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World RugbyTM supports dedicated women's welfare, injury surveillance and medical/technical interventions, yet breast health has received limited attention. This article aims to provide insights into breast health issues in rugby, including breast impacts and injuries. We discuss how breast anatomy and position may be problematic in rugby. Breast volume relates to body size, which may be increasing in women's rugby, suggesting increased breast surface area and mass, potentially increasing injury risk. Breast health issues in rugby have been reported previously, with 58% of contact footballers (including rugby) experiencing breast injuries. There are damaging effects related to these breast health issues, with breast impacts often causing pain and swelling. Breast impacts may lead to haematomas, cysts and fat necrosis which can calcify over time making them difficult to distinguish from breast carcinoma, causing further investigation and anxiety. In sport, poor bra fit and insufficient support are associated with pain, skin strain and performance decrements. This article reports the potential implications of these breast health issues on performance in rugby. Recent breast‐related projects supported by rugby communities may address recommendations identified in the literature for robust breast injury classifications, updated injury surveillance systems and prospective data collection on breast injury prevalence, severity and impact in rugby. These data should inform breast injury care pathways and intervention research, including evidence‐based bra design. Understanding the implications of breast impacts on tissue properties, health and wellbeing is vital. Finally, data should inform rugby‐specific breast education, raising awareness of this aspect of athlete health. Highlights: This article presents published data suggesting breast impacts and injuries are likely to be prevalent in all codes of women's rugby. Player's body mass may be increasing, which is associated with increased breast volume, surface area and mass, which could have an effect on breast injury prevalence in rugby.Breast impacts can induce pain, swelling and haematomas or fat necrosis causing palpable lumps. These impacts can result in cysts that may calcify mimicking breast carcinoma, causing pain, prompting further investigation. Whilst not linked to breast cancer, breast impacts during breast development may cause deformity.Published data from bra fittings indicates most contact footballers (including rugby players) wear ill‐fitting bras which are unlikely to protect against the consequences of excessive breast motion; pain, breast skin strain and performance decrements. As body/breast size increases in rugby players, the challenges of finding appropriate bras also increase.Previous research suggests breast impacts and injuries are under‐reported and under‐estimated. This article summarises priorities from the literature related to breast health issues in rugby; robust breast injury classifications, updated injury surveillance systems and prospective breast injury data collection, which should inform breast injury care pathways, awareness and intervention research. [ABSTRACT FROM AUTHOR]

Aims: Superficial CD34‐positive fibroblastic tumour (SCD34FT) is an uncommon but distinctive low‐grade neoplasm of the skin and subcutis that shows frequent CADM3 expression by immunohistochemistry (IHC). In this study, prompted by an index case resembling 'atypical fibrous histiocytoma (FH)' that was positive for CADM3 IHC, we systematically examined a cohort of tumours previously diagnosed as 'atypical FH' by applying CADM3 and fluorescence in situ hybridization (FISH) for PRDM10 rearrangement, to investigate the overlap between these tumour types. Methods and Results: Forty cases of atypical FH were retrieved, including CD34‐positive tumours (n = 20) and CD34‐negative tumours (n = 20). All tumours were stained for CADM3. All CADM3‐positive tumours were evaluated by FISH to assess for PRDM10 rearrangement. Eleven CD34‐positive tumours (11/20, 55%) coexpressed CADM3 and were reclassified as SCD34FT. None (0/20) of the CD34‐negative atypical FH were CADM3‐positive. Reclassified SCD34FT (10/11) arose on the lower extremity, with frequent involvement of the thigh (n = 8). Features suggestive of atypical FH were observed in many reclassified cases including variable cellularity, spindled morphology, infiltrative tumour margins, collagen entrapment, epidermal hyperpigmentation, and acanthosis. Variably prominent multinucleate giant cells, including Touton‐like forms, were also present. An informative FISH result was obtained in 10/11 reclassified tumours, with 60% (6/10) demonstrating PRDM10 rearrangement. Conclusion: A significant subset of tumours that histologically resemble atypical FH, and are positive for CD34, coexpress CADM3 and harbour PRDM10 rearrangement, supporting their reclassification as SCD34FT. Awareness of this morphologic overlap and the application of CADM3 IHC can aid the distinction between SCD34FT and atypical FH. [ABSTRACT FROM AUTHOR]

ABSTRACT Research highlights the long‐term collective effects of mass human rights violations (MHRVs) on survivors’ wellbeing. This multi‐method, multi‐context paper combines the social identity approach (SIA), transitional and social justice theories and human rights‐conceptualised wellbeing to propose a human rights understanding of trauma responses and experiences in the context of MHRVs. In Study 1, ethnographic research in four locations in Kosova, 5 years post war indicates that lack of perceived conflict‐related and social justice is experienced as a key contributor to survivors’ individual and collective wellbeing. In Study 2, 61 semi‐structured interviews with MHRVs survivors from post‐war Kosova, post‐conflict Northern Ireland and post‐dictatorship Albania two to three decades post conflict also show that such justice experiences inform wellbeing. These studies illustrate the importance of expanding the SIA to health and trauma theories by taking account of a human rights‐conceptualised wellbeing as well as adopting a holistic analysis of justice perception. [ABSTRACT FROM AUTHOR]

The UK's National Health Service has introduced Social Prescribing initiatives to tackle loneliness and ill‐health, yet it lacks a theoretical foundation and evidence base for Social Prescribing's effectiveness. Recent research applies the Social Identity Approach to Health (SIAH) to explain Social Prescribing's health benefits, emphasising how social connection unlocks health‐enhancing psychological mechanisms. This systematic review therefore aims to assess UK‐based Social Prescribing programmes designed to boost social connection and alleviate loneliness, examining programme efficacy and the role of SIAH processes in health outcomes. Following PRISMA guidelines, a narrative synthesis of articles published from May 5, 2006 (when social prescribing was first introduced in the NHS), to April 8, 2024, was conducted, and their quality assessed using CONSORT‐SPI (2018). Of these programmes, 10 employed a mixed‐methods design, 8 qualitative and 1 quantitative service evaluation, totalling 3,298 participants. Results indicate that Social Prescribing's psychological value lies in quality rather than quantity of social connections, with meaningful connections fostering shared identity, perceived support and self‐efficacy, the latter of which sustains social engagement post‐programme. The SIAH was a useful tool for mapping mixed‐methods findings onto a common theoretical framework to highlight these key proponents. Overall, this review underscores the importance of SIAH‐informed Social Prescribing interventions in enhancing social connectedness, reducing loneliness, and promoting overall health. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Background and aims: With the prevalence of e‐cigarette use among Australian youth increasing significantly in recent years, greater attention is being paid to encouraging and supporting cessation. However, research to inform such efforts is lacking. The present study sought to (i) measure desire to quit e‐cigarette use and actual quitting attempts among young Australians and (ii) explore correlates of quitting‐related cognitions and behaviours. Design, setting and participants: This was a cross‐sectional on‐line survey conducted in Australia. The participants were 14−25‐year‐old e‐cigarette users (n = 602; 53% women). Measurements: Desire to quit vaping and attempts to quit vaping were the primary dependent variables. The independent variables included several individual (e.g. harm perceptions, perceived appeal of vapes), social (descriptive norms) and environmental (e.g. ease of e‐cigarette access) factors. Findings A majority of respondents (61%) expressed a desire to quit vaping, and just over half (55%) had made a quit attempt. Finding vapes easy to access was associated with both a lack of desire [odds ratio (OR) = 0.71] and attempts to quit (OR = 0.77), while self‐reported addiction to vaping (OR = 1.42 and OR = 3.11) and perceiving vaping to be associated with mental health risks (OR = 1.30 and OR = 1.40) were positively correlated with these variables. Perceiving that vaping is common among people of one's age (OR = 0.82) and finding vapes appealing (OR = 0.55) were associated with a lack of desire to quit, while perceiving vaping to have physical health risks was positively associated with quitting desire (OR = 1.58). School‐based education on vaping was associated with reporting an attempt/s to quit (OR = 0.47). Conclusions: This survey of young Australian e‐cigarette users suggests a high level of desire to quit using e‐cigarettes and attempts to quit. Increasing knowledge regarding the physical and mental health risks associated with e‐cigarette use may assist with promoting quitting‐related intentions. Changing social norms, reducing the accessibility of e‐cigarettes and reducing the appeal of the products also constitute potential means of increasing the desire to quit. [ABSTRACT FROM AUTHOR]

Advances in single‐cell level analytical techniques, especially cytometric approaches, have led to profound innovation in biomedical research, particularly in the field of clinical immunology. This has resulted in an expansion of high‐dimensional data, posing great challenges for comprehensive and unbiased analysis. Conventional manual analysis is thus becoming untenable to handle these challenges. Furthermore, most newly developed computational methods lack flexibility and interoperability, hampering their accessibility and usability. Here, we adapted Seurat, an R package originally developed for single‐cell RNA sequencing (scRNA‐seq) analysis, for high‐dimensional flow cytometric data analysis. Based on a 20‐marker antibody panel and analyses of T‐cell profiles in both adult blood and cord blood (CB), we showcased the robust capacity of Seurat in flow cytometric data analysis, which was further validated by Spectre, another high‐dimensional cytometric data analysis package, and conventional manual analysis. Importantly, we identified a unique CD8+ T‐cell population defined as CD8+CD45RA+CD27+CD161+ T cell that was predominantly present in CB. We characterised its IFN‐γ‐producing and potential cytotoxic properties using flow cytometry experiments and scRNA‐seq analysis from a published dataset. Collectively, we identified a unique human CB CD8+CD45RA+CD27+CD161+ T‐cell subset and demonstrated that Seurat, a widely used package for scRNA‐seq analysis, possesses great potential to be repurposed for cytometric data analysis. This facilitates an unbiased and thorough interpretation of complicated high‐dimensional data using a single analytical pipeline and opens a novel avenue for data‐driven investigation in clinical immunology. [ABSTRACT FROM AUTHOR]

Pannexin 3 (Panx3) is a glycoprotein that forms mechanosensitive channels expressed in chondrocytes and annulus fibrosus cells of the intervertebral disc (IVD). Evidence suggests Panx3 plays contrasting roles in traumatic versus aging osteoarthritis (OA) and intervertebral disc degeneration (IDD). However, whether its deletion influences the response of joint tissue to forced use is unknown. The purpose of this study was to determine if Panx3 deletion in mice causes increased knee joint OA and IDD after forced treadmill running. Male and female wildtype (WT) and Panx3 knockout (KO) mice were randomized to either a no‐exercise group (sedentary; SED) or daily forced treadmill running (forced exercise; FEX) from 24 to 30 weeks of age. Knee cartilage and IVD histopathology were evaluated by histology, while tibial secondary ossification centers were analyzed using microcomputed tomography (µCT). Both male and female Panx3 KO mice developed larger superficial defects of the tibial cartilage after forced treadmill running compared with SED WT mice. Additionally, Panx3 KO mice developed reduced bone volume, and female PANX3 KO mice had lengthening of the lateral tubercle at the intercondylar eminence. In the lower lumbar spine, both male and female Panx3 KO mice developed histopathological features of IDD after running compared to SED WT mice. These findings suggest that the combination of deleting Panx3 and forced treadmill running induces OA and causes histopathological changes associated with the degeneration of the IVDs in mice. [ABSTRACT FROM AUTHOR]

Objective: To consider whether one sibling's criminal legal system contact influences another's material conditions, social support, and mental health and behavioral problems. Background: Sibling incarceration is both the most common form of familial incarceration in the United States, with more than one in four Americans reporting ever experiencing this event, and highly unequally distributed. Despite how prevalent and unequally distributed sibling criminal legal system contact is, little research considers the consequences of that event for family life. This study seeks to partially fill that gap by testing whether and how a sibling's criminal legal system contact is associated with changes in the material conditions, social support, and wellbeing of caregivers and other children. Method: Using data from the Project on Human Development in Chicago Neighborhoods, the authors estimate hierarchical linear models to consider the relationship between sibling criminal legal system contact and three core indicators of familial and child wellbeing: familial (1) social support and (2) material insecurity, and (3) child wellbeing, as indicated by behavioral and mental health problems using validated scales. Results: Sibling criminal legal system contact is associated with a reduction in the wellbeing of other children and contributes to declines in familial social support and material security. Conclusion: Taken together, the results suggest that a sibling's criminal legal system contact can disrupt home life for siblings and families alike, highlighting yet another way that mass criminalization may imperil families and children. [ABSTRACT FROM AUTHOR]

Gestures—hand movements that accompany speech and express ideas—can help children learn how to solve problems, flexibly generalize learning to novel problem‐solving contexts, and retain what they have learned. But does it matter who is doing the gesturing? We know that producing gesture leads to better comprehension of a message than watching someone else produce gesture. But we do not know how producing versus observing gesture impacts deeper learning outcomes such as generalization and retention across time. Moreover, not all children benefit equally from gesture instruction, suggesting that there are individual differences that may play a role in who learns from gesture. Here, we consider two factors that might impact whether gesture leads to learning, generalization, and retention after mathematical instruction: (1) whether children see gesture or do gesture and (2) whether a child spontaneously gestures before instruction when explaining their problem‐solving reasoning. For children who spontaneously gestured before instruction, both doing and seeing gesture led to better generalization and retention of the knowledge gained than a comparison manipulative action. For children who did not spontaneously gesture before instruction, doing gesture was less effective than the comparison action for learning, generalization, and retention. Importantly, this learning deficit was specific to gesture, as these children did benefit from doing the comparison manipulative action. Our findings are the first evidence that a child's use of a particular representational format for communication (gesture) directly predicts that child's propensity to learn from using the same representational format. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosing hemophilia B (HB) carrier status is important to manage bleeding in carriers and to prevent bleeding in potential offspring. Without a family history of hemophilia, diagnosing HB carrier status is challenging. Genetic testing is the gold‐standard, however it is reserved for individuals with a high suspicion of carrier status. Aims: To describe the distribution of activated partial thromboplastin time (aPTT) and factor IX coagulant (FIX:C) levels in HB carriers and assess the ratio of FIX:C to other Vitamin K dependent factors (FII:C, FVII:C, FX:C) as an indicator of HB carrier status. Methods: In this retrospective, single‐centre cohort study, subjects were included if they were obligate or genetically proven HB carriers. Distributions of aPTT and FIX:C were described and the relationship between FIX:C levels in carriers and severity of familial HB was analysed. Ratios of FIX:C to FII:C, FVII:C, FX:C were calculated. Results: Seventy‐two female HB carriers (median age: 34 years; IQR 24–43) were included. Median aPTT and FIX:C levels were 33.0 s [IQR 30.0–37.0] and 57 IU/dL [IQR 43–74]. Fifteen carriers (21%) had mild HB (FIX:C levels of 10–40 IU/dL). FIX:C levels trended higher in carriers of mild HB versus carriers of moderate/severe HB. In six carriers, the median ratio of FIX:C to other Vitamin K dependent factors was 0.44, with 92% of ratios being ≤ 0.75. Conclusion: aPTT and FIX:C levels were unreliable in diagnosing HB carrier status. A low ratio of FIX:C to other Vitamin K dependent factors may be a useful marker of HB carrier status. [ABSTRACT FROM AUTHOR]

Background: Patient‐reported outcomes measures (PROMs) are increasingly being collected within cancer clinical trials, yet limited literature on the feasibility and acceptability of doing so. Methods: We collected parent‐proxy and adolescent (≥12 years old) PROMs through a longitudinal, psychosocial sub‐study ('PRISM‐Impact') embedded in a precision medicine trial for children with poor prognosis cancer ('PRISM'). We report on feasibility (response, participation, and attrition rates; follow‐up and responding to elevated distress) and acceptability (parents' perceived benefit/burden of participation; and impact on decision to participate in PRISM) of PRISM‐Impact. Results: Over the reporting period, 462 families were eligible for PRISM‐Impact. Family and adolescent response rates were 53% and 45%, respectively. Parents whose child had relapsed were more likely to participate in PRISM‐Impact than parents whose child had not (p < 0.001). Parent and adolescent attrition rates were 30% and 56% respectively. We conducted 478 calls for intake and to follow‐up on missing questionnaires, and 122 calls to respond to elevated distress. Parents reported wanting to participate in PRISM‐Impact for altruistic reasons and because they valued psychosocial research. Parents reported little‐to‐no burden and some benefit from participating in PRISM‐Impact, with little change in ratings overtime. Most parents felt that participating in PRISM‐Impact did not impact their desire to participate in PRISM (72%), with some feeling more eager to participate (19%). Conclusions: PRISM‐Impact response rates were comparable to other psycho‐oncology studies, despite the poor prognosis population. Integration of PROMs within a paediatric oncology trial is acceptable to parents, and may provide a more comprehensive assessment of the impact of trial participation. [ABSTRACT FROM AUTHOR]

In countries where population census data are limited, generating accurate subnational estimates of health and demographic indicators is challenging. Existing model‐based geostatistical methods leverage covariate information and spatial smoothing to reduce the variability of estimates but often ignore the survey design, while traditional small area estimation approaches may not incorporate both unit‐level covariate information and spatial smoothing in a design consistent way. We propose a smoothed model‐assisted estimator that accounts for survey design and leverages both unit‐level covariates and spatial smoothing. Under certain regularity assumptions, this estimator is both design consistent and model consistent. We compare it with existing design‐based and model‐based estimators using real and simulated data. [ABSTRACT FROM AUTHOR]

This document explores the use of ultrasound (US) in rheumatology practice, specifically focusing on a new model called Point of Care US (POCUS) in Rheumatology (POCRUS). The authors argue that learning US examination skills can improve diagnostic accuracy and clinical confidence in rheumatology. They propose a probability-directed approach to US, using standardized assessments based on international classification criteria for rheumatic and musculoskeletal diseases. The document acknowledges the support of various organizations in organizing and reporting the findings of an online course on POCRUS. [Extracted from the article]

Introduction: Advanced therapies offer unprecedented opportunities for treating rare neurological disorders (RNDs) in children. However, health literacy, perceptions and understanding of novel therapies need elucidation across the RND community. This study explored healthcare professionals' and carers' perspectives of advanced therapies in childhood‐onset RNDs. Methods: In this mixed‐methodology cross‐sectional study, 20 healthcare professionals (clinicians, genetic counsellors and scientists) and 20 carers completed qualitative semistructured interviews and custom‐designed surveys. Carers undertook validated psychosocial questionnaires. Thematic and quantitative data analysis followed. Results: Participants described high positive interest in advanced therapies, but low knowledge of, and access to, reliable information. The substantial 'therapeutic gap' and 'therapeutic odyssey' common to RNDs were recognised in five key themes: (i) unmet need and urgency for access; (ii) seeking information; (iii) access, equity and sustainability; (iv) a multidisciplinary and integrated approach to care and support and (v) difficult decision‐making. Participants were motivated to intensify RND clinical trial activity and access to advanced therapies; however, concerns around informed consent, first‐in‐human trials and clinical trial procedures were evident. There was high‐risk tolerance despite substantial uncertainties and knowledge gaps. RNDs with high mortality, increased functional burdens and no alternative therapies were consistently prioritised for the development of advanced therapies. However, little consensus existed on prioritisation to treatment access. Conclusions: This study highlights the need to increase clinician and health system readiness for the clinical translation of advanced therapeutics for RNDs. Co‐development and use of educational and psychosocial resources to support clinical decision‐making, set therapeutic expectations and promotion of equitable, effective and safe delivery of advanced therapies are essential. Patient or Public Contribution: Participant insights into the psychosocial burden and information need to enhance the delivery of care in this formative study are informing ongoing partnerships with families, including co‐production and dissemination of psychoeducational resources featuring their voices hosted on the Sydney Children's Hospitals Network website SCHN Brain-Aid Resources. [ABSTRACT FROM AUTHOR]

Objective: Precision medicine is transforming cancer treatment, yet the perspectives of surgeons who often play a critical role in the delivery of precision medicine remain understudied. Methods: We conducted semi‐structured interviews with 13 surgeons involved in a precision medicine trial for children with poor prognosis cancer. We explored knowledge of genetics, confidence with somatic and germline results, ratings of benefit to stakeholders and willingness to undertake surgical procedures. Results: Surgeons generally had positive attitudes towards precision medicine but expressed concerns about families' unrealistic expectations, mixed opinions on the benefits and the use of research‐only biopsies. Most surgeons rated their genetics knowledge as 'good' (69%) and felt 'very confident' in identifying genetic specialists (66%), but 'not confident' (66.6%) in making treatment recommendations. Surgeons' willingness to undertake a procedure was influenced by potential patient benefit. Conclusions: Our findings support the need for more workforce and training support for surgeons to fully engage with precision medicine. [ABSTRACT FROM AUTHOR]

The presence of multiple donor‐specific antibodies (DSAs) targeting HLA antigens poses a challenge to transplantation. Various techniques, including the use of recombinant cell lines and crossmatch cells have been developed to isolate DSAs. To simplify the extraction of HLA‐specific DSAs from complex sera, we introduced magnetic beads with single HLA specificity (MagSort). Sera were treated with MagSort, allowing HLA‐specific antibodies to bind to the beads, and these specific antibodies were subsequently eluted. MagSort beads, coated with 59 different HLA variants, underwent testing through 1329 adsorption/elution processes, demonstrating their effectiveness and specificity in adsorbing and eluting HLA‐specific antibodies. The MagSort method proves comparable to the cell method, showing similar isolated antibody binding patterns. The isolated antibody binding patterns from MagSort reveal both known eplets and unknown patterns, suggesting its utility for eplet discovery. Additionally, MagSort proved effective in extracting signals for flow cytometry cross‐matching, offering a means to assess the binding capability of isolated antibodies against specific donor cells. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of poly‐refractory rheumatoid arthritis (RA) defined as failure of all biological (b)/targeted synthetic (ts)‐disease‐modifying drugs (DMARDs). To further investigate whether patients with persistent inflammatory refractory RA (PIRRA) and noninflammatory refractory RA (NIRRA), determined by objective ultrasound (US) synovitis, have distinct clinical phenotypes in both EULAR difficult‐to‐treat RA (D2T‐RA) and poly‐refractory RA groups. Methods: A cross‐sectional study of 1,591 patients with RA on b/tsDMARDs that evaluated D2T‐RA criteria and subclassified as poly‐refractory if inefficacy/toxicity to at least one drug of all classes. PIRRA was defined if US synovitis in one or more swollen joint and NIRRA if absent. Univariate tests and multivariate logistic regression were conducted to investigate factors associated with poly‐refractory, PIRRA, and NIRRA phenotypes. Results: 122 of 1,591 were excluded due to missing data. 247 of 1,469 (16.8%) had D2T‐RA and only 40 of 1,469 (2.7%) poly‐refractory RA. This latter group had higher disease activity score 28 C‐reactive protein (CRP) (median 5.4 vs 5.02, P < 0.05), CRP levels (median 13 vs 5 mg/l, P < 0.01), and smoking (ever) rates (20% vs 4%, P < 0.01) compared with other D2T patients. Smoking was associated with poly‐refractory RA (odds ratio 5.067, 95% CI 1.774–14.472, P = 0.002). Of 107 patients with D2T‐RA with recent US, 61 (57%) were PIRRA and 46 (43%), NIRRA. Patients with NIRRA had elevated body mass index (median 30 vs 26, P < 0.001) and higher fibromyalgia prevalence (15% vs 3%, P < 0.05), lower swollen joint count (median: 2 vs 5, P < 0.001), and lower CRP levels (5 vs 10, P < 0.01). Conclusion: Only 2.7% of D2T‐RA failed all classes of b/tsDMARDs. Among D2T‐RA, less than 60% had objective signs of inflammation, representing a target for innovative strategies. [ABSTRACT FROM AUTHOR]

The article discusses the 5th International Conference on Social Identity and Health (ICSIH 5) and its research on the Social Identity Approach to Health (SIAH). It highlights the theoretical foundations of SIAH, its benefits, and the role of multiple group memberships in enhancing resilience. It emphasizes the application of Social Cure insights in clinical, health, sport, and organizational settings.

Volunteering can enhance both help‐recipients' and volunteers' lives, so it is important to explore what motivates people to begin and continue volunteering. For instance, research underpinned by the social identity approach recognises that group‐related processes are consequential. Recent quantitative research within this tradition highlighted the potential importance of volunteering as a means of religious identity enactment, but no work has yet explored this idea qualitatively, which means that the richness and complexity of identity enactment as a motive for volunteering remains unexamined. Addressing this, we conducted interviews with volunteers (N = 26) within English religiously motivated voluntary organisations that are responding to an important real‐world issue: growing levels of food insecurity. Theoretically guided reflexive thematic analysis developed four themes showing that volunteering can facilitate enactment of different identities (i.e., religious, volunteer and human), thus illustrating the nuanced and complex nature of identity enactment through volunteering. Theoretical and practical implications are explored. [ABSTRACT FROM AUTHOR]

Aim: To better understand parents' beliefs about causation in cerebral palsy (CP) and the emotions related to those beliefs. Method: We surveyed 226 parents of children with CP aged 1 to 18 years, recruited from the Victorian Cerebral Palsy Register, to evaluate their beliefs about the causes of CP, including genetic causes, causes specific to their own child, and their attitudes and emotions in relation to these. Results: Although 92% of participants reported that understanding the causes of their child's CP was important, uncertainty about the cause was expressed by 13%. The most frequently endorsed causal factors, in general and in their own child respectively, were intrapartum hypoxia (81%, 36%) or brain damage (69%, 22%), brain damage during pregnancy (73%, 28%), and preterm birth (66%, 28%). Genetic causes were deemed relevant by 13% of participants and hospital or professional error by 16%. Parents shared related feelings of anger (59%), sadness (80%), guilt (61%), and confusion (53%); parental anger was more likely when their child's CP was attributed to intrapartum events. Interpretation: Substantial parental interest in understanding the causes of CP, together with uncertainty about the causes, parents' causal attributions, and significant emotional sequelae, highlight a strong need for provision of information and support for families of children recently diagnosed with CP. What this paper adds: Understanding the causes of their child's cerebral palsy (CP) was important to parents.Parents most often endorsed intrapartum factors as a cause of CP.Parents reported experiencing strong emotions about the causes of their child's CP. What this paper adds: Understanding the causes of their child's cerebral palsy (CP) was important to parents.Parents most often endorsed intrapartum factors as a cause of CP.Parents reported experiencing strong emotions about the causes of their child's CP. This original article is commented on by Vasyutin on page 148 of this issue. [ABSTRACT FROM AUTHOR]

Introduction: Performing surgical procedures is a recognized source of stress for surgeons. Vocational stress is an important contributor to performance, patient care, and burnout with dispositional and environmental factors contributing. Accurately assessing surgeon stress is critical to measuring effectiveness of stress reduction programs. The primary aim was to identify differences between surgeons' self‐reported anticipated stress and anxiety prior to gynecological surgery, compared with their recollection of experienced stress and anxiety during surgery. Secondary aims assessed any differences by level of training, surgical type, and surgeon role. Material and methods: Attending and resident gynecologists performing routine elective surgeries completed a visual analog scale (VAS) assessing perceived stress and the State–Trait Anxiety Inventory (STAI) prior to and immediately after completing 161 elective surgeries including total laparoscopic hysterectomy, laparoscopic excision of moderate–severe endometriosis, or hysteroscopic myomectomy. Results: Eight attending gynecologists and nine residents participated. Residents commenced as primary surgeon in 62/90 (69%) procedures. Stress experienced during surgery was greater than anticipated in 92/161 (57%) surgery episodes (mean VAS increase: 3.9; 95% CI: 1.1–6.8, p = 0.009). State anxiety was greater than anticipated in 99/161 (62%) episodes (mean state anxiety increase: 4.4; 95% CI: 3.0–5.8, p < 0.001). Greater preprocedural anticipatory stress and anxiety was observed in residents vs. attending gynecologists (VAS 51.9 vs. 22.8, p < 0.001; state anxiety 38.3 vs. 28.1, p < 0.001) and in primary vs. assistant surgeons (VAS 47.2 vs. 29.9, p < 0.001; state anxiety 36.9 vs. 28.3, p < 0.001). Intraoperative stress and anxiety were greater in primary surgeons (VAS 50.4 vs. 30.5, p < 0.001; anxiety 41.3 vs. 32.5, p < 0.001) and residents (VAS 43.4 vs. 31.7, p < 0.001; anxiety 53.5 vs. 33.7, p < 0.001) compared with assistants and attending gynecologists. Perceived stress and anxiety were positively correlated at both timepoints (r = 0.68, p < 0.001; r = 0.82, p < 0.001). Conclusions: When asked to reflect on stress experienced during surgery, our data show that stress during surgery is greater than anticipated for many surgical episodes. Self‐reported stress symptoms commence prior to surgery and are more commonly reported by surgeons operating as primary surgeon and by those in training. Future research should focus on determinants of presurgical stress and examine when stressors become inhibitory to performance. [ABSTRACT FROM AUTHOR]

The transition to veterancy can be psychologically challenging, and although the military provides support, the importance of social connectedness for well‐being is largely unrecognised. The significance of this oversight is highlighted by the Social Identity Model of Identity Change (SIMIC), which conceptualises life change as social identity change. SIMIC has been applied to numerous life transitions, but not to veterancy, although there is evidence that the social and psychological challenges of this transition may be especially profound (e.g., due to the chronically salient, highly structured and largely unique nature of military life and identity). To remedy this, in Study 1 (N = 210), UK‐based veterans completed an online survey. Consistent with SIMIC, social group maintenance and gain predicted mental health via the psychological resources they provided (meaning, self‐esteem, sense of personal control), and group gain was predicted by perceived military support during the transition. Study 2 (N = 14) extended these findings qualitatively through exploration of veterans' transition experiences. These studies are the first to apply aspects of the SIMIC to the veterancy transition, and they show the applicability of SIMIC in this context. They also highlight the need for transition‐related education that includes guidance on group joining and reconnecting. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Eating disorder recovery is an identity transition characterised by ambivalence, in which group memberships play an important part. However, our understanding of how memberships of groups with different recovery norms (i.e., supportive vs. unsupportive of recovery) can facilitate or inhibit recovery is limited. To address this gap, this study adopted the Social Identity Model of Recovery to examine how recovery is manifest through the changing composition of an individual's group memberships. We employed a convergent mixed methods design to quantitatively determine whether specific groups (i.e., family, friends, and online groups) are more helpful to eating disorder recovery than others, and to qualitatively explore how group (in)compatibility shapes recovery efforts. There was a high level of convergence across survey (N = 112) and interview (N = 12) data: groups could have a positive or negative impact according to their recovery norms; different groups provided different forms of support and identity‐expression; incompatibility was not always experienced as a problem and could afford strategic benefits. Our findings are amongst the first to attest to the importance of considering identity networks (and their normative content) during eating disorder recovery. [ABSTRACT FROM AUTHOR]

Introduction: The genetic variant responsible for haemophilia A (HA) significantly impacts endogenous coagulant factor VIII (FVIII:C) level, thus impacting DDAVP responsiveness. Blood group (BG) also impacts FVIII:C levels, but this is difficult to evaluate in a genetically heterogeneous population. Canada has a large cohort of mild‐moderate HA due to a single point variant: c.6104T>C, p.Val2035Ala—the Twillingate variant. Aim: To evaluate the impact of BG on endogenous FVIII:C levels and DDAVP responsiveness in a single genotype of mild‐moderate HA. Methods: This was a retrospective, single‐centre study. BG and FVIII:C levels were obtained for males with the Twillingate variant. One‐hour absolute and fold increases in FVIII:C post‐DDAVP were calculated. T‐tests and Mann–Whitney U tests were used to compare FVIII:C levels and DDAVP challenge variables between individuals according to BGs (O vs. non‐O). Results: Twenty males were included. There were significant differences between BGs (O vs. non‐O) in their lowest FVIII:C level at age <12 years (medians: 0.05 vs. 0.08 IU/mL; P =.05). Fifteen subjects underwent DDAVP challenges. Mean 1‐h FVIII:C were 0.29 (O BG) versus 0.41 IU/mL (non‐O BG); P =.04. There were no significant differences between BGs (O vs. non‐O) in mean absolute FVIII:C increase (0.20 vs. 0.27 IU/mL; P =.10) and FVIII:C fold increase (3.3‐fold vs. 3.8‐fold; P =.51). Conclusion: In HA subjects with an identical genotype, BG significantly impacts baseline FVIII:C levels and FVIII:C levels post‐DDAVP, but does not impact absolute and fold increases in FVIII:C with DDAVP. [ABSTRACT FROM AUTHOR]

Objective: Cancer predisposition syndromes are being more frequently recognized in the etiology of pediatric oncology and genetic‐related technologies are evolving rapidly, leading to an increasing availability of genetic testing for families. This systematic review assessed the psychological impact of genetic testing on children and parents in the context of childhood cancer. Methods: Searches were performed using three databases (Web of Science, Pubmed and Embase) to identify relevant empirical studies. Following Cochrane guidelines, we screened 3838 articles and identified 18 eligible studies, representing the perspectives of children and/or parents. Results: The included studies described the impact of genetic testing in different contexts (e.g. predictive testing and diagnostic testing) and in different subgroups, (e.g. carriers and non‐carriers). Overall, the studies did not identify clinically‐relevant long‐term increases in negative emotions (depression, anxiety, distress, uncertainty, guilt) as a result of genetic testing. Negative emotions were typically time‐limited and generally occurred in families with particular characteristics (e.g. those with a history of multiple cancer diagnoses, families receiving an unfavorable result for one child and a favorable result in siblings, and those with pre‐existing mental health difficulties). Positive emotions (hopefulness, relief and peace of mind) were also reported. Knowing their genetic risk status appeared to help to foster empowerment among families, regardless of the result and any associated emotions. Conclusions: Genetic testing in pediatric oncology does not appear to cause significant additional harm and can lead to positive outcomes. Clinicians need to be especially attentive when counseling families at increased risk of distress. [ABSTRACT FROM AUTHOR]

The sympatric red snappers, Lutjanus erythropterus and Lutjanus malabaricus, are highly valued by commercial and recreational fishers along the tropical northern coasts of Australia and throughout their distribution. Studies on the life history and ecology of these congeners are confounded by difficulties in distinguishing the cryptic juveniles of each species (i.e., < 200 mm total length). This study aimed to validate a robust and cost‐effective method to discriminate these juveniles using body and/or otolith morphometric data in a multivariate analysis. Juvenile samples were collected from the northwest (n = 71) and northeast (n = 19) coasts of Australia, and species identification was confirmed using DNA barcoding. The most parsimonious multivariate models achieved accurate species prediction rates of 98.8%, which consisted of just three body variables (dorsal fin length, the distance from the snout to the anterior edge of the eye, and either jaw length or distance from the snout to the preoperculum). The high level of discrimination for these cryptic juveniles highlights the robustness of this morphometric approach. The slightly lower rate of discrimination using otolith morphology (84.9%) was associated with greater regional variation in L. malabaricus between the northwest and northeast coasts. Slight variations in otolith shape are typically used to determine stock structure, which highlights the potential need to collect samples over a broader area of a species geographic range when using an otolith morphometric discrimination model. The method outlined in this study could be applied to distinguish other cryptic congeneric fish species, including from archived otolith collections. Moreover, this method has the potential to be utilized in assessing species compositions using body measurements from in situ stereo‐video. [ABSTRACT FROM AUTHOR]

Summary: Accurate estimates of subnational health and demographic indicators are critical for informing policy. Many countries collect relevant data using complex household surveys, but when data are limited, direct weighted estimates of small area proportions may be unreliable. Area level models treating these direct estimates as response data can improve precision but often require known sampling variances of the direct estimators for all areas. In practice, the sampling variances are estimated, so standard approaches do not account for a key source of uncertainty. To account for variability in the estimated sampling variances, we propose a hierarchical Bayesian spatial area level model for small area proportions that smooths both the estimated proportions and sampling variances to produce point and interval estimates of rates of interest. We demonstrate the performance of our approach via simulation and application to vaccination coverage and HIV prevalence data from the Demographic and Health Surveys. [ABSTRACT FROM AUTHOR]

Aims: To test whether showing spectators counter‐advertisements exposing alcohol harms alone, or exposing alcohol harms and alcohol sponsorship, before watching an alcohol‐sponsored sporting event promotes less favourable post‐event attitudes and intentions towards alcohol sponsor brands and alcohol in general. Design: On‐line between‐subjects experiment. Setting: Australia. Participants: A sample of Australian adults aged 18–49 years who planned to watch an alcohol‐sponsored National Rugby League (NRL) State of Origin series game was recruited through an online panel. Interventions: Participants were randomly assigned to one of three counter‐advertising conditions: control (neutral advertisement); counter‐advertisement exposing alcohol harms; and counter‐advertisement exposing alcohol sponsorship and harms, to view at least four times during the week before watching the alcohol‐sponsored sporting event. Measurements Participants (n = 1932) completed a pre‐test questionnaire a week before the sporting event. Within 4 days of watching the sporting event, participants completed post‐test measures assessing sponsor brand awareness, attitudes and preferences towards the brand, as well as knowledge, attitudes and intentions for alcohol in general (n = 1075). Findings Compared with the control advertisement, the counter‐advertisement exposing alcohol sponsorship and harms promoted higher (6–13%) awareness of sponsor brands, less favourable attitudes towards sponsor brands and drinking beer, lower purchase intentions for sponsor brands (Cohen's d = 0.15, 0.31, 0.27, respectively) and perceived less image‐based similarity and fit between the sporting event and sponsor brands (Cohen's d = 0.20 and 0.56). Both counter‐advertisements promoted lower perceptions of the appropriateness of consuming alcohol while watching sport (Cohen's d = 0.22 and 0.34), higher awareness of alcohol harms (6–34%) and higher intentions (8–13%) to reduce alcohol consumption than the control advertisement. Conclusions: At alcohol‐sponsored sporting events, counter‐advertisements addressing alcohol harms may promote knowledge of harms and intentions to drink less. Counter‐advertisements that additionally expose and critique alcohol sponsorship may detract from perceptions of sponsor brand image and intentions to purchase the sponsor's products. [ABSTRACT FROM AUTHOR]

Background: The impact of survivorship care plans (SCPs) on the proximal and distal outcomes of adult and childhood cancer survivors, and parent proxies, is unclear. This study aimed to determine the relationship between SCP receipt and these outcomes. Methods: A cross‐sectional survey of adult and childhood cancer survivors (and parent proxies for survivors aged younger than 16 years) across Australia and New Zealand was conducted. Multivariate regression models were fitted to measure the impact of SCP receipt on proximal (unmet information needs and propensity to engage with, and attend, cancer‐related follow‐up care) and distal outcomes (quality of life and satisfaction with cancer‐related follow‐up care) with control for cancer history and sociodemographic factors. Results: Of 1123 respondents, 499 were adult cancer survivors and 624 were childhood cancer survivors (including 222 parent proxies). We found that SCP receipt was predictive of greater attendance at, and awareness of, cancer‐related follow‐up care (adult: odds ratio [OR], 2.46; 95% CI, 1.18–5.12; OR, 2.38; 95% CI, 1.07–5.29; child/parent: OR, 2.61; 95% CI, 1.63–4.17; OR, 1.63; 95% CI, 1.06–2.50; respectively). SCP receipt also predicted fewer unmet information needs related to "follow‐up care required" and "possible late effects" (adult: OR, 0.44; 95% CI, 0.20–0.96; OR, 0.29; 95% CI, 0.13–0.64; child/parent: OR, 0.46; 95% CI, 0.30–0.72; OR, 0.57; 95% CI, 0.38–0.85; respectively). In terms of distal outcomes, SCP receipt predicted a better global quality of life for adult cancer survivors (β, 0.08; 95% CI, −0.01–7.93), proxy‐reported health‐related quality of life (β, 0.15; 95% CI, 0.44–7.12), and satisfaction with follow‐up care for childhood cancer survivors (OR, 2.93; 95% CI, 1.64–5.23). Conclusions: Previous studies have shown little impact of SCPs on distal end points. Results suggest that SCPs may be beneficial to cancer survivors' proximal and distal outcomes. This study found that survivorship care plans may be beneficial to both adult and childhood cancer survivors' distal and proximal outcomes. [ABSTRACT FROM AUTHOR]

Social media platforms enable like‐minded users to form online groups, interact and thereby contribute to ideological polarisation. However, online groups also polarise along a continuum of liking or affect for their group compared to other groups. We explore affective polarisation on social media and its implications for online intergroup interaction. Using social identity theory, we investigate the effects of group identification, passion, and affective polarisation on social media users' intergroup approach and avoidance tendencies. We test the research model in the context of political groups on social media. We find group identification contributes to affective polarisation by strengthening favouritism for the ingroup rather than hostility for the outgroup. Although those with greater group identification prefer to confront (approach) the opposition group on social media, the behaviour is a function of inflated feelings for the ingroup more so than animus for the outgroup. Interestingly, users with greater affective polarisation tend to shut out (avoid) the rival group on social media. Our findings imply affective polarisation contributes to group isolation that may exacerbate ideological polarisation. [ABSTRACT FROM AUTHOR]

Background: Germline genome sequencing in childhood cancer precision medicine trials may reveal pathogenic or likely pathogenic variants in cancer predisposition genes in more than 10% of children. These findings can have implications for diagnosis, treatment, and the child's and family's future cancer risk. Understanding parents' perspectives of germline genome sequencing is critical to successful clinical implementation. Methods: A total of 182 parents of 144 children (<18 years of age) with poor‐prognosis cancers enrolled in the Precision Medicine for Children with Cancer trial completed a questionnaire at enrollment and after the return of their child's results, including clinically relevant germline findings (received by 13% of parents). Parents' expectations of germline genome sequencing, return of results preferences, and recall of results received were assessed. Forty‐five parents (of 43 children) were interviewed in depth. Results: At trial enrollment, most parents (63%) believed it was at least "somewhat likely" that their child would receive a clinically relevant germline finding. Almost all expressed a preference to receive a broad range of germline genomic findings, including variants of uncertain significance (88%). Some (29%) inaccurately recalled receiving a clinically relevant germline finding. Qualitatively, parents expressed confusion and uncertainty after the return of their child's genome sequencing results by their child's clinician. Conclusions: Many parents of children with poor‐prognosis childhood cancer enrolled in a precision medicine trial expect their child may have an underlying cancer predisposition syndrome. They wish to receive a wide scope of information from germline genome sequencing but may feel confused by the reporting of trial results. Parents of children with poor‐prognosis cancer enrolled in a precision medicine trial may overestimate the likelihood of their child receiving a clinically relevant germline finding and may feel confused by the reporting of trial results. We discuss the implications of these data for informed‐consent and return of results practices in precision medicine trials. [ABSTRACT FROM AUTHOR]

Background: Precision medicine is projected to become integral to childhood cancer care. As such, it is essential to support families to understand what precision medicine entails. Methods: A total of 182 parents and 23 adolescent patients participating in Precision Medicine for Children with Cancer (PRISM), an Australian precision medicine clinical trial for high‐risk childhood cancer, completed questionnaires after study enrollment (time 0 [T0]). Of the parents, 108 completed a questionnaire and 45 completed an interview following return of precision medicine results (time 1 [T1]). We analyzed the mixed‐methods data comprising measures exploring families' perceptions and understanding of PRISM's participant information sheet and consent form (PISCF), and factors associated with understanding. Results: Most parents were satisfied with the PISCF, rating it as at least "somewhat" clearly presented (n = 160/175; 91%) and informative (n = 158/175; 90%). Many suggested improvements including the use of clearer language and a more visually engaging format. Parents' actual understanding of precision medicine was low on average, but scores improved between T0 and T1 (55.8/100‐60.0/100; p =.012). Parents from culturally and/or linguistically diverse backgrounds (n = 42/177; 25%) had lower actual understanding scores than those from a Western/European background whose first language was English (p =.010). There was little correlation between parents' perceived and actual understanding scores (p =.794; Pearson correlation –0.020; 95% CI, –0.169 to 0.116). Most adolescent patients read the PISCF either "briefly" or "not at all" (70%) and had a perceived understanding score of 63.6/100 on average. Conclusions: Our study revealed gaps in families' understanding of childhood cancer precision medicine. We highlighted areas for potential intervention such as through targeted information resources. Plain Language Summary: Precision medicine is projected to become part of the standard of care for children with cancer. Precision medicine aims to give the right treatment to the right patient and involves several complex techniques, many of which may be challenging to understand.Our study analyzed questionnaire and interview data from parents and adolescent patients enrolled in an Australian precision medicine trial.Findings revealed gaps in families' understanding of childhood cancer precision medicine. Drawing on parents' suggestions and the literature, we make brief recommendations about improving information provision to families, such as through targeted information resources. Gaps exist in parents' and adolescent patients' understanding of childhood cancer precision medicine. This study highlights areas for potential intervention such as through targeted information resources. [ABSTRACT FROM AUTHOR]

Issue addressed: To examine the potential impact on trends in reported adolescent sugar‐sweetened beverage (SSB) consumption following the adult‐targeted Western Australian (WA) LiveLighter "Sugary Drinks" campaign, which is a television‐led healthy lifestyle promotion and education mass media campaign that aired in multiple bursts between July 2013 and December 2018. Methods: Data were from a repeated cross‐sectional survey of Australian secondary school students aged 12‐17 years conducted nation‐wide in 2009‐2010 (n = 13 790 from 238 schools), 2012‐2013 (n = 10 309 from 196 schools) and 2018 (n = 9102 from 104 schools). Results: Significant declines in high SSB consumption (≥4 cups/week) were observed between 2009‐2010 and 2012‐2013 among students in both WA (27.1% vs 20.3%; odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.50‐0.84, P =.001) and all other states and territories combined (30.6% vs 21.4%; OR = 0.60, 95% CI = 0.53‐0.68, P <.001). Compared to 2012‐2013, the proportion of students in WA who reported high SSB consumption was significantly lower in 2018 (20.3% vs 9.6%; OR = 0.37, 95% CI = 0.21‐0.65, P =.001), whereas this significant decrease was not observed in all other states and territories combined (21.4% vs 17.8%; OR = 0.81, 95% CI = 0.67‐0.97, P =.024). Interaction testing indicated that the recent decline observed in WA was more pronounced among female than male students. Conclusions: Mass media campaigns targeted towards the Australian adult population may have favourable effects among adolescents with the steeper decline in high SSB consumption observed in WA between 2012‐2013 and 2018 coinciding with the repeated airing of the LiveLighter "Sugary Drinks" campaign in this state. So what?: Government investment in mass media campaigns may hasten declines in adolescents' SSB consumption. [ABSTRACT FROM AUTHOR]

Background/Aims: Discretionary, energy‐dense, nutrient‐poor food and drinks are heavily marketed and readily available in retail settings frequented by adolescents. This study examines associations between food purchasing practices in various retail settings and dietary intake among Australian adolescents. Methods: Participants were students in years 8 to 11 (ages 12‐17 years) who completed the 2009‐10 (n = 13 790), 2012‐13 (n = 10 309) or 2018 (n = 9102) National Secondary Students' Diet and Activity (NaSSDA) cross‐sectional survey. Multistage stratified random sampling was used. An online survey completed at school assessed self‐reported frequency of food purchasing practices in various retail settings and consumption of discretionary food, sugary drinks, fruit and vegetables. Generalised linear regression models examined associations between food purchasing practices and dietary behaviour. Results: Relative to students who brought lunch from home, those who purchased lunch from school or nearby outlets reported higher intake of discretionary food and sugary drinks and lower fruit intake. Buying lunch from school was also associated with lower vegetable intake. Buying food or drinks on the school commute, outside school grounds during school hours, from supermarket checkouts, and using mobile phone apps were each associated with higher discretionary food and sugary drink intake (all P <.01). Conclusions: Purchasing food or drink in various retail settings is associated with higher intake of discretionary food and drink among Australian adolescents, and some purchasing practices appeared to displace fruit and vegetable intake. So What?: These findings highlight a need to improve the accessibility and promotion of healthier food and drink options in schools and other retail settings. [ABSTRACT FROM AUTHOR]

Introduction: Suicidality in youth is a serious public health problem. The Texas Youth Depression and Suicide Research Network (TX‐YDSRN) was initiated in 2020 to create a research registry for youth with depression and/or suicidality in Texas. This report presents baseline clinical/demographic characteristics of the first 1000 participants, focusing on suicidal thoughts and behaviors. Methods: The registry includes 8–20‐year‐old youth receiving treatment for depression, or who screen positive for depression and/or suicidal ideation/behavior. Baseline data include diagnosis, depression/anxiety severity, suicidal ideation/behavior, trauma history, and measures of resilience. Results: We present baseline data on the first 1000 participants. Most (79.6%) of the sample had a primary depressive disorder. The sample had moderate to severe depression (Patient Health Questionnaire for Adolescents, PHQ‐A; 12.9 ± 6.4) and anxiety (Generalized Anxiety Disorder, GAD‐7; 11.3 ± 5.9). Nearly half reported ≥1 lifetime suicide attempts and 90% reported lifetime or current suicidal ideation. Participants with past/current suicidality (attempts and/or ideation) had greater illness severity (depression, anxiety, and suicidal thoughts/behaviors), lower resilience, and higher rates of trauma exposure than those without suicidality. Conclusions: Baseline data indicate moderate levels of depression, anxiety, and suicidality and their correlates in this cohort. Future reports will determine trajectories of outcomes and predictors, moderators, and social determinants related to these outcomes. [ABSTRACT FROM AUTHOR]

Summary: The integrated nested Laplace approximation (INLA) is a well‐known and popular technique for spatial modelling with a user‐friendly interface in the R‐INLA package. Unfortunately, only a certain class of latent Gaussian models are amenable to fitting with INLA. In this paper, we review template model builder (TMB), an existing technique and software package which is well‐suited to fitting complex spatio‐temporal models. TMB is relatively unknown to the spatial statistics community, but it is a flexible random effects modelling tool which allows users to define customizable and complex mixed effects models through C++ templates. After contrasting the methodology behind TMB with INLA, we provide a large‐scale simulation study assessing and comparing R‐INLA and TMB for continuous spatial models, fitted via the stochastic partial differential equations (SPDE) approximation. The results show that the predictive fields from both methods are comparable in most situations even though TMB estimates for fixed or random effects may have slightly larger bias than R‐INLA. We also present a smaller discrete spatial simulation study, in which both approaches perform well. We conclude with a joint analysis of breast cancer incidence and mortality data implemented in TMB which requires a model which cannot be fit with R‐INLA. [ABSTRACT FROM AUTHOR]

Objectives: SARS‐CoV‐2 infection causes a spectrum of clinical disease presentation, ranging from asymptomatic to fatal. While neutralising antibody (NAb) responses correlate with protection against symptomatic and severe infection, the contribution of the T‐cell response to disease resolution or progression is still unclear. As newly emerging variants of concern have the capacity to partially escape NAb responses, defining the contribution of individual T‐cell subsets to disease outcome is imperative to inform the development of next‐generation COVID‐19 vaccines. Methods: Immunophenotyping of T‐cell responses in unvaccinated individuals was performed, representing the full spectrum of COVID‐19 clinical presentation. Computational and manual analyses were used to identify T‐cell populations associated with distinct disease states. Results: Critical SARS‐CoV‐2 infection was characterised by an increase in activated and cytotoxic CD4+ lymphocytes (CTL). These CD4+ CTLs were largely absent in asymptomatic to severe disease states. In contrast, non‐critical COVID‐19 was associated with high frequencies of naïve T cells and lack of activation marker expression. Conclusion: Highly activated and cytotoxic CD4+ T‐cell responses may contribute to cell‐mediated host tissue damage and progression of COVID‐19. Induction of these potentially detrimental T‐cell responses should be considered when developing and implementing effective COVID‐19 control strategies. [ABSTRACT FROM AUTHOR]

Objective: Juvenile fibromyalgia (JFM) is a complex chronic pain condition that remains poorly understood. The study aimed to expand the clinical characterization of JFM in a large representative sample of adolescents with JFM and identify psychological factors that predict pain interference. Methods: Participants were 203 adolescents (ages 12–17 years) who completed baseline assessments for the multisite Fibromyalgia Integrative Training for Teens (FIT Teens) randomized control trial. Participants completed the Pain and Symptom Assessment Tool, which includes a Widespread Pain Index (WPI; 0–18 pain locations) and Symptom Severity checklist of associated somatic symptoms (SS; 0–12) based on the 2010 American College of Rheumatology criteria for fibromyalgia. Participants also completed self‐report measures of pain intensity, functional impairment, and psychological functioning. Results: Participants endorsed a median of 11 painful body sites (WPI score) and had a median SS score of 9. Fatigue and nonrestorative sleep were prominent features and rated as moderate to severe by 85% of participants. Additionally, neurologic, autonomic, gastroenterologic, and psychological symptoms were frequently endorsed. The WPI score was significantly correlated with pain intensity and catastrophizing, while SS scores were associated with pain intensity and all domains of physical and psychological functioning. Depressive symptoms, fatigue, and pain catastrophizing predicted severity of pain impairment. Conclusion: JFM is characterized by chronic widespread pain with fatigue, nonrestorative sleep, and other somatic symptoms. However, how diffusely pain is distributed appears less important to clinical outcomes and impairment than other somatic and psychological factors, highlighting the need for a broader approach to the assessment and treatment of JFM. [ABSTRACT FROM AUTHOR]

Two serious health conditions, obesity and atopic dermatitis (AD), share some pathological features such as insulin resistance, leptin resistance and inflammation, and a growing body of evidence suggests a link between obesity and AD. Obesity predisposes an individual to and/or worsens AD, whereas AD increases the risk of obesity. Obesity and AD's interactions are mediated by cytokines, chemokines and immune cells. Obese individuals with AD are more resistant to anti‐inflammatory therapy, while weight loss can alleviate AD. In this review, we summarize the evidence linking AD and obesity. We also discuss the pathogenic role of obesity in AD, and vice versa. Because of the connection between these two conditions, mitigation of one could possibly prevent the development of or alleviate the other condition. Effective management of AD and weight loss can enhance the wellness of individuals with both of these conditions. However, proper clinical studies are warranted to validate this speculation. [ABSTRACT FROM AUTHOR]

The authors present the journal's revised and expanded scope and the orientations and activities that are being undertaken in support of new initiatives. They talk about the re-scope undergone by the journal that meaningfully expanded the journal's original scope, the journal's value for targeted special issues, and the relevance of the journal to their communities, including stakeholders and practitioners.

Fanconi anemia (FA) is a heritable malformation, bone marrow failure and cancer predisposition syndrome that confers an exceptionally high risk of squamous carcinomas. These carcinomas originate in epithelia lining the mouth, proximal esophagus, vulva and anus: their origins are not understood, and no effective ways have been identified to prevent or delay their appearance. Many FA‐associated carcinomas are also therapeutically challenging: they may be multi‐focal and stage‐advanced at diagnosis, and most individuals with FA cannot tolerate standard‐of‐care systemic therapies such as DNA cross‐linking drugs or ionizing radiation due to constitutional DNA damage hypersensitivity. We developed the Fanconi Anemia Cancer Cell Line Resource (FA‐CCLR) to foster new work on the origins, treatment and prevention of FA‐associated carcinomas. The FA‐CCLR consists of Fanconi‐isogenic head and neck squamous cell carcinoma (HNSCC) cell line pairs generated from five individuals with FA‐associated HNSCC, and five individuals with sporadic HNSCC. Sporadic, isogenic HNSCC cell line pairs were generated in parallel with FA patient‐derived isogenic cell line pairs to provide comparable experimental material to use to identify cell and molecular phenotypes driven by germline or somatic loss of Fanconi pathway function, and the subset of these FA‐dependent phenotypes that can be modified, complemented or suppressed. All 10 FANC‐isogenic cell line pairs are available to academic, non‐profit and industry investigators via the "Fanconi Anemia Research Materials" Resource and Repository at Oregon Health & Sciences University, Portland OR. [ABSTRACT FROM AUTHOR]

The ocean and coasts are largely absent from the 'Green New Deal' proposal. In response to the limited attention paid to the sustainability and equitable governance approaches of the blue economy, a US 'Blue New Deal' has been proposed aiming to protect the health of the ocean and support coastal communities' adaptation to climate change. The Blue New Deal emerged as a central policy proposal from 2020 Democratic presidential candidate Elizabeth Warren to enhance the role of the blue economy while simultaneously addressing the climate crisis. Through a just transitions analysis, this article evaluates the proposal for a US Blue New Deal — as designed by Senator Elizabeth Warren — that would be applied towards enhancing socioeconomic resiliency, environmental justice, and addressing social inequities. As part of a critical policy analysis evaluating the areas of focus Warren's Blue New Deal presents, environmental justice and sustainability are central to the success of managing, and enhancing the role of, the blue economy. The challenges facing the Blue New Deal reflect a 'one size fits all' federal approach that has implications for addressing multifaceted obstacles in key sectors of the blue economy, its governance, and tackling interconnected crises that exacerbate socioeconomic inequities and vulnerabilities of marginalised coastal communities. This article proposes a blue justice framework for the Blue New Deal that seeks to address the tensions and contradictions that exist in its current form and indicates how a comprehensive policy framework can enhance the sustainability and equitable involvement of the blue economy. [ABSTRACT FROM AUTHOR]

Implementation of genetic testing in healthcare increases, but access to, and number of, genetics providers remain scarce. This study analyzed the impact of genetic counselor (GC) involvement on frequency of documentation of pre‐ and post‐test counseling of genetic testing between GCs and genetics providers (GPs), and GCs and non‐genetics providers (NGPs). A retrospective chart review of 467 charts from patients who had genetic testing ordered between July 2016 and June 2018 at a primarily pediatric institution was conducted. GCs were involved for 223 charts (GC group), and not involved for 244 (non‐GC group). The non‐GC group was further stratified into patient charts with Genetics Providers (GP group) (n = 100) involved and those with Non‐Genetics Providers (NGP group) (n = 144) involved. Categorical, binomial, pre‐test variables (counseling, test description, results possibilities, insurance coverage, and cost) and categorical, binomial, post‐test variables (results disclosure, family testing recommendations, recurrence risk, and provided resources) were collected and compared using Fisher's exact test (p < 0.005). With the exception of test description, documentation for all variables occurred more frequently in the GC group compared to the NGP group (all p < 0.001). Documentation for the majority of variables also occurred more frequently in the GC group compared to the GP group (p < 0.005), with the exceptions of overall pre‐test counseling and family testing recommendations. GC involvement was associated with increased documentation of most pre‐ and post‐test genetic counseling variables. With increased emphasis placed on transparency, accurateness, and access for patients of the EMR, in part due to the passage of the CARES Act, documentation should reflect the content of counseling provided. The cause of the documentation discrepancy identified may have differing effects on patient care and provider education. [ABSTRACT FROM AUTHOR]

Background: An increasing number of children diagnosed with both low‐ and high‐risk neuroblastoma are surviving. Yet, treatment can be intensive and often multimodal, especially for high‐risk neuroblastoma, resulting in significant long‐term health problems. We aimed to describe neuroblastoma survivors' pediatric hospitalizations, readmissions, and their associated costs. Method: We conducted a population‐based study of all children (<18 years) residing in New South Wales (NSW), Australia, and hospitalized with a recorded diagnosis of neuroblastoma during 2001–2020. We used linked NSW Admitted Patient Data Collection and death registration data to examine the frequency, length of stay, and readmissions following the first admission when neuroblastoma was diagnosed (i.e., the index admission), and the associated hospitalization costs by age and timing postindex admission discharge. Results: In total, 300 children (64% aged <3 years) were hospitalized for neuroblastoma over the study period. The median number of readmissions and length of stay within 2 years postdischarge were 17 (interquartile range IQR: 5.5–25) and 45.5 (IQR: 10–125) days, and median cost per child was AUD$124,058 (IQR $34,217–$264,627). Following discharge from the index admission, there were 7088 readmissions (median: 20 per child, IQR: 7–29). Fifty‐eight percent of readmissions occurred within 1‐year postdischarge, primarily due to fever, nausea, abdominal pain, and respiratory conditions. Conclusion: The burden of health problems requiring hospitalization among neuroblastoma survivors results in significant associated healthcare costs, warranting further efforts to optimize health care for neuroblastoma survivors that focuses on early intervention and long‐term monitoring. [ABSTRACT FROM AUTHOR]

Objective: Management guidelines encourage self‐care in patients with symptomatic osteoarthritis (OA). We undertook this study to investigate the relationship between health literacy (HL) and appropriateness of selection of self‐care strategies in people with self‐reported symptoms of OA. Methods: We conducted an online national observational, demographically representative, cross‐sectional survey of adults (ages 45–74 years). The eligibility criterion of "self‐reported OA symptoms" was screened for using guideline‐endorsed clinical criteria. Participants completed a custom‐built questionnaire that included validated scales for HL, pain intensity, sleep quality, and OA function/disability. Management strategies were grouped into self‐care activities, analgesics, and complementary medicines, and analyses of appropriateness were based on predefined, evidence‐based quality indicators. Results: Of 6,800 participants, 628 met the inclusion criteria and completed the survey. HL was categorized as follows: low (100 of 628, 15.9%), moderate (317 of 628, 50.5%), and excellent (211 of 628, 33.6%). In the past 7 days, mean pain intensity (0–10 scale) was 3.11 (95% confidence interval [95% CI] 3.06–3.16), and 71.7% of participants (450 of 628) had not achieved adequate pain relief. In the past month, 54.1% (340 of 628) reported disrupted sleep. Participants managed their pain with multiple self‐care activities (mean 1.44; 95% CI 1.32–1.57), analgesics (mean 1.74; 95% CI 1.60–1.88), and complementary medicines (mean 1.01; 95% CI 0.90–1.12). There was a statistically significant (P < 0.001) interaction between HL and appropriateness of current management strategies (HL low, guideline‐recommended management strategies less likely). Higher HL did not always translate into making appropriate pain management choices. Conclusion: Appropriate selection and use of evidence‐based management options is critical for patients with OA to obtain the full benefits from their treatment. Knowledge about suitable choices for OA self‐care is suboptimal, and future education should be tailored to different levels of HL. [ABSTRACT FROM AUTHOR]

Social identity approach (SIA) research shows that community members often work together to support survivors of collective victimization and rectify social injustices. However, complexities arise when community members have been involved in perpetrating these injustices. While many communities are unaware of their role in fostering victimization, others actively deny their role and responsibility to restore justice. We explore these processes by investigating experiences of community violence and collective justice‐seeking among Albanian survivors of dictatorial crimes. Survivors (N = 27) were interviewed, and data were analysed using theoretical thematic analysis guided by the SIA. The analysis reveals the diverse ways communities can become harmful 'Social Curses'. First, communities in their various forms became effective perpetrators of fear and control (e.g., exclusion and/or withholding ingroup privileges) during the dictatorship because of the close relationship between communities and their members. Second, communities caused harm by refusing to accept responsibility for the crimes, and by undermining attempts at collective action to address injustices. This lack of collective accountability also fosters survivors' feelings of exclusion and undermines their hope for systematic change. Implications for SIA processes relating to health/wellbeing (both Social Cure and Curse) are discussed. We also discuss implications for understanding collective action and victimhood. [ABSTRACT FROM AUTHOR]