8 boys and 2 girls, the mean age was 15.49 (10.8-17.2). In the pre-COVID-19 group, 2 out of 4 patients had received psychiatric treatment before, but none had attempted suicide before. In the COVID-19 group, 6 out of 10 patients had previously received psychiatric treatment, moreover 3 of them attempted suicide before. Based on our analysis, the number of individuals who displayed suicidal attempts has raised. Between 2018 and 2021 the largest number of suicides concerned the 13-18 y.o. group, both for the Silesian Voivodeship (H=9.374; p=0.0092) and for the whole country (H= 10.203; p=0.0061). Conclusions: 1. Results of our study indicate that the pandemic may have caused a wide range of negative mental health consequences for young individuals; 2. During the SARS-Cov-2 era, we observed an alarming 2.5-fold increase in the number of patients treated after suicide attempts at the children's orthopedic trauma department; 3. Suicide attempts in children are often related with high energy trauma.

Background and objectives: Suicide is a topical issue in Lithuania and all around the world. It is the second most common cause of death among young people. There is a lack of research studies on the psychosocial aspects of adolescent suicide in Lithuania. This study aimed to evaluate demographics, life circumstances, and health conditions as factors related to suicide attempt in adolescents. Materials and Methods: A retrospective study was performed at the Children’s Hospital (Vilnius University Santara Clinics). Medical documentation of adolescents treated in this hospital after suicide attempts from January 2011 to April 2018 were analyzed. Results: There were 117 cases of hospitalization due to suicide attempts during this period, and 102 cases were included in the study. There were 83.8% female and 16.2% male patients with an average age of 15.02 ± 1.9 years (p = 0.405); 40.6% of patients lived in divorced families, 17.7% lived in orphanages, 4.2% lived in foster care, 36.4% suffered from parental alcoholism, and 17.2% experienced suicide in their close surroundings. They had comorbidities (girls 72.5%, boys 68.8%), mostly depression (31.3%), were suffering from bullying (54.1%) or violence (26.0%), and 85.4% showed signs of other types of self-harm (girls more often (p < 0.001)). Most of them chose to cut for suicide attempts (86.0% girls, 56.2% boys). In 52.8% of cases, the attempt was spontaneous and 34% relapsed. Thirty-four events occurred in March (18.9%) (p = 0.688). Conclusions: Our study revealed the possible circumstances related to adolescent suicide attempt. Female gender was more common overall and males were more likely to carry out more potentially lethal methods. Other common associated factors were a lack of prosperity in family life, experience of bullying, violence, comorbidities, and the early spring period. Signs of any self-harm could be an indicator of later suicide attempt.

The current clinical model for genetic-testing is based on clinical-criteria/family-history(FH) and a pre-defined mutation probability threshold. It requires people to develop cancer before identifying unaffected individuals in the family to target prevention. This process is inefficient, resource intense and misses >50% of individuals/mutation carriers at risk. Population genetic-testing can overcome these limitations. It is technically feasible to test populations on a large scale; genetic-testing costs are falling and the acceptability/awareness is rising. MEDLINE/EMBASE/Pubmed/CINAHL/PsychINFO databases were searched using a free-text and MeSH terms; reference lists of publications retrieved screened; additionally web-based platforms, Google, and clinical-trial registries were searched. Quality of studies were evaluated using appropriate check-lists. A number of studies have evaluated population-based BRCA-testing in the Jewish-population. This has been found to be acceptable, feasible, clinically-effective, safe, associated with high satisfaction rates and extremely cost-effective. Data support change in guidelines to population-based BRCA-testing in the Jewish-population. Population panel-testing for BRCA1/BRCA2/RAD51C/RAD51D/BRIP1/PALB2 gene mutations is the most cost-effective genetic-testing strategy in general-population women and can prevent thousands more breast/ovarian cancers than current clinical-criteria based approaches. A few ongoing studies are evaluating population-based genetic-testing for multiple cancer susceptibility genes in the general-population but more implementation studies are needed. A future population-testing programme could also target other chronic diseases.

Bipolar disorder (BD) is a high suicide-risk mental disorder. The purpose of this study was to identify the relationship between temperament and character traits with suicide probability, suicide attempt and perceived stress level in patients with BD. A total of 39 euthymic patients with bipolar disorder who had a history of suicide attempt and 39 euthymic patients without a history of suicide attempt were included in this study. Sociodemographic and clinical data form, Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), The Structured Clinical Interview for DSM-5-Clinician Version (SCID-5/CV), Temperament and Character Inventory (TCI), Perceived Stress Scale (PSS), Suicide Probability Scale were used for obtaining the data. HDRS, PSS and SPS scores of the group comprised of patients who attempted suicide were higher than the other group. There was no significant difference between the group of patients who had attempted suicide and the other group in terms of temperament characteristics. In the group of patients who had attempted suicide, self-directedness (SD) and cooperativeness (CO) scores were lower and self-transcendence (ST) score was higher than the other group. HA and ST were positively and SD negatively associated with SPS scores. In the regression analysis for suicide risk, the factors most associated with suicide risk were high HDRS and low CO score. Low SD in BD, high ST with CO may be associated with suicide attempt. Alongside low SD, high HA and ST may be associated with suicidal ideation. Treating residual depressive symptoms can reduce the risk of suicide.

GvHD still remains, despite the continuous improvement of transplantation platforms, a fearful complication of transplantation from allogeneic donors. Being able to separate GvHD from GvL represents the greatest challenge in the allogeneic transplant setting. This may be possible through continuous improvement of cell therapy techniques. In this review, current cell therapies are taken into consideration which are based on the use of TCR alpha/beta depletion, CD45 RA depletion, T regulatory cells enrichment, NK cell-based immunotherapies and suicide gene therapies in order to prevent GvHD and maximally amplify the GvL effect in the setting of haploidentical transplantation.

Monkeypox virus was named so because of its detection in monkeys in 1958. It belongs to the same family as smallpox and chickenpox viruses. There had been numerous outbreaks of this malady initially in the African continent and other parts of the world. The simultaneous spread in nineteen countries in 2022 has raised some serious concerns.Monkeypox is no more a rare disease and has the potential for bioweapon use. We discuss the various ways to prevent its spread, treatment options available, diagnosis, and differentiation from other closely related diseases. We also discuss if the present outbreak could be a bioattack or if this disease is here to stay.The literature suggests that we can effectively manage Monkeypox because of the availability of drugs and vaccination against smallpox. There is also a need for active surveillance against the new resistant recombinant viral strains. The possibility of this outbreak being a bioattack seems remote, although there are questions about the transmission which still need to be answered.

Kinesio tape is considered one of the most common techniques which using recently, where it is used as a therapeutic technique for pain relief, correction of joint position, prevention of oedema and injuries, improve range of motion and muscular activity for the individual. This study is a descriptive research design and aims to identify the effect of using Kinesio tape on the neuromuscular activity of quadriceps muscle after the rehabilitation program of the knee joint. The study sample consists of (10) players from different sports (football, basketball …etc.) and suffering from knee joint injuries. This sample was taken from Kafr-El sheikh and Kaleen club. Results showed that Kinesio tape doesn’t have any explicit effect on the neuromuscular activity of muscle but acts as a catalyst for muscle and promote a person’s feeling of psychological wellbeing and reassurance.When comparing results of using Kinesio tape during performing leg squatting and balance test with not using tape, founded that when performing leg squatting and balance test with using Kinesio tape, there were significant effects on muscle activity compared to not using it.

Tripping is the largest cause of falls and low swing foot ground clearance during the mid-swing phase, particularly at the critical gait event known as Minimum Foot Clearance (MFC) is the major risk factor for tripping-related falls. Intervention strategies to increase MFC height can be effective if applied in real-time based on feed-forward prediction. The current study investigated the capability of machine learning models to classify the MFC into various categories using toe-off kinematics data. Specifically, three MFC sub-categories (less than 1.5cm, between 1.5-2.0cm and higher than 2.0cm) were predicted applying machine learning approaches. A total of 18,490 swing phase gait cycles’ data were extracted from six healthy young adults, each walking for 5-minutes at a constant speed of 4km/h on a motorised treadmill. Both K-Nearest Neighbour (KNN) and Random-Forest were utilised for prediction based on the data from toe-off for five consecutive frames (0.025s duration). Foot kinematics data were obtained from inertial measurement unit attached to the mid-foot, recording tri-axial linear accelerations and angular velocities of the local coordinate. KNN and Random-Forest achieved 84% and 86% accuracy, respectively, in classifying MFC into the three sub-categories with run time of 0.39 seconds and 13.98 seconds respectively. The KNN-based model was found to be more effective if incorporated into an active exoskeleton as the intelligent system to control MFC based on the preceding gait event, toe-off due to its quicker computation time. The machine learning based prediction model shows promise for the prediction of critical MFC data indicating higher tripping risk.

Background: There is a lack of literature specifically examining the workplace bullying of apprentices and trainees in traditional, male-dominated sectors such as the Australian building and construction industry. Using social identity theory (SIT), the aim of this study was to gather the attitudes, thoughts, and feelings of construction industry leaders to better understand how social identification (i.e., group membership) impacts bullying on targets and perpetrators, and the willingness to report bullying for targets and bystanders. Method: One-on-one, semi-structured interviews using a purposive sample of eight leaders from construction and blue-collar industries. Qualitative data were analysed using reflexive thematic analysis. Results: Four overarching themes were identified: difficulties for apprentices transitioning into industry, the need for continued improvement to industry culture, reluctance to report bullying, and rethinking apprenticeships to empower. Each theme provides insight into the psychosocial phenomenon of the bullying of trade apprentices and suggests that an apprentices’ level of social identification with work groups shapes how bullying is identified, interpreted, and prevented. Conclusion: Findings from this study will be important for tailoring evidence-based interventions, human resource policies and initiatives for education and awareness training. Themes also highlight systemic inadequacies impacting apprentices’ mental health and skill development, with implications for the future sustainability of apprenticeship training agreements.

Rabies persists as a longstanding issue in Zambia, despite being preventable. The current control measures, including dog vaccination, population control, and movement restriction, guided by ‘The Control of Dogs Act Chapter 247 of the Laws of Zambia’, have not yielded the desired impact in many areas of the country including Manyinga and Mwansabombwe districts. These two districts continue to report low dog vaccination rates, unrestricted dog movements, and escalating cases of animal and human rabies, along with dog bites. Aligned with global aspirations to achieve zero human rabies cases by 2030, this study scrutinizes the determinants and obstacles hampering the execution of rabies control initiatives in Manyinga and Mwansabombwe. Spanning approximately 11 months, this cross-sectional study gathered pre- and post-vaccination data from 301 households in Manyinga and 100 households in Mwansabombwe. Questionnaires probed knowledge, attitudes, and practices related to rabies prevention and control. A transect survey, key informant interviews, and assessment of rabies vaccination and dog bite records complemented the data collection. Findings revealed that 88% of respondents from both districts possessed knowledge about rabies, confirming affected species and transmission. Moreover, 76.8% in Manyinga and 88.6% in Mwansabombwe were acquainted with rabies prevention and control methods. Concerning dog owners, 89% were aware of rabies, 66% understood its prevention and control, and the majority identified bites as the primary mode of transmission. Vaccination coverage stood at 64% in Manyinga and 21% in Mwansabombwe. Notably, education and occupation exhibited a positive significant association with rabies knowledge. In terms of dog bite cases, Manyinga recorded 538 dog bite cases from 2017 to June 2022 while Mwansabombwe recorded 81 dog bite and 23 jackal bite cases from 2021 to June 2022. The study underscores critical knowledge gaps in rural areas and emphasizes the imperative for enhanced public education and awareness programs, improved rabies surveillance, free mass vaccination campaigns, and community engagement to augment vaccination coverage and knowledge about rabies.

Chikungunya virus (CHIKV), a single-stranded RNA virus transmitted by Aedes mosquitoes, poses a significant global health threat, with severe complications observed in vulnerable populations. The only licensed vaccine, IXCHIQ, approved by the USFDA, is insufficient to address the growing disease burden, particularly in endemic regions lacking herd immunity. Monoclonal antibodies (mAbs), explicitly targeting structural proteins E1/E2, demonstrate promise in passive transfer studies, with mouse and human-derived mAbs showing protective efficacy. The article explores various vaccine candidates, including live attenuated, killed, nucleic-acid-based (DNA/RNA), virus-like particle, chimeric, subunit, and adenovirus vectored vaccines. RNA vaccines emerge as promising candidates due to their rapid response capabilities and enhanced safety profile. The review underscores the importance of E1 and E2 proteins as immunogens, emphasising their antigenic potential. Several vaccine candidates, such as CHIKV/IRES, measles vector (MV-CHIK), synthetic DNA-encoded antibodies, and mRNA-lipid nanoparticle vaccines, demonstrate encouraging preclinical and clinical study results. In addition to identifying potential molecular targets for antiviral therapy, the study looks into the roles played by Toll-like receptors, RIG-I, and NOD-like receptors in the immune response to CHIKV. It also offers insights into novel tactics and promising vaccine candidates.

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country with high mortality and strict lockdown. This study explored the emotions and challenges of pregnant and post-partum women during the pandemic, using AI-based mixed-methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 post-partum. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and tried to cultivate gratitude and hope. The study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic, and also highlights women’s resilience and coping strategies.

Background: Studies addressing diet quality and mental health have shown a strong association. There is limited evidence of specific vitamins essential for treating depression. This study aims to understand the impact of diet quality through supplementation of vitamins D, B6, and magnesium on depressive symptoms. Methods: Multiple datasets from the National Health and Nutrition Examination Survey 2017-March 2020 investigated the associations between vitamin D, B6, and magnesium on depression symptoms. A cross-sectional sample of adults over 20 was extracted (n=9,232). Chi-square tests and logistic regression analyses were used to investigate the associations. Results: Individuals with low doses of vitamin D were more likely to report symptoms of depression relative to those with low doses of vitamin B6 (χ²=3.9063, p=0.0481 vs. χ²=5.2071, p=0.0225). These results remained significant among those with high magnesium proportionate to high vitamin B6 (χ²=6.1272, p=0.0133 vs. χ²=5.2071, p=0.0225). Logistic regression results provided associations for all models except unadjusted vitamin D and adjusted vitamin D. Conclusions: Preventive measures could be addressed by identifying the risks of vitamin deficiencies. Further epidemiological research is needed for the individual effects of vitamin supplementation and depression symptoms.

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy that involves the continuous administration of antiretroviral drugs to HIV-negative individuals wit a substantial risk of contracting an HIV infection. The use of PrEP has shown a reduction in the risk of HIV acquisition through sexual intercourse by up to 99%. Despite its effectiveness, PrEP uptake remains low among populations at high risk of HIV infection. This highlights the need for further research in stratetegies to enhance awareness and uptake of PrEP amongst these specific populations

This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in UOs with more than five confirmed cases of scabies, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases of at high scabies risk underwent a dermatological examination and the infested HCWs were suspended from work until definitive healing. Mass prophylactic treatment was established for all HCWs working in UOs with more than five confirmed cases of scabies. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. We obtain a prevalence of scabies of 2.6% (21/800) and a duration of the outbreak of 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and have an allergy to dust mites. We obtained a low prevalence of scabies infection, limiting the duration of the outbreak and the related economic burden.

INTRODUCTION: Radiation dermatitis is a common sequela of radiotherapy (RT) that can affect up to 95% of patients, developing moderate to severe skin reactions in up to 30% of them. Variation in fractionation or administration methods may reduce the incidence and severity of radiation dermatitis. It is considered that topical use of preparations holding certain preservatives, surfactants, additives, oils, and impurities should be avoided in cancer patients. In clinical practice, creams of different compositions are used, with and without Epidermal Growth Factor (EFG). OBJECTIVE: To analyze the effectiveness of three creams of different compositions for the control of symptoms and skin side effects of RT.METHODS: A pilot study comparing three treatment groups (HR, HU, and RS creams) during the RT program and with a follow-up of 2 weeks thereafter. Study variables: fractionation, Patient-Observer scale, Maxidex (elasticity, hydration, melanin, erythema).RESULTS: The pilot study sample included 15 patients (5 for each group), so the results were not statistically significant. There were no undesirable side effects to the application of the creams under study and compliance and tolerance were excellent.Regardless of fractionation, RS cream appears to be more effective in controlling symptoms during RT, while HU cream may control them more effectively after the RT regimen is completed.During RT, in hypofractionated therapies, the RS cream seems to preserve elasticity, hydration, and hyperpigmentation allowing erythema that could increase skin repair processes. After the RT is finished, the HR cream further improves elasticity and allows the appearance of erythema.In normofractionated therapies during RT all creams seem to have comparable results in the four cutaneous components analyzed; after completion of RT, HR cream appears to better control hydration and hyperpigmentation.CONCLUSIONS: All the creams analyzed have good control of symptoms and the appearance of the skin during and after RT. The prescription of one or another composition should be done individually according to the cutaneous and clinical particularities of each patient. A study with experimental design is needed to analyze the statistical significance of the differences between the creams analyzed.

(1) Background: This study identifies and analyzes those variables that may influence sick leave due to mental illness, based on a retrospective descriptive study of a mutual insurance company in the industrialized region of southern Europe (Catalonia). (2) Methods: All workers who were on sick leave due to mental illness during the period 2009-2019 were included in the study. The relationships between sick leave due to mental illness and social/employment-related and economical and demographic factors were analyzed using multivariate logistic regression and Cox regression model. (3) Results: The period studied included 34,764 workers. Anxious-depressive disorders account for 83.3% of the diagnosed mental disorders. The age cohorts between 30 and 50 years represent 60% of the affected workers. Highest income and high population density regions are the most affected. The levels of mental illness are higher in spring and summer. Professions related to manufacturing industry, automobile mechanics companies, the hospitality industry, education and healthcare and social service companies was more heavily affected. (4) Conclusions: Population density and GDP per capita, the age cohort, the season of the year, the type of payment, the type of contract, and the worker’s business and profession can predict the appearance of sick leave due to mental illness. Mutual insurance companies should plan interventions to minimize these factors and avoid the socioeconomic consequences.

Background The high incidence of diverticulitis and hemorrhoidal proctitis episodes in the population imposes an important healthcare and economic burden. Aim To determine the association between intake of certain plant foods and diverticulitis and hemorrhoidal proctitis episodes. Methods Case-control study with quantitative food frequency questionnaire focusing on selected plant foods and derived products. These were grouped by main chemical components into: ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods like curcumin. We quantified intake according to 24-h recall, either on a 1-4 scale (no intake, low, moderate, high intake) or as the number of units consumed (e.g. cups of tea/coffee, n of oranges or lemons); this value was multiplied by the number of reported intake days per week (1-7). Overall intake was expressed as a continuous variable obtained by successively multiplying the score for each food category, and the result was transformed into a common logarithm (range 0.3 to 27.7). Cases and controls were compared using the chi-squared test, student’s t test, odds ratio (OR) and 95% confidence interval (CI), and predictive analysis (multiple logistic regression). Results The sample included 410 cases and 401 controls, who were similar in mean age and gender distribution. The mean score for overall intake of included plant foods was 6.3 points (standard deviation [SD] 4.5), and this was significantly higher in cases (8.5 points, SD 5.3) than in controls (4.1 points, SD 1.2; p < 0.001). Overall intake was similar in cases presenting diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (> 7 points) compared to controls (OR 13.2, 95% CI 8.3 to 20.8, p < 0.001). Predictive logistic regression models showed that the chemical food group most closely associated with diverticulitis and hemorrhoidal proctitis was capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. The OR for age was near the null value. Neither alliin nor miscellaneous food groups showed any association. Conclusions High, frequent consumption of some plant foods and derived products increases the risk of presenting symptoms of diverticulitis and hemorrhoidal proctitis.

To evaluate the efficacy of fish oil for protection against coronary heart disease (CHD), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of fish oil for protection against CHD. We retrieved relevant articles published from January 1966 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. RCTs of fish oil in preventing CHD were selected. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. The first selection involved 350 citations. After screening and evaluation of suitability, 19 RCTs adjusted for clustering were included in the meta-analysis. All selected manuscripts considered that fish oil was effective in preventing CHD, secondary outcome measures included angina, sepsis and death. Compared with the control group, fish oil may confer significant protection against CHD (odds ratio = 0.84; 95% confidence interval: 0.72–0.98). There was no significant difference in the incidence of secondary outcomes between the observation group and the control group (P > 0.05). The above results show that fish oil plays an important role in reducing CHD and cardiovascular events. However, because of the suboptimal quality of the studies included into the meta-analysis, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.

There are many types of coronavirus on the bases of important hosts including human, rat, turkey, rabbit, etc. The virus looks like a crown or corona of the sun with its round projection, spike. Now a day, newly emerged coronavirus disease (COVID 19) was first detected at Wuhan, China in December 2019 and it became a public health emergency international concern. Although a couple of researches has been conducting, much secretes of the virus and disease is still not understood and not reached a common understanding yet. However, sharing basic information is crucial based on the existing published research articles and updated information. Therefore, this review aimed to draw attention to the COVID 19 pandemic facts, opportunities, and challenges based on up to date information on cases in Ethiopia. Accordingly, the coronavirus is a single-stranded, non-segmented RNA genome virus. Two third of the genome (5'end) consists of two genes that code nonstructural proteins and the other 2-7 genes (3' end) code structural proteins including spike, envelope, membrane, and nucleocapsid. The virus transmits from animal to human and suggested as it might be originated from a bat and/or seafood. Coronavirus transmit human to human by direct contact and droplets during coughing and sneezing and common symptoms like fever, dry cough, and tiredness, short breathing, etc. can be seen from the patient. So that stay at home and social distancing are the most practicing pre-prevention methods. The disease causes high economic loss, face to face education closure, community cultural practice, and mass gathering activities are prohibited. However, various charity associations and creativities found increase than before. To this end, peoples should accept and follow governmental advice and instructions to escape from the pandemic.

The primary purpose of this investigation was to identify safety-oriented bicycling practices commonly used by adult riders in an urban setting (Brooklyn, New York), and to explore whether there are any differences between the safety-oriented practices of men and women riders. Methods: 24 adult riders (14 men, 10 women) in Brooklyn were interviewed concerning their perceptions of bicycling hazards and their safety-oriented practices. Interviews were recorded, transcribed, and analyzed through thematic analysis. Fisher’s Exact Test was employed to test for gender differences. Results: Participants identified a variety of hazards, mainly due to motor vehicles but also pedestrians and roadway conditions. The analysis distilled twenty-one bicycling practices to summarize prevalent views of the participants about safe riding practices. Related items were grouped under broader categories, generating seven safety-oriented bicycling strategies. Few differences based on gender were found in the analysis; however, women in this study were more likely than men to say that they felt disrespected by other road users. Conclusion: Seven strategies may be important for safe urban bicycling: minimizing exposure to other road users (especially motor vehicles) while riding, being vigilant and anticipating what others might do, riding in a predictable fashion, making one’s presence known to other road users, making sure it is safe before proceeding, obeying traffic rules, and riding at a safe speed. Future studies could develop these concepts further and test whether they are associated with involvement in traffic crashes.

Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behaviour change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalisation of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviours of adolescents now and in the future.

Suicidal behaviour is a public health problem whose magnitude is both substantial and increasing. Since many individuals seek medical treatment following a suicide attempt, strategies aimed at reducing further attempts in this population are a valid and feasible secondary prevention approach. An evaluation of the available evidence suggests that existing treatment approaches have limited efficacy in this setting, highlighting the need for innovative approaches to suicide prevention. Existing research on the neurobiology of social pain has highlighted the importance of this phenomenon as a risk factor for suicide, and has also yielded several attractive targets for pharmacological preventive strategies. In this paper, the available evidence related to these targets is synthesized and critically evaluated. The way in which social pain is related to the “anti-suicidal” properties of recently approved treatments, such as ketamine and psilocybin, is also examined. Such strategies may be effective for the short-term reduction of suicidal ideation and behaviour in individuals who have made a suicide attempt suicide prevention, particularly in cases where social pain is identified as a contributory factor. These pharmacological approaches may be effective regardless of the presence or absence of a specific psychiatric diagnosis.

A meta-analysis showed a significant association between activated immune-inflammatory and nitro-oxidative (IO&NS) pathways and suicide attempts (SA). There are no data whether suicidal ideation (SI) is accompanied by activated IO&NS pathways and whether there are differences between SA and SI. The current study searched PubMed, Google Scholar, and Web of Science, for articles published from inception until May 10, 2021, and systematically reviewed and meta-analyzed the association between recent SA/SI (< 3 months) and IO&NS biomarkers. We included studies which compared psychiatric patients with and without SA and SI and controls (either healthy controls or patients without SA or SI) and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence intervals (CI). Our search included 59 studies comprising 4.034 SA/SI cases and 12.377 controls. Patients with SA/SI showed activated IO&NS pathways (SMD: 0.299; CI: 0.200; 0.397) when compared to controls. The immune profiles were more strongly associated with SA than with SI, particularly when compared to healthy controls, as evidenced by activated IO&NS pathways (SMD: 0.796; CI: 0.503; 1.089), an immune-inflammatory response (SMD: 1.409; CI: 0.637; 1.462), inflammation (SMD: 1.200; CI: 0.584; 1.816), and neurotoxicity (SMD: 0.904; CI: 0.431; 1.378). The effects sizes of the IO&NS, immune-inflammatory response and inflammatory profile were significantly greater in SA than in SI. In conclusion: increased neurotoxicity due to inflammation and nitro-oxidative stress and lowered neuroprotection may explain at least in part why psychiatric patients show increased SA and SI. The IO&NS pathways are more pronounced in recent SA than in SI.

Background: Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. Methods: We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI).Findings: Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599-1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. Conclusions: Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.

The soils represent a valuable renewable resource on human timescales and interact with distinctive grassland ecosystems characterized by their elevated biodiversity and essential provision of ecosystem services, such as water supply and carbon sequestration. However, knowledge concerning the effects of wildfires on soil properties and nutrient availability remains limited in the Andes. Andean grasslands currently stand as ecosystems most affected by wildfires in the Peruvian Andes. Our objective is to analyze the effect of fire activity on soil physicochemical properties and analyze its social context in Cusco, situated in the southern Andes of Peru. Five soil samples were collected during both the dry and rainy seasons to characterize changes in soil properties. Additionally, the vegetation restored after the wildfire was analyzed. Changes in soil properties subsequent to the fire indicate slight increases in pH, electrical conductivity, organic matter, nitrogen, phosphorus, and potassium during the onset of the rainy season; thereafter, a gradual reduction in these values was observed. This reduction can be attributed to the seasonal rainfall and runoff regime contributing to the leaching process. Our findings suggest that the complete regeneration of vegetation following a wildfire may require approximately four to five years. This assertion is supported by the perceptions of the affected population, as revealed through interviews conducted within two local farming communities. These results hold significance for decision-makers in formulating policies and regulations regarding grasslands and their seasonal restoration.

Button batteries pose a significant threat to young children and are found in many household items and children’s toys. Along with product manufacturers and retailers, parents and caregivers have a role in button battery ingestion prevention through vigilance regarding items containing button batteries in the home, and knowledge of button battery ingestion symptoms. There is limited information available about parent and caregiver perspectives towards button battery safety. Identifying the areas where increased education is required is important for informing safety campaigns and delivering targeted education. This study aimed to examine parent and caregiver elemental perspectives on button battery safety. One hundred and seventy-four parents and caregivers of children aged 0 to 5 completed a cross-sectional online survey. Distribution occurred via social media. The survey contained multiple-choice questions pertaining to button battery perspectives, and one open-ended question. Respondents recognized the dangers of button battery ingestion, yet only 37% reported being familiar with button battery ingestion symptoms. While 68% knew of household items containing button batteries, only 21% were aware of product recall information sources. Approximately 64% understood immediate post-ingestion steps and 17% found current safety labels unsatisfactory. In an open-ended question, parents and caregivers provided comments about button battery safety that revealed five broad themes; supervision and education; safe storage of button batteries in the home; ensuring children cannot access button batteries; disposing of button batteries safely; and avoiding purchasing items containing button batteries. This study provides a foundation for ongoing investigation of parent and caregiver perspectives on button battery home safety.

Background Although COVID-19 outcomes vary between and within countries, there is little published data on how aspects of social determinants of health (SDoH) affect COVID-19 outcomes in the African context. Objective The current study set to examine COVID-19 case and death rates and their correlates among African countries using data from different sources. Methods An ecological cross-sectional study comprising 28 African countries with a recent Demographic and Health Survey, DHS (2010-2018). Response variables were COVID-19 case and death rates (as of August 15, 2020). Covariates comprised three healthcare systems measures; rates of hospital beds (2005-2017), ventilators (2020) and doctors (2010-2018) per 10,000 population, and 9 broad topics common to multiple SDoH frameworks aggregated to the country level; geography (urban residence), wealth index, education, employment, crowding, and access to information. Rates per 10,000 population were calculated for healthcare measures and mapped for visualization. A Negative Binomial regression was used to assess whether aspects of SDoH are correlated with COVID-19. Results Our analysis indicated that 1 in 4 (25.1%) households in study countries are without clean water and handwashing access. Country-level health system capacity (hospital beds, ventilators, and medical doctors) varied considerably between the countries. Negative Binomial regression showed that the odds of COVID-19 morbidity and death was higher in countries with a high proportion of households without access to quality water and doctors per 10,000 people. Having a high proportional of educated women (1.003: 95% CI, 1.001 – 1.005), hospital beds per population and less people per room (0.959: 95% CI, 0.920 – 1.000) was negatively correlated with COVID-19 deaths while being insured and owning a mobile phone was correlated with illness. Conclusion Both aspects of SDoH and healthcare system contribute either negatively or positively to COVID-19 outcomes. Addressing healthcare system capacity and economic and environmental SDoH will be critical for mitigating the spread of COVID-19 and re-emerging diseases on the African continent.

Background and Objectives: Romania ranks among the countries with a notably high rate of preventable deaths due to inadequacies in prevention, screening, early detection, and timely management processes. Cervical cancer (CC) is a significant contributor to these preventable deaths, particularly affecting patients from marginalized backgrounds, rural regions, and the Roma population. The purpose of this article was to identify correct and consistent information of the Roma population about the risk of CC, as well as the importance of understanding the causes of the disease and awareness of the available prevention methods. Materials and methods: A cross-sectional study was conducted using a self-administered questionnaire applied only to Roma women in Romania. Results: We enrolled 759 patients in the study. These were divided into 2 groups, Group 1 comprised 289 (38.1%) women who had been tested for HPV infection, while Group 2 included 470 (61.9%) women who had never been tested for HPV infection. Characterization of women in Group 1: mostly aged between 25-54 years, with high school education, married, who started sexual activity under the age of 18 years, with only one sexual partner and with over 5 pregnancies. Regarding contraceptive methods, 35.7% of women do not know/ use any contraceptive method, and 32.2% use hormonal contraceptives. Two thirds of the women tested had heard of HPV, and 19.7% were vaccinated against HPV with at least 2-3 doses. A percentage of 8.7 had a diagnosis of CC, compared to those who were not tested (p-0.0001), whereas 63% of the tested women do not know much about CC, as opposed to 85.7% of the group of untested women. Conclusion: Cervical cancer (CC) continues to be a public health issue in Romania, particularly in patients belonging to vulnerable groups. Promotion campaigns for HPV vaccination and CC screening are necessary to reduce the associated mortality and morbidity.

In this particular historical moment, the increase in mortality for cardiovascular disease in adults, the increase of metabolic diseases linked to overweight and obesity, it is necessary to focus the attention of medical doctors, researchers and policy makers on the promotion of correct lifestyles and prevention. The "prevention" and "cure or treatment" have long been considered distinct strategies, the almost exclusive prerogative of the public health authorities for the preventive aspects and of the clinician for the treatments. This approach has led, and still leads, to very high healthcare costs, without having a significant impact on obesity incidence. The promotion of correct lifestyles in the population and in subjects at risk in the fight against obesity/overweight, to contrast the reduction of physical activity and sedentary lifestyle, to promote the consumption of fruit and vegetables, to the reduction of the excessive consumption of salt as "Strategic lines of intervention" need to be pursued in all western countries. Actually, the preventive actions undertaken were not very effective, especially for the individuals in pediatric age. In this narrative review, based on published data, the critical points for obesity prevention will be discussed focusing on action needed during life from pre-conception to childhood, adulthood and in geriatric age to contrast obesity.

Lassa fever, commonly known as Lassa hemorrhagic fever (LHF), is one of the progressive illnesses invading a large population of two to three million individuals in West Africa. The infection transmitted through the rodents severely impacts the local population and the medical professionals in surrounding areas, which were also the primary target of LHF. In epidemic areas, Lassa fever causes a public health threat since it poses a significant morbidity and fatality Case rate (CFR) ≥ 50%). The disease is widespread in West Africa and has developed into one of the most common and life-threatening viral hemorrhagic fevers. Monitoring and preventing persistent disease outbreaks has been challenging in affected regions due to insufficient healthcare facilities, diagnostics labs, care centers, and low socioeconomic conditions. An absence of public awareness and the emergence of an ecological niche is advantageous for the survival and multiplication of the mouse (Mastomys natalensis) inhabiting the Lassa virus serving as the disease's natural host and reservoir. The current review focuses on early diagnosis and appropriate treatment, highlighting the immediate requirement of clinically approved vaccines for LHF, causing preventative and control actions more difficult in the present era.

Limited understanding exists concerning leptospirosis in Zanzibar. The objective of this study is to evaluate the degree of knowledge and awareness of leptospirosis within the urban and peri-urban populations of Unguja. A cross-sectional study was conducted utilizing semi-structured questionnaires from January to April 2022. Two hundred respondents were randomly selected (130 males and 70 females) aged between 18 and 89 years. Descriptive analysis was employed to assess the main trends in knowledge and awareness, and χ2 analysis was utilized to determine associations between demographic characteristics with respondents’ knowledge and awareness. The majority of respondents (64%) lacked awareness of leptospirosis' etiology, but a significant proportion of respondents had a favorable attitude (68.6%) towards leptospirosis compared to their average knowledge and awareness (35%) and practices (29.3%). Nonetheless, the livestock keeper, farmers, fishermen, and healthcare providers had low levels of knowledge and awareness. The findings also demonstrated that males had a strong association with occupational physical activities, while educational level was associated with preventive practices. Living in urban or peri-urban areas was significantly linked with the respondents' practices. The study's outcomes demonstrated low levels of community knowledge and awareness regarding leptospirosis' etiology, mode of transmission, and symptoms among livestock keepers, farmers, fishermen, and healthcare providers. Although most respondents had a favorable attitude, their low level of knowledge and poor practices indicate that supplementing a positive attitude with enhanced knowledge and awareness is necessary to promote individual engagement in preventive measures.

Violence can promote various mental complications such as depression, however, the type of violence that promotes it has not been estimated in detail. The purpose of this study was to assess whether depression is associated with domestic violence in pregnant women treated at a Peruvian health center, 2022. A quantitative, observational, cross-sectional analytical study. A total of 180 pregnant adults who attend the health facility in person were selected. Intrafamily violence was assessed using a questionnaire from the Ministry of Women and Vulnerable Populations of Peru and depression using the Beck Depression Inventory. The study has the approval of the ethics committee of the university and the permission of the head of the health establishment. 36.11% [95%CI: 29.39-43.43] of the pregnant women presented depression and 1.11% severe de-pression; likewise, 41.67% [95%CI: 36.64-49.05] reported having experienced domestic violence. It was identified that presenting domestic violence increases the probability of presenting depression during pregnancy (aPR: 9.89; p&lt;0.001). The associated types of violence were psychological (aPR: 10.44; p&lt;0.001) and physical (aPR: 1.78; p=0.007). There is an association between domestic violence and depression during pregnancy, the types of violence associated being psychological and physical.

One of the most notable changes in the Esophageal Cancer (EC) epidemiology is the rising incidence and prevalence of esophageal adenocarcinoma (EAC) in developed countries, likely due to lifestyle and/or environmental factors that may play an important role in EAC onset. The aim of this systematic review was to collect and summarize all the available evidence regarding lifestyle, diet and EAC risk. We searched the PubMed and Scopus databases in January 2021 for studies providing information about lifestyle, diet, WCRF/AICR recommendations and EAC risk. A total of 106 publications met the inclusion criteria. Body mass index (BMI) and waist circumference (WC) are associated with increased EAC risk. Physical activity does not appear to have a significant direct role in EAC risk. A diet rich in fruit, vegetables, and whole grains appeared to be more protective than a diet rich in animal fat, red meat, and processed meat. Alcohol does not seem to be related to EAC whereas smokers, particularly heavy smokers, have an increased risk of EAC. Primary prevention remains the best option to avert EAC. BMI and WC, along with low consumption of red and processed meat, high consumption of plant food, and the avoidance of smoking are pivotal for EAC prevention.

Health literacy is an indicator of a society’s ability to make better health judgement for themselves and the people around them. This study investigates the prevalence of health literacy among Malaysian adults and provides an overall picture of the current health literacy state of the society. The study also highlights socio-demographics markers of communities with limited health literacy which may warrant future intervention. A population based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above participated in the study. The health literacy score was divided into three levels; limited, sufficient and excellent. Findings showed that majority Malaysian population has sufficient health literacy level, albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups are associated with respondents with older age, lower education level and lower household income. Overall health literacy state for Malaysia is categorized at a lower sufficient level. Health literacy improvements should focus on communities with limited health literacy level.

We analyze real telematics information for a sample of drivers with usage-based insurance policies. We examine the statistical distribution of distance driven above the posted speed limit – which presents a strong positive asymmetry – using quantile regression models. We find that, at different percentile levels, the distance driven at speeds above the posted limit depends on total distance driven and, more generally, on such factors as the percentages of urban and nighttime driving and on the driver’s gender. However, the impact of these covariates differs according to the percentile level. We stress the importance of understanding telematics information, which should not be limited to simply characterizing average drivers, but can be useful for signaling dangerous driving by predicting quantiles associated with specific driver characteristics. We conclude that the risk of driving long distances above the speed limit is heterogeneous and, moreover, we show that prevention campaigns should target primarily male, non-urban drivers, especially if they present a high percentage of nighttime driving.

Not a lot is known about either death or the dying process. Politicians and many in the medical profession in the UK tend to shy away from interfering with it by not allowing euthanasia as an end of life option for the patient. This is the first paper in a series of two, comparing the situation in human medicine and veterinary medicine, in which euthanasia is well practiced for relieving suffering at the end of an animal’s life. This first part takes the form of a literature review including best practice around end of life care, its deficiencies and the need for assisted dying. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. In countries which have legalized physician assisted suicide for the terminally ill reporting indicates that it works well, without increases in involuntary euthanasia and most importantly without intimidation of the vulnerable. However, there is still an ever increasing tendency to overuse sedation and opioids at the end of life, which merits further investigation. With advances in medical science able to significantly prolong the dying process, patient autonomy demands a review of the law in the UK.

Suicide and suicidal behavior are major public health concerns and affect 3-9% of the population worldwide. Despite growing evidence, there are still few effective interventions available to reduce suicide risk. In this article, we describe theoretical models of suicide ideation and behavior and propose to examine the possible effectiveness of a new and innovative preventive strategy. A model of suicidal intrusion (mental imagery related to suicide, also referred to as suicidal flash-forwards) is presented describing one of the assumed mechanisms in the etiology of suicide and the mechanism of therapeutic change. We provide a brief rationale for an Eye Movement Dual Task (EMDT) treatment for suicidal intrusions describing techniques that can be used to target these suicidal mental images and thoughts to reduce overall behavior. Based on the available empirical evidence for the mechanisms of suicidal intrusions, this approach appears to be a promising new treatment to prevent suicidal behavior as it potentially targets one of the linking pins between suicidal ideation and suicidal actions.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

Rationale - From the year 1 anno Domini until 1855 with the third Plague, major pandemics occurred on average every 348 years. Since then, they have occurred on average every 33 years, with Coronavirus disease 2019 (COVID-19) now underway.Even though current technologies have greatly improved the way of life of human beings, COVID-19, with more than 700 000 000 cases and 6 950 000 deaths worldwide by the end of 2023, reminds us that much remains to be done. Objective - Given the frequency and duration of recent pandemics, it might be wise to start thinking about preventative methods to minimize the impact of future pandemics. This report looks back at 18 months of COVID-19, from March 2020 to August 2021, with the aim of highlighting potential solutions that could prove practical, or even essential, for the future. Material - COVID-19 data, including case and death reports, were extracted daily from the Worldometer platform to build a database for macroscopic analysis of the spread of the virus around the world. Demographic data were integrated into the COVID-19 database for a better understanding of the spatial spread of the SARS-CoV-2 virus in cities/municipalities. Method - Without loss of generality, we only analyzed data from the top 30 (out of 200 and above) countries ranked by total number of COVID-19 cases. Statistics (regression, t-test (p < 0.05), correlation, mean ± std, etc.) were carried out with Excel software. Spectral analysis, using Matlab software, was also used to try to better understand the temporal spread of COVID-19. Results - A good linear correlation was observed between the number of cases and the respective number of deaths depending on the country, i.e. y = 0.0121x + 19559 with R² = 0.8042. The analysis then focused mainly on the number of cases.This study showed that COVID-19 mainly affects G20 countries. The most interesting result is that cities/municipalities with high population density are a powerful activator of the spread of the virus. The current demographic context seems to be becoming a societal problem that must be addressed adequately.Spectral analysis highlighted that the very first months of spread of COVID-19 were the most notable with a strong expansion of the SARS-CoV-2 virus. On the other hand, the following six months showed a certain stability due mainly to multiple preventive measures such as confinement, closure of non-essential services, wearing of masks, distancing of 2 meters, etc. Discussion - Analysis of case and death data showed that COVID-19 mainly affects G20 countries. Nevertheless, the most interesting result of this study is that cities and municipal areas with population densities of several thousand inhabitants per square kilometer largely favored the spread of the SARS-CoV-2 virus. It is believed that such a demographic context is becoming a societal problem that developed countries around the world will sooner or later face and therefore needs to be adequately addressed. Conclusion - COVID-19 has made us understand that it is time to act both preventatively and curatively. Phenomenological insights suggest that the next pandemic could occur in less than 50 years. It may be time to launch new societal projects aimed at relieving congestion in densely populated regions.

Background: Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as Cardiac Rehabilitation (CR) have shown a marked reduction of disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. Methods: A scoping review of the literature was conducted following the Joanna Briggs Institute (JBI) guidelines. Three major databases including CINAHL, PubMed, EBSCOhost and Scopus were used to obtain studies published between 2010 and 2023. Search terms such as “Cardiac rehab*”, “Barrier*”, “Cardiovascular”, “Disease” And “diagnosis*” Were utilized in order to obtain subject-specific studies relevant to the research question. Results: From the initial 2098 studies only 14 were included in the final analysis, consisting of both qualitative and quantitative designs. The thematic analysis included “healthcare system-related factors”, “Socioeconomic factors”, and “individual characteristics”. Healthcare system-related factors were mostly related to poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery. Socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. Identified individual characteristics were female gender, older age, and comorbidities. Conclusion: Lack of resources, poor access, educational attainment, and high cost of care were some of the barriers to CR, particularly in low and middle-income countries (LMICs). Health policymakers and healthcare providers should implement strategies incorporating issues identified in this scoping review. Systematic reviews may be required to confirm these findings.

23-Hydroxy ursolic acid (23-OH UA) is a potent atheroprotective and anti-obesogenic phytochemical, with anti-inflammatory and inflammation resolving properties. In this study, we examined whether dietary 23-OH UA protects mice against the acute onset and progression of experimental autoimmune encephalomyelitis (EAE), a mouse model of multiple sclerosis (MS). Female C57BL/6 mice were fed either a defined low-calorie maintenance diet (MD) or an MD supplemented with 0.2 % wgt/wgt 23-OH UA for 5 weeks prior to actively inducing EAE and during the 30 days post-immunization. We observed no difference in the onset of EAE between both groups of mice, but ataxia and EAE disease severity were suppressed by 52% and 48%, respectively, and disease incidence was reduced by over 49% in mice that received 23-OH UA in their diet. Furthermore, disease-associated weight loss was strikingly ameliorated in 23-OH UA-fed mice. ELISPOT analysis showed no significant differences in frequencies of T cells producing IL-17 or IFN- between 23-OH UA fed mice and control mice, suggesting that 23-OH UA does not appear to regulate peripheral T-cell responses. In summary, our findings demonstrate that dietary 23-OH UA may represent an effective oral adjunct therapy for the prevention and treatment of relapsing-remitting MS.

Due to the advancement and availability of internet in present age, device tend to become wireless as well. Mobile ad-hoc network is a wireless environment that consist of advanced agility of nodes and does not contain on any central administrative authority. As it does not contain any central administrative authority so being wireless environment, the network is vulnerable to security threats and suffers in performance as well. Security of MANET is the core issue in this era, meanwhile the data is sent over untrustworthy network. Several techniques were proposed to secure data over Mobile Adhoc Network though cryptography that is one of the most reliable techniques to protect data. In our proposed methodology a Secure Cryptographic technique for Mobile Adhoc Networks (SCTMA) we proposed A Collusion attack prevention (CAP) scheme with ElGamal key generator along with DNA encryption Algorithm is used to make it more secure. The proposed scheme protects the network against collusion attacks and improves the performance as well. Performance analysis will be measured on the basis of key generation time, response time, encryption time and decryption time. The proposed scheme also protects the network against collusion attacks.

In this work, quiescence is added to the Susceptible-Infectious-Recovered (SIR) model with demography. In order to investigate consequences of quiescence in the infection process in more depth, we use stochastic simulations on the stochastic version of model that we built. This method provides a more accurate picture of the dynamics of infectious diseases by taking into consideration the inherent randomness in the disease processes. We examine the effects of quiescence on the number of infected people using simulations. The results, presented in histograms depicting the distribution of infected individuals, reveal a notable trend: the mean number of infected individuals is higher when quiescence is incorporated into the dynamics. These finding emphasizes the dynamic influence of quiescence on infectious disease spread. The higher mean number of infections during periods of quiescence highlights the need for public health strategies that are flexible enough to focused interventions during these times to reduce the possibility of an increase in infections.

Background Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to allow the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals; (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematological malignancies. The Medline, Cochrane and Scopus databases were consulted, following the PRISMA and STROBE guidelines; (3) Results Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. We identify neutropenia, fungal contamination, lack of adequate environmental control measures in hospitals and patients´ homes, duration of hospitalization, and anemia as independent risk factors. We show that HEPA, LAF and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not influence the reduction of IA significantly in our study; (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for these last ones. Studies should also be done to evaluate the efficiency of environmental control measures against IA at patients' homes.

This work deals with a systematic review of literature data concerning the theme of the integrated approach to occupational health and safety management, with particular reference to the programming of assistance plans, which guide the company's organizational choices also by aiming at the principles of the Total Worker Health. In the current regulatory framework on this issue, the UNI ISO 45001: 2018 standard assumes particular relevance, which defines the dynamic approach to occupational health and safety management systems, paying particular attention to external contextual factors that may influence corporate organizational decisions. The adoption of these systems is not mandatory, but allows companies to fulfill their duties in terms of health and safety at work, through an organizational approach aimed at awareness, involvement and participation of all subjects of the company prevention system, overcoming the phase of the mere technological and prescriptive approach, towards a holistic vision of prevention, which places the person at the center of preventive actions. In this context, the role of institutional networks and socio-economic partnerships assumes particular importance, in the activation of territorial assistance interventions to support companies for the improvement of risk management levels. To this end, the importance of verifying the effectiveness of assistance interventions emerges from the scientific debate, through the use of indicators such as quantitative ones for measuring the performance of all phases of the intervention with particular attention to the effects in terms of improved solutions developed.

Nurses focus more on curative aspects rather than health promotion and disease prevention, thus weakening primary health care and lessening engagement with the community. Providing a learning environment that can support the professional growth of nurses through engagement with local communities and educational institutions would strengthen primary health care in the community; however, this poses challenges due to the traditional mindset of nurses towards primary health care. This integrative review aimed to explore key features of the potential of the nursing center model as a contracting-out approach to strengthen primary health care services. This integrative review provides lessons for implementing the Nursing Centre model for any country, mainly where nurses are not fully utilized for health promotion and disease prevention.

The study aimed to identify football players at high risk (HR) for anterior cruciate ligament (ACL) injury via a four-test battery and assess possible factors affecting classification. Ninety-one professional and semi-professional athletes participated in a field-based preseason screening. Aknowledged inter-limb asymmetry limits for quadriceps and hamstrings isometric strength, and Single Leg Triple Hop for distance, in addition to the Landing Error Scoring System (LESS) comprised the test-battery. Additional assessment of hip adductors and core stability completed the global functional profile of the players. Sixty-one players were identified as HR and 30 as low-risk (LR) for ACL injury. Test-battery classified adequately 78,0% of them (Chi-square= 27,485 p=,000), identifying only 4 misclassified cases in the LR group, this low number being important for avoiding improper treatment of injury-prone athletes. All partcipants were considered healthy, and history of a previously rehabilitated injury did not interfere with the results. LESS seems to be the optimal criterion for classification and also the best predictor of both the initial grouping and the secondary one with the wrong vs correct classification cases. The proposed test-battery provides a promising option for field-based preseason ACL-risk assessment of football players and needs to be studied prospectively.

We aimed to study the knowledge of diabetes among high-risk individuals for diabetes in the Indian state of Kerala. The baseline data collected from 1007 participants of the Kerala Diabetes Prevention Program were analyzed. Diabetes knowledge was assessed using a scale adapted from a large nationwide study conducted in India. The composite score of the scale ranges from 0 to 8. The mean age of participants was 46.0 (SD: 7.5) years, and 47.2% were female. The mean diabetes knowledge score was 6.9 (SD: 2.1), with 59.5% having the maximum possible score of 8. Of 1007 participants, 968 (96.1%) had heard the term diabetes, and of them, 84.7% know what diabetes is, 87.2% think more and more people are getting diabetes nowadays, 79.6% know that diabetes can cause complications in organs, and 75.9% know that diabetes can be prevented. While the level of diabetes knowledge was high among our participants, a quarter of them (24.1%) were not aware that diabetes can be prevented. Thus, there is a need for health promotion programs to increase the knowledge of diabetes prevention among high-risk individuals in Kerala.

Background: In long-term care facilities, there are many residents who do not have the ability to seek shelter by themselves in the case of an emergency. Thus, it is extremely important that the staff of nursing homes are equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. Purpose: Discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes and the relationship and predictivity of awareness to self-efficacy. Method: Recruit staff from two nursing homes through purposive sampling, using a two-team pre-and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool is the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale,” to compare the effectiveness of advanced and general fire safety trainings. Result: After receiving improved advanced fire safety training, the total score and the result of the experiment group on fire prevention and emergency response awareness and self-efficacy had both performed better than the control group who received general fire safety training (p < .001); fire prevention and emergency response awareness has significant and positive correlation with self-efficacy (r=.601, p < .001), and awareness is a significant predictor variable to self-efficacy (p < .001). Conclusion/Practical Application: This study finds that the key to improving learning effectiveness includes adding fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duty responsibilities of staff fire defense formation, in turn enabling mutual responsive support for the needs of the site; also, to become familiarized with the knowledge requires appropriate frequency of training and enhancing the staff’s awareness to fire prevention and emergency response, which is the most important key of learning effectiveness.

PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in the main urban areas (so called “Randstad”, entailing Amsterdam, Utrecht, Leiden, The Hague and Rotterdam), investigating regional differences is necessary. This study seeks to unravel regional differences jointly with psycho-social determinants of PrEP uptake. This cross-sectional study included 3,232 HIV-negative Dutch MSM recruited via the EMIS survey in late 2017. Prevalence and standardized prevalence ratio (SPR) of PrEP awareness, intention and uptake were measured on a regional level (Randstad vs. the rest of the country). Multilevel logistic modelling was conducted to identify the association of PrEP uptake with PrEP awareness and intention, sociodemographic, psycho-social determinants, and random effects from regional differences. MSM from the Randstad used more PrEP (SPR=1.4 vs. 0.7) compared to the rest of the country, but there were minor differences for awareness and intention. The regional distinction was estimated to explain 4.6% of the PrEP use variance. We observed a greater influence from PrEP intention (OR=4.5, 95%CI 2.0-10.1), while there was limited influence from the awareness of PrEP (OR=0.4, 95%CI 0.04-4.4). Lower education (OR=0.4, 95%CI 0.2-0.9) was negatively associated with PrEP uptake, however, no significant difference was found between middle and high education (OR=1.2, 95%CI 0.7-2.0). We showed that regional differences – MSM in non-urban regions – and other psycho-social determinants account for lower PrEP uptake. Based on these findings, more fine-tuned PrEP access with a focus on non-urban regions can be implemented, and tailored campaigns increasing intention/use can be conducted among target populations.

Background: Fluoride toothpaste (FT) has recently been included in the World Health Organization’s (WHO) Model List of Essential Medicines. Whereas it is essential for preventing dental caries, its current affordability around the globe remains unclear. This study aimed to analyse the affordability of FT in as many as possible countries worldwide. Methods: A standardized protocol was developed to collect country-specific information about the characteristics of the cheapest FT at a common point of purchase. 82 members of the WHO Global Oral Health Network of Chief Dental Officers (CDOs), directors of WHO Collaborative Centres and other oral health experts collected data using mobile phone technology. The Fluoride Toothpaste Affordability Ratio (FTAR) was calculated as the price associated with the recommended annual consumption of FT, relative to the daily wage of the lowest-paid unskilled government worker (FTAR >1 = unaffordable spending on fluoride toothpaste). The daily expenditure per capita of the poorest 15% of the income distrubition was used as the main proxy of the daily wage, using World Bank data. Alternatively, we used the daily minimum wage as a proxy of the daily wage. Stratified descriptive statistics were undertaken with respect to different World Bank Income Groups and WHO Regions. Results: There are significant discrepancies in the affordability of FT across 78 countries. FT was strongly affordable in high-income countries, relatively affordable in upper middle-income countries, and strongly unaffordable in lower middle-income and low-income countries. The affordability of FT across WHO Regions was dependent upon the economic mix of WHO Regions’ member states. Conclusion: FT is still unaffordable for many people, particularly in low-resource settings. Health policy members should develop better strategies to address and improve the universal affordability of FTs, for the incidence of dental caries to be reduced at a global level.

Stunting in children is a serious problem of nutritional disorders and is strictly monitored by the Indonesian government, it is not only cause physical but also cognitive abnormalities in the form of less intelligence in children so that when they grow up, their productivity will decrease. The incidence of stunting in 2018 in Indonesia was 30.8 %, while in West Java was 29.92%, still at a moderate to high level, consequently, prevention and early detection efforts need to be carried out by various parties, including health professionals and health cadres. Therefore, the aim of this study was to examine the association between the socio demographic characteristics factors as well as the knowledge and motivation of health cadres in the stunting prevention in West Java. A correlational study with a cross-sectional approach was employed with the samples of health cadres from 8 districts/cities in West Java Province: Karawang, Tasikmalaya, Garut, Bandung, Subang, Sukabumi, Cianjur, and West Bandung. A total of 363 health cadres participated and the sampling technique used is the stratified method. The data were collected using a questionnaire developed specifically for this study and were analyzed using a correlation with Chi-Square test and presented in the form of a frequency distribution. The study findings found that majority of the health cadres have good knowledge of 81.27%, which was significantly influenced by education level and marital status with p &lt;0.05. Meanwhile, approximately half of the respondents had moderate motivation with 47.66%, while one-third or 39.12% had high motivation. This motivation was significantly influenced by education level, marital status, and age with p &lt;0.05. It was concluded that health cadres need to further enhance the roles and functions in the prevention and early detection of stunting in West Java by providing continuous guidance, stunting training prevention and award presentations.

CVDs are a leading cause of death globally. In CVDs, the heart is unable to deliver enough blood to other body regions. Since effective and accurate diagnosis of CVDs is essential for CVD prevention and treatment, machine learning (ML) techniques can be effectively and reliably used to discern patients suffering from a CVD from those who do not suffer from any heart condition. Namely, machine learning algorithms (MLAs) play a key role in the diagnosis of CVDs through predictive models that allow us to identify the main risks factors influencing CVD development. In this study, we analyze the performance of ten MLAs on two datasets for CVD prediction and two for CVD diagnosis. Algorithm performance is analyzed on top-two and top-four dataset attributes/features with respect to five performance metrics –accuracy, precision, recall, f1-score, and roc-auc – using the train-test split technique and k-fold cross-validation. Our study identifies the top two and four attributes from each CVD diagnosis/prediction dataset. As our main findings, the ten MLAs exhibited appropriate diagnosis and predictive performance; hence, they can be successfully implemented for improving current CVD diagnosis efforts and help patients around the world, especially in regions where medical staff is lacking.

Dirofilaria immitis infection is one of the most severe parasitic diseases of dogs. Prevention is achieved by the administration of drugs containing macrocyclic lactones (MLs). These products are very safe and highly effective, targeting the third and fourth larval stages (L3, L4) of the parasite. Until 2011, claims of ineffectiveness of MLs, reported as “Lack of Efficacy” (LOE), were generally attributed to owners’ non-compliance, or other reason for inadequate preventative coverage. There was solid argumentation that a resistance problem is not likely to occur because of i) the great extent of refugia, ii) the complexity of resistance development to MLs, and iii) the possible big number of genes involved in resistance selection. Nevertheless, today it is unequivocally proven that ML resistant D. immitis strains exist, at least in the Lower Mississippi region, USA. Accordingly, tools have been developed, to evaluate and confirm the susceptibility status of D. immitis strains. A simple, in-clinic, microfilariae suppression test, 14-28 days after ML administration, and a “decision tree” (algorithm), including compliance and preventatives’ purchase history, and testing gaps, may be applied for assessing any resistant nature of the parasite. On the molecular level, specific SNPs may be used as markers of ML resistance, offering a basis for validation of clinically suspected resistant strains. In Europe, no LOE/resistance claims have been reported so far, and the existing conditions (stray dogs, rich wildlife, majority of owned dogs not on preventive MLs treatment) do not favor selection pressure on the parasites. Considering the genetic basis of resistance and the epizootiological characteristics of D. immitis, ML resistance neither establishes easily nor spreads quickly, a fact confirmed by the current known dispersion of the problem, which is limited. Nevertheless, ML resistance may propagate from an initial geographical point, via animal and vector mobility, to other regions, while it can also emerge as an independent evolutionary process in a new area. For these reasons and considering the current chemoprophylaxis recommendations and increasing use of ML endectoparasiticides as a potential selection pressure, it is important to remain vigilant for timely detection of any ML LOE/resistance, in all continents where D. immitis is enzootic.

Cancer risk is known to increase tremendously when the immune system is suppressed, e.g., as observed in young organ-transplant recipients and AIDS patients. Based on such data, it may be hypothesized that the main reason for the development of clinical cancer is the weakening or suppression of the immune system, and that uncontrolled multiplication of cancer cells occurs when some aspects of the immune system fall below certain critical levels. Therefore, cancer may be prevented and treated by boosting these critical aspects of the immune system so that they are maintained above the critical levels. If multiple immune system boosting interventions are utilized, more aspects of the immune system would be boosted, increasing the likelihood of enhancing the critical aspects of the immune system and generating a cancer preventive and/or therapeutic effect. Clinical trials are needed to validate this approach for cancer prevention and treatment. If validated, the proposed approach could result in a major reduction of the death and suffering caused by cancer in the world.

Anterior Cruciate Ligament (ACL) tear is currently a main issue in all of sports communities. Although the number of ACL injuries in football remains low, it’s consequences on both professional and personal lives remain a major concern of rehabilitation. If practitioners often require more time to bring athletes in the best condition, the fact remains that this concept of time before return to sport is nowadays considered as obsolete. Indeed, the better understanding of the mechanisms of lesion and the strains placed on the graft after reconstruction, allow us to establish a personalized program based on clinical criteria and the patient's objectives. The current scientific literature allows us today to optimize the return to play and performance by the use of neuromotor and neurocognitive approaches, muscle strengthening methods and a preventive program necessary to cover the previous level of the players while taking into account physiological and psychological changes due to ACL reconstruction. Indeed, it is important to have a systemic approach centered on the patient, the sports movement, as close as possible to the field in order to find an optimal function of the knee in interaction with its environment.If there is a risk of reinjury of the ACL, it appears important to be able to identify the risk factors so that the player can return to play in optimal conditions.

An effective behavior changes program is the first-line of prevention for youth obesity. However, effectiveness in prevention of adolescent obesity requires several approaches, with special attention paid to disordered eating behaviors and psychological support among other environmental factors. The aim of this systematic review was to compare the impact of two types of obesity prevention programs, inclusive of behavior change components on weight outcomes. Energy-balance studies were aimed at reducing calories from high-energy sources and increasing PA levels, while “shared risk factors for obesity and eating disorders” focused on reducing disordered eating behaviors to promote a positive relationship with food and eating. A systematic search of ProQuest, PubMed, PsycInfo, SciELO, and Web of Science identified 8825 articles. Twenty were considered “energy-balance” and fifteen “shared-risk factors for obesity and eating disorders”. Overall, energy-balance studies were unable to support a maintenance weight status, diet, and PA over time. Shared risk factors programs also did not result in significant differences in weight status over time. However, the majority of shared risk factors studies demonstrated reduced body dissatisfaction, dieting, and weight-control behaviors. More research is needed to examine how a shared risk factor approach can address both obesity and eating disorder.

Globally, an approximate of 380,000 patients succumbed to death due to the pandemic COVID-19 which also infected more than six million people since December 2019. Not sparing anyone, COVID-19 infections are widely reported among healthcare professionals, sanitation workers and researchers too while global leaders and various governments are providing their best in defending their citizens against this airborne and contact spread virus. In order to contain the virus and protect millions of lives from this deadly coronavirus, there is a need to have a combination of advanced engineering technology and medical facilities. Application of applied science, engineering and technology diffuse almost every aspect of contemporary living. Grasping the fundamentals to determine humanity's most imperative and forthcoming challenges is essential. Artificial Intelligence, the technology that learns, adapts and reciprocates the actions according to the situations, finds optimum position in the fight against corona virus and acts as a powerful tool against this pandemic. In this research article, the authors discusses how Artificial Intelligence (AI) can be leveraged to fight the deadly virus. The research paper further discusses the efficient utilization of AI across the globe to help in testing, treating and serving the population in these hard times. This manuscript focuses on the potential impact of the process in which AI can be implemented to prevent, test and treat.

Cheating prevention in online exams is often hard and costly to tackle with proctoring, and it even sometimes involves privacy issues, especially in social distancing due to the pandemic of COVID-19. Here we propose a low-cost and privacy-preserving anti-cheating scheme by programmatically minimizing the cheating gain. A novel anti-cheating scheme we developed theoretically ensures that the cheating gain of all students can be controlled below a desired level aided by the prior knowledge of students’ abilities and a proper assignment of question sequences. Furthermore, a heuristic greedy algorithm we developed can refine an assignment of questions from a cyclic pool of question sequences to efficiently reduce the cheating gain. Compared to the integer linear programming and min-max matching methods in a small-scale simulation, our heuristic algorithm provides results close to the optimal solutions offered by the two standard discrete optimization methods. Hence, our anti-cheating approach could potentially be a cost-effective solution to the well-known cheating problem even without proctoring.

The 2019-nCoV has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. This epidemic had spread to 19 countries with 11,791 confirmed cases, including 213 deaths, as of January 31, 2020. The World Health Organization declared it as a Public Health Emergency of International Concern. This study analyzed and discussed 70 research articles published until January 31, 2020 for a better understanding of the epidemiology, causes, clinical diagnosis, prevention and control of this virus. Studies thus far have shown origination in connection to a seafood market in Wuhan, but specific animal association has not been confirmed. The reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines are effective for reducing the transmission. To date, no specific antiviral treatment is proven effective, hence, infected people primarily rely on symptomatic treatment and supportive care. Although these studies had relevance to control a public emergency, more research need to be conducted to provide valid and reliable ways to manage this kind of public health emergency in both short- and long- term.