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Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

Introduction: Vision plays an important role in walking development. Understanding gait characteristics and development in infants and children with visual disorders is crucial to identify early walking impairment and promoting optimal motor performance. We aimed to identify typical gait patterns and differences between infants and children with visual disorders and their sighted peers, and how these change over time, identifying key research gaps in this area. Methods: A search of three databases identified 1,531 papers, of which eight met inclusion criteria. Results: Children who are blind showed differences in gait compared to peers with low vision or full sight. Differences were identified across age groups with slower walking, postural, head, and trunk position alterations and uncoordinated and reduced upper limb swing motions observed in children with blindness. Discussion: We identified three macro areas of interest related to gait characteristics in children with visual disorders: (1) and (2) compensation mechanisms of limbs, and (3) probing the environment. In general, children who are blind also showed the use of a wider base of support, more external rotation of the feet, and fewer steps taken per minute. There are no studies reporting gait characteristics in the early stages of walking development, scarcity of longitudinal investigations, and studies using different variables to measure gait. The lack of such evidence prevented the establishment of gait development trajectories over time in pediatric populations with visual disorders. Implications for Practitioners: This review is the first to summarize existing knowledge of gait characteristics in children with visual disorders, advancing our understanding regarding the key differences in gait patterns that are observed in this population. Information gathered in this work can help inform future studies and practitioners in this field, enhancing decision-making processes to support walking development and promoting increasing knowledge of gait progresses in infants and children with visual disorders. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

This paper presents a method that uses observed data from an age-period table to set bounds on the age, period, and cohort effects in an age-period-cohort multiple classification (APCMC) model. The rationale is that with enough periods over a long time span the age distributions within periods on the dependent variable will be affected by different sets of cohorts for each of the periods. This is likely to result in different trends in these separate period age distributions such that the trends in the age distributions will encompass the trend in the age effects that generated the dependent variable values. This approach can help to identify bounds that likely encompass the age, period, cohort parameters that generated the data. The data used in this papers are estimated homicide arrests by single years for those aged 15–64 for the periods 1964 to 2019 in the United States. I utilize the observed trends in the age-distributions for each of the 56 periods as different constraints on the trends for the age effects in the APCMC fixed effects model. These estimates are used to form bounds on the age effects, period effects, and cohort effects. [ABSTRACT FROM AUTHOR]

Background: Management of short bowel syndrome in children has been surrounded by much debate with timing of the lengthening procedure still controversial. Early bowel lengthening procedure (EBLP) has been defined as any bowel lengthening procedure performed before 6 months of age. The purpose of this paper is to report the institutional experience in EBLP and to review the literature on this subject to identify common indications. Methods: An institutional retrospective analysis of all the intestinal lengthening procedures was performed. Furthermore, an Ovid/Embase search regarding children who underwent bowel lengthening in the past 38 years was conducted. Primary diagnosis, age at procedure, type of procedure, indication, and outcome were analyzed. Results: Ten EBLP were performed in Manchester from 2006 to 2017. Median age at surgery was 121 days (102-140), preoperative small bowel (SB) length was 30 cm (20-49) while postoperative SB length was 54 cm (40-70), with a median increased bowel length of 80%. Ninety-seven papers were reviewed, with more than 399 lengthening procedures performed. Twenty-nine papers matched criteria with more than 60 EBLP were observed of which 10 were performed in a single center from 2006 to 2017. EBLP was performed due to SB atresia, to excessive bowel dilatation or failure to enteral feeds, at a median age of 60 days (1-90). Serial transverse enteroplasty was the most frequent procedure used lengthening the bowel from 40 cm (29-62.5) to 63 cm (49-85), with a median increased bowel length of 57%. Conclusions: This study confirms that no clear consensus on indication or timing to perform early SB lengthening is reported. According to the gathered data, EBLP should be considered, only in cases of actual necessity after review of qualified intestinal failure center. [ABSTRACT FROM AUTHOR]

During the COVID-19 epidemic, social media has become the main channel for people to learn information related to the epidemic, among which information in the form of videos has played a significant role in the prevention and control of COVID-19. However, few studies have analyzed the process of knowledge learning of individuals through watching COVID-19 videos. Therefore, to explore the process of COVID-19 video viewers' knowledge acquisition, this paper constructs a knowledge learning path model based on the cognitive mediation model and dual coding theory. A sample of 255 valid questionnaires was collected to validate this model. The results of this study show that an individual's perceived risk of COVID-19 affects their surveillance motivation positively, while surveillance motivation further stimulates the attention and elaboration about the information in COVID-19 videos. Among them, attention positively influences the elaboration about the information. Ultimately, both an individual's attention and elaboration positively influence the knowledge he or she acquires from the COVID-19 videos. This paper not only verifies the hypothesized relationships in the original cognitive mediation model, but also extends the model to the context of video knowledge learning. Analyzing the knowledge learning process of COVID-19 video viewers, this paper can provide suggestions for government propaganda departments and relevant media to improve public knowledge of COVID-19. [ABSTRACT FROM AUTHOR]

The variation of the journal impact factor is affected by many statistical and sociological factors such as the size of citation window and subject difference. In this work, we develop an impact factor dynamics model based on the parallel system, which can be used to analyze the correlation between the impact factor and certain elements. The parallel model aims to simulate the submission and citation behaviors of the papers in journals belonging to a similar subject, in a distributed manner. We perform Monte Carlo simulations to show how the model parameters influence the impact factor dynamics. Through extensive simulations, we reveal the important role that certain statistics elements and behaviors play to affect impact factors. The experimental results and analysis on actual data demonstrate that the value of the JIF is comprehensively influenced by the average review time, average number of references, and aging distribution of citation. [ABSTRACT FROM AUTHOR]

This paper considers the distribution of mortality across social groups classified by caste, gender and sector of origin in India in the mid-2010s: as such, the essay is intended to be both a methodological/measurement-oriented study and a substantive empirical assessment of an important dimension of human functioning in India. The analysis is carried out employing micro-data on the age-distributions of population and death-rates available in the National Family Health Survey of 2015–16 (NFHS-4). Mortality in the paper is measured in terms of the crude death rate, an indicator of "inefficiency" in the age-distribution of deaths, and an "age-adjusted" death rate which takes account of both the mean and the dispersion of a distribution. The last-mentioned indicator is taken to be the preferred measure of mortality. The analysis in the paper suggests that mortality outcomes across castes replicate the caste hierarchy and that there is a sharp rural-urban divide in the distribution of death. Mortality sex-ratios are found to be relatively more favourable for the lower than the higher castes. The results presented in the paper are not unexpected, but they provide quantitative confirmation of one's worst suspicions regarding the skewed distribution of mortality across social groups in India. [ABSTRACT FROM AUTHOR]

Low vitamin B12 has been associated with raised plasma homocysteines and the consumption of B vitamins has been shown to reduce homocysteines. Raised levels of homocysteines have been linked to causing symptoms of mental illness. B12 is also required in the synthesis of monoamines and is required to maintain neurological health. Aim: This study reviews research into the effects of the supplementation of B12 in the prevention and recovery of mental illness, and the potentiation of psychotropic medication. Methodology: This literature review follows a systematic approach to searching databases CINAHL, EMBASE, Medline, and PsycINFO where 287 non-duplicated articles results were received. Appropriate articles were identified through title and abstract screening and inclusion and exclusion criteria were applied. Five articles were chosen to address the research question following critical appraisal. Thematic analysis was then conducted. Findings: This review identified five randomised controlled trials into the supplementation of various doses of B12 in conjunction with folic acid and B6. The supplement was measured against post-stroke depression prevention, the reduction of symptoms of depression in woman with cardiovascular disease, the effect on negative symptoms in schizophrenia, the reduction and prevention of depression in older adults, and the potentiation of psychotropic interventions. The papers reviewed showed inconclusive results, but evidence to support sub-groups and specific high-risk groups. Strong evidence showed supplementation of B12, folic acid and B6 has high rates of preventing post-stroke depression. Conclusion: The findings show that this area of research is still to be developed. The effects of B12 supplementation with other B vitamins on mental health have shown to be inconclusive. There is a case for its use to be considered within certain patient groups to aid recovery of mental health or in some high-risk patient groups. Recommendations are made for further research into high-risk groups of people that may have symptoms or symptoms that could be improved through the supplementation of B12. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Power dynamics influence every aspect of scientific collaboration. Team power dynamics can be measured by team power level and team power hierarchy. Team power level is conceptualized as the average level of the possession of resources, expertise, or decision‐making authorities of a team. Team power hierarchy represents the vertical differences of the possessions of resources in a team. In Science of Science, few studies have looked at scientific collaboration from the perspective of team power dynamics. This research examines how team power dynamics affect team impact to fill the research gap. In this research, all coauthors of one publication are treated as one team. Team power level and team power hierarchy of one team are measured by the mean and Gini index of career age of coauthors in this team. Team impact is quantified by citations of a paper authored by this team. By analyzing over 7.7 million teams from Science (e.g., Computer Science, Physics), Social Sciences (e.g., Sociology, Library & Information Science), and Arts & Humanities (e.g., Art), we find that flat team structure is associated with higher team impact, especially when teams have high team power level. These findings have been repeated in all five disciplines except Art, and are consistent in various types of teams from Computer Science including teams from industry or academia, teams with different gender groups, teams with geographical contrast, and teams with distinct size. [ABSTRACT FROM AUTHOR]

Ceramic-on-ceramic (COC) total hip arthroplasties (THAs) with large heads (>36 mm) were introduced to reduce dislocation rates and restore the hip anatomy as closely as possible to the native one. To date, the literature is scarce and fragmented; a review is desirable to point out the outcomes and the possible specific complications (noise, groin pain, and taperosis). A systematic review about large-diameter COC THAs was conducted according to the PRISMA guidelines. The PubMed and Cochrane databases were searched using the terms "large", "big", "head", "hip", and "ceramic." The methodological quality of the papers was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Seven papers (level of evidence: 5 case series and 2 case-control studies) met the inclusion criteria. Clinical outcomes were excellent in >90% of the patients. Groin pain was reported in only 1 article (7%). Radiological outcomes were positive. Minimal revision rates (<2%) were reported at short- to mid-term follow-ups. Dislocation rates were usually <1%. No bearing surfaces failed. No case of trunnionitis was reported. Noise occurred in up to 30% of the patients, mostly squeaking. The noise did not influence clinical outcomes or patients' satisfaction. Noise was inconstantly associated with component positioning, younger age, high articular excursions, and larger sizes. Large-diameter heads in COC THAs (≥40 mm) showed promising clinical and radiological outcomes with minimal revision rates. Noise is a cause of concern and should be carefully evaluated at longer follow-ups and in larger, prospective, and specifically designed case series. [ABSTRACT FROM AUTHOR]

The adult-centric concept of 'age-appropriateness' is an arbitrary signifier and yet it commands a powerful common-sense appeal in governing the shape of sexuality education. The visibility of LGBTQ+ lives in primary schools is deeply impacted by the cis-heteronormative ways in which age-appropriateness is commonly understood and mobilised; very often resulting in silence and delay. The concept of age-appropriateness also becomes entangled with moral panics about 'promoting' LGBTQ+ lives, or children being somehow 'recruited' to identify as LGBTQ+. This paper draws on findings from a study with the parents of eleven trans and gender diverse children (then aged between 5 and 13) conducted in 2017, as well as a follow-up study conducted with seven participants from the same group of parents and children in 2022. The paper explores how the politics of age and agency intersect and become intensified as trans and gender diverse children and their parents navigate and make decisions about their bodies, lives and everyday worlds in primary schools. These stories of trans and gender diverse children provide an arresting invitation to adults to attend closely to the rich stories of children themselves in (re)considering the potential of sexuality education across contexts. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use is the major preventable cause of premature death worldwide, responsible for about 8 million deaths per year, mostly in low- and middle-income countries, such as Morocco. Adolescents' tobacco use is a matter of concern, because early initiation increases the risk of becoming a lifelong user. There exists a notable gap in the synthesis of evidence concerning tobacco use among Moroccan adolescents. Thus, the purpose of this study was to provide a comprehensive view of the prevalence of tobacco products' use and associated factors among adolescents in Morocco. Methods: We systematically searched PubMed, Scopus, Web of Science and ScienceDirect for relevant studies reporting prevalence rates of tobacco products' use among Moroccan adolescents, published until June 2024, using inclusion and exclusion criteria in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Additional searches were completed on other sources to reach unpublished reports. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the quality of included studies. Results: After the final screening, 22 papers met the inclusion criteria. Life-time prevalence of tobacco use ranged from 7.8% to 20.4% for cigarettes smoking, from 10.6% to 21.9% for waterpipe, from 7.9% to 9.1% for chewing tobacco and from 9.2% to 12.4% for snuff. The last 12-month prevalence of cigarette smoking was comprised between 6.9% and 10.8%. As for the prevalence of current use, ranges of (1.8%-16.4%) and (4.9%-8.4%) were noted for cigarettes and waterpipe, respectively. The most commonly highlighted risk factors for tobacco use included male sex, older age, having friends or family members who use tobacco and low perception of risk associated with tobacco use. Conclusion: Our findings reveal an alarming situation of tobacco use among Moroccan adolescents. Therefore, it is crucial that all stakeholders engage in concerted efforts to develop and implement evidence-based preventive interventions among early adolescents. [ABSTRACT FROM AUTHOR]

Idiopathic anaphylaxis (IA) remains a frustrating challenge for both patients and physicians. The aim of this paper is to focus on IA in pediatric ages and suggest possible diagnostic algorithms according to specific age ranges (infants, children, and adolescents). In fact, in a variable percentage of patients, despite extensive diagnostic tests, the cause of anaphylactic episodes cannot be identified. Moreover, the lack of a unanimous IA definition requires a careful and detailed diagnostic workup. Prompt recognition of signs and symptoms, especially in younger children, and an accurate clinical history often allow a choice of the most appropriate diagnostic tests and a correct differential diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. Methods: A public consultation was undertaken with people of any gender aged 18–50 years living in the United Kingdom who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors' knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Results: Fifty‐four people joined the initial discussion round (66% women, 21% men, 13% nonbinary or transgender; 55% aged 18–30 years, 30% 31–40 years, 15% 41–50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term 'preconception health', understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g., preconception health, medical terms), using language that is positive, encouraging and gender‐sensitive where possible, and using messages that are specific, nonjudgmental and realistic. The phrases 'health and well‐being during the childbearing years', 'health and well‐being before pregnancy and parenthood' and 'planning for parenthood' resonated with most public contributors. School‐based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. Conclusion: This public consultation produced recommendations from a diverse group of people of reproductive age in the United Kingdom to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co‐development of public awareness campaigns and guidance for healthcare professionals. Patient or Public Contribution: This public consultation included a diverse group of members of the public. They were not involved in the original design of the project, but following the initial round of online group discussions, they contributed to the interpretation and refinement of the emerging concepts in a subsequent round of group meetings. After the consultation activity, public contributors formed a Public Advisory Group and have subsequently been involved in other studies on the same topic. Two public contributors (E.R. and F.F.) provided critical input in the preparation and revision of this manuscript and are co‐authors of the paper. [ABSTRACT FROM AUTHOR]

Background: This study examines the perceptions of the Australian public canvassed in 2021 during the COVID‐19 pandemic about their health system compared to four previous surveys (2008, 2010, 2012 and 2018). Methods: In 2021, a nationwide online survey was conducted with a representative sample of Australians (N = 5100) recruited via market research panels. The results were compared to previous nationwide Australian survey samples from 2018 (N = 1024), 2012 (N = 1200), 2010 (N = 1201) and 2008 (N = 1146). The survey included questions consistent with previous polls regarding self‐reported health status and overall opinions of, and confidence in, the Australian health system. Results: There was an increase in the proportion of respondents reporting positive perceptions at each survey between 2008 and 2021, with a significantly higher proportion of respondents expressing a more positive view of the Australian healthcare system in 2021 compared to previous years (χ2(8, N = 9645) = 487.63, p < 0.001). In 2021, over two‐thirds of respondents (n = 3949/5100, 77.4%) reported that following the COVID‐19 pandemic, their confidence in the Australian healthcare system had either remained the same (n = 2433/5100, 47.7%) or increased (n = 1516/5100, 29.7%). Overall, respondents living in regional or remote regions, younger Australians (< 45 years) and women held less positive views in relation to the system. In 2021, the most frequently identified area for urgent improvement was the need for more healthcare workers (n = 1350/3576, 37.8%), an area of concern particularly for Australians residing in regional or remote areas (n = 590/1385, 42.6%). Conclusions: Irrespective of disruptions to the Australian healthcare system caused by the COVID‐19 pandemic, Australians' perceptions of their healthcare system were positive in 2021. However, concerns were raised about inadequate workforce capacity and the cost of healthcare, with differences identified by age groups and geographical location. Patient or Public Contribution: Health consumer representatives from the Consumers Health Forum of Australia contributed to the co‐design, deployment, analysis and interpretation of the results of this survey. J.A. and L.W. from the Consumers Health Forum of Australia contributed to the development of the paper. [ABSTRACT FROM AUTHOR]

Backgrounds: Freezing of gait (FoG) is a common and debilitating symptom of Parkinson's disease (PD) that can lead to falls and reduced quality of life. Wearable sensors have been used to detect FoG, but current methods have limitations in accuracy and practicality. In this paper, we aimed to develop a deep learning model using pressure sensor data from wearable insoles to accurately detect FoG in PD patients. Methods: We recruited 14 PD patients and collected data frommultiple trials of a standardized walking test using the Pedar insole system. We proposed temporal convolutional neural network (TCNN) and applied rigorous data filtering and selective participant inclusion criteria to ensure the integrity of the dataset. We mapped the sensor data to a structured matrix and normalized it for input into our TCNN. We used a train-test split to evaluate the performance of the model. Results: We found that TCNN model achieved the highest accuracy, precision, sensitivity, specificity, and F1 score for FoG detection compared to othermodels. The TCNN model also showed good performance in detecting FoG episodes, even in various types of sensor noise situations. Conclusions: We demonstrated the potential of using wearable pressure sensors andmachine learningmodels for FoG detection in PD patients. The TCNNmodel showed promising results and could be used in future studies to develop a real-time FoG detection system to improve PD patients' safety and quality of life. Additionally, our noise impact analysis identifies critical sensor locations, suggesting potential for reducing sensor numbers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented services have been shown to promote recovery in people with mental illness; their implementation is important for current psychiatric practice and is being considered by many professional institutions.The Japanese government released the policy 'A Vision for Reform of Mental Health and Medical Welfare' (Ministry of Health, Labour and Welfare, 2004; https://www.mhlw.go.jp/topics/2004/09/dl/tp0902‐1a.pdf), aiming to update public consciousness, reorganize the mental healthcare welfare system and strengthen the foundation of mental healthcare to promote a basic policy focusing on the transition 'from hospital to community life'. What the paper adds to existing knowledge?: This is the first study to clarify recovery‐oriented attitudes among psychiatric nursing directors and related factors in Japan. It shows an association between recovery‐oriented attitudes and hospital size. What are the implications for practice?: A relationship exists between the recovery knowledge and recovery‐oriented attitudes of psychiatric nursing directors. It may thus be valuable for directors to see and hear about the experiences of patients living in the community during their recovery process. As hospital size and organizational climate may hinder the successful implementation of recovery‐oriented practices, these factors must be considered when introducing such practices.Further research is needed on the relationship between psychiatric nursing directors' recovery‐oriented attitudes and practices. Moreover, to develop intervention studies that uncover success factors for enhancing recovery‐oriented attitudes, organizational factors that enable recovery‐oriented practices must be further investigated. Introduction: Recovery‐oriented practices in mental health services have become a global priority. Despite their proven effectiveness, Japanese hospitals have not widely implemented such practices. Aim: This study clarified psychiatric nursing directors' recovery‐oriented attitudes and factors regarding promoting recovery‐oriented practices to identify methods for developing these practices in Japan. Method: This cross‐sectional study used a questionnaire survey with 250 nursing directors from 1287 Japanese psychiatric hospitals. Multivariable regression analysis assessed how socio‐demographic variables and Recovery Knowledge Inventory (RKI) scores affected Recovery Attitudes Questionnaire (RAQ‐7) scores. Results: The analysis revealed that more clinical and managerial experience was associated with more negative recovery‐oriented attitudes. High RKI scores, knowledge of strength, hospital size and outpatient work experience were associated with more positive recovery‐oriented attitudes. Discussion: Implementing recovery practices requires consideration of knowledge and experience in recovery and hospital size alongside recovery training based on a hospital's organizational structure. Although the low response rate could influence the study's generalisability, it could also indicate low interest in recovery‐oriented practices among professionals. Implications for Practice: Acquiring more knowledge and experience regarding recovery promotes recovery‐oriented attitudes among nursing directors. An appropriate organizational culture and consideration of hospital size are required when introducing such recovery practices. [ABSTRACT FROM AUTHOR]

Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

Background: Delirium is a common disorder affecting patients' psychiatric illness, characterized by a high rate of underdiagnosis, misdiagnosis, and high risks. However, previous studies frequently excluded patients with psychiatric illness, leading to limited knowledge about risk factors and optimal assessment tools for delirium in psychiatric settings. Objectives: The scoping review was carried out to (1) identify the risk factors associated with delirium in patients with psychiatric illness; (2) synthesize the performance of assessment tools for detecting delirium in patients with psychiatric illness in psychiatric settings. Design: Scoping review. Data sources: PubMed, Web of Science, and Embase were searched to identify primary studies on delirium in psychiatric settings from inception to Dec 2023 inclusive. Two independent reviewers screened eligible studies against inclusion criteria. A narrative synthesis of the included studies was conducted. Results: A final set of 36 articles meeting the inclusion criteria, two main themes were extracted: risk factors associated with delirium in patients with psychiatric illness and assessment tools for detecting delirium in psychiatric settings. The risk factors associated with delirium primarily included advanced age, physical comorbid, types of psychiatric illness, antipsychotics, anticholinergic drug, Electroconvulsive therapy, and the combination of lithium and Electroconvulsive therapy. Delirium Rating Scale-Revised-98, Memorial Delirium Assessment Scale, and Delirium Diagnostic Tool-Provisional might be valuable for delirium assessment in patients with psychiatric illness in psychiatric settings. Conclusions: Delirium diagnosis in psychiatric settings is complex due to the overlapping clinical manifestations between psychiatric illness and delirium, as well as their potential co-occurrence. It is imperative to understand the risk factors and assessment methods related to delirium in this population to address diagnostic delays, establish effective prevention and screening strategies. Future research should focus on designing, implementing, and evaluating interventions that target modifiable risk factors, to prevent and manage delirium in patients with psychiatric illness. What is already known about the topic?: • Delirium is common among individuals living in psychiatric settings and remains clinically under-detected, and it is associated with the length of hospital stay and poor prognoses. • Dementia with behavioral and psychological symptoms of dementia (BPSD) and other psychiatric illnesses has been shown to make delirium more likely. However, despite extensive research on factors associated with delirium, there is a notable lack of studies conducted in psychiatric settings. • Early detection and identification of delirium are crucial in psychiatric settings; however, literature regarding the assessment and identification of delirium has not been synthesized, particularly in the context of comorbid psychiatric illness. What this paper adds?: • Risk factors associated with delirium in patients with psychiatric illness primarily include advanced age, physical comorbid, types of psychiatric illness, antipsychotics, anticholinergic drug, Electroconvulsive therapy (ECT), and the combination of lithium and ECT. • Delirium Rating Scale-Revised-98, Memorial Delirium Assessment Scale, and Delirium Diagnostic Tool-Provisional might hold promising value as assessment tools for delirium in patients with psychiatric illness in psychiatric settings. [ABSTRACT FROM AUTHOR]

The Philippines is a source of labor for many countries. Roughly 10 million overseas Filipinos are working and living outside of the Philippines. This paper examines the association between sociodemographic characteristics (sex, age, educational level, and income) and self-rated physical and mental health, access to healthcare, and health habits among immigrant Filipinos living in Santa Cruz de Tenerife, Spain. Through convenience sampling, Filipino migrants (n = 103) aged 18 years and above participated in the online survey between October 2022 and March 2023. The data were analyzed using descriptive statistical analysis and chi-square. Almost all respondents self-rated their health as excellent and very good. Female respondents are more affected by mental health. Most are enrolled in the Universal Health System of Spain (public insurance). There is more utilization of private health insurance among respondents aged 60 years and above and high-wage earners. Cigarette smoking and alcohol drinking are associated with males. More than half of the respondents perform weekly exercise occasionally or never. These findings suggest a potential need for targeted interventions with an emphasis on the practice of preventive health and the promotion of healthy lifestyles, especially among financially disadvantaged migrants with lesser health access. [ABSTRACT FROM AUTHOR]

Purpose: Population ageing is a demographic transition and burdens every country's health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab. Design/methodology/approach: This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above. Findings: This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population. Originality/value: This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences. [ABSTRACT FROM AUTHOR]

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management. [ABSTRACT FROM AUTHOR]

This paper is concerned with the sustained periodic oscillation phenomenon in a three-species delayed predation system with Holling type II functional response and age structure in top predator. The top predator fertility function is regarded as a piecewise continuous smooth function with regard to their maturation period τ 2 . The complicated dynamic behavior is proved by integrated semigroup theory and Hopf bifurcation theorem for semilinear equations with non-dense domain. Through qualitative analysis and bifurcation study of the system, we yield that this system has a nontrivial periodic solution that bifurcates from the positive equilibrium age distribution when bifurcation parameter τ passes through some critical values. Numerical simulations are also provided to illustrate theoretically analytical results. [ABSTRACT FROM AUTHOR]

This document is an editor's note from the journal "Statistics, Politics & Policy." It introduces a special issue on political demography, which explores the intersection of demographic factors and politics. The note explains that this field has been under-researched but is now gaining attention. The special issue includes papers that examine the political consequences of population change and the political determinants of population change. It also discusses the importance of micro-level studies and the impact of demographic factors on political systems. Additionally, the note mentions two other articles in the issue that cover the impact of digitalization on public services in Ukraine and factors affecting internally generated funds in Ghana. [Extracted from the article]

Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community's use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents' contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents' contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( I 2 ). A random-effects model was used to calculate the pooled estimates of adolescents' contraceptive uptake. Results. The overall pooled proportion of adolescents' contraceptive uptake was 40% ( I 2 = 99.70 , p ≤ 0.001 ; 95 % CI = 19 , 61). Adolescents' usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents' families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents' contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents' use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents' contraceptive utilization in Ethiopia. [ABSTRACT FROM AUTHOR]

This paper explores how dignity is articulated and pursued by care workers in two currently prominent policy initiatives seeking to reform Danish care services for older people. Based on ethnographic case studies of 'reablement' practices and the use of 'welfare technologies', the paper shows how these attempts to create dignified care services transform interactions between care recipients and care workers. The analysis is inspired by a socio-material perspective on dignity as 'crafted' and 'co-laboured' in daily practices, in an interplay between multiple human and non-human actors. In the cases studied, dignity is articulated as closely related to older people's increasing autonomy and independence of formal care, and is pursued through enhancing care recipients' self-care ability, and through technological automation of care tasks. However, these articulations and pursuits of dignity do not stand alone. When everyday care practices are closely examined, dignity is also pursued by care workers as increased co-operation and equality between care workers and care recipients, as de-objectification, and as promotion of enjoyment and quality of life. In these practices, care is ambivalently positioned as both a potential threat to dignity, and as a prerequisite to achieving it. The paper concludes by discussing the risks of policy agendas pursuing a narrow understanding of dignity as simply independence of care. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The use of chemical restraint in emergency situations is to control aggression or violence to protect consumers and staff and is to be used as a last resort when all other behavioural control alternatives have been exhausted.Chemical restraint involves the use of medication. What the paper adds to existing knowledge?: This is the first paper to systematically review the prevalence of the use of chemical restraint.The use of chemical restraint is common across emergency departments and acute psychiatric inpatient units worldwide.Consumers who are restrained are also likely to receive chemical restraint.The studies reviewed demonstrate that there is a need for more standardized data collection so that clearer comparisons can be made between healthcare settings and countries. What are the implications for practice?: Implications of practice include the need to report adverse events post‐chemical restraint as these can deleteriously affect a person's physical health.Identification of and staff education about first‐line management techniques before chemical restraint is administered are significant to reduce its use. Introduction: Chemical restraint is used to manage uncontrolled aggression, agitation or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim: This systematic review aimed to synthesize the international prevalence of chemical restraint for non‐consenting adults. Method: PsycINFO, CINAHL, MEDLINE/PubMed and Google Scholar databases were searched for peer‐reviewed literature published between January 1996 and July 2018. This paper reports on data extracted from retrospective audits of chemical restraint practice. Results: Forty‐eight papers were included. The median prevalence of use of any restraint was 21.2% (25th% 8.0 to 75th% 36.3). Median prevalence of people who were chemically restrained, of all people restrained in any manner, was 43.1% (25th% 22.9% to 75th% 70.7%). Of all people admitted to facility(ies), the median prevalence of chemical restraint was 7.4% (25th% 2.7 to 75th% 17.6). There was no statistically significant difference in any prevalence measure considering healthcare setting or country. There was a significant decrease over the review period in the use of any restraint, including chemical restraint. Discussion and implications for practice: This is the first known comprehensive meta‐view of chemical restraint use worldwide, highlighting the need for standardized data collection to enable comparisons between healthcare settings and countries. Relevance statement: There is an international imperative to reduce or eliminate the use of coercive practices, such as physical and chemical restraint, in mental health care. This study provides important information for mental health nursing by synthesizing the international prevalence of chemical restraint for non‐consenting adults. This meta‐view of the worldwide use of chemical restraint can inform ongoing efforts to reduce its use. [ABSTRACT FROM AUTHOR]

In recent years, whole-body vibration (WBV) training has received an increasing interest in the sports and medical fields. However, there has been inconsistency among several studies regarding the effect of WBV training on the human body, which is partly due to the lack of the existence of guidelines for using WBV training machines. To understand the effect of WBV training on the human body and build the needed regulations, it is essential first to understand the biodynamic responses to vibration which represent how vibration is transmitted to and through the human body. The purpose of this study is to systematically review previous studies that measured biodynamic responses when using WBV training machines to highlight inconsistencies in their results and provide possible reasons for them. An extensive literature search was performed on the SCOPUS database to obtain relevant studies. One hundred and fifty-six potentially relevant studies were obtained but after further screening, 23 papers from 2007 to 2020 met inclusion criteria and were included in the study. The papers were analysed with respect to acceleration, transmissibility, interface force, and apparent mass during different vibration settings, body posture, age, and sex. Results and conflicts among studies were highlighted and possible explanations for the inconsistency were provided. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test the effect of Otago exercises on fear of falling, balance, empowerment and functional mobility in older people living in nursing homes. Methods: This study is a parallel‐group randomized controlled trial. In total, 56 individuals were stratified randomized according to age‐gender. Participants were recruited from September 2021 to August 2022. Data were collected at baseline, in the 8th and 12th weeks. The researcher gave Otago exercise training to the intervention group three times per week for the first 4 weeks and applied it to the individuals, and in the next 8 weeks, the researcher visited the institution to ensure the continuity of the exercises and contacted the individuals by phone. Friedman test and generalized linear model were used in the analysis of data. Results: In the study, group and time interaction were found to be significant in terms of the Berg balance scale, 30‐second sit‐and‐stand test, elderly empowerment scale and timed up‐and‐go test. It was determined that the intervention did not improve fear of falling, upper extremity strength and 6‐min walk test results. Conclusion: Health personnel and administrators should have increased awareness about Otago exercises and can recommend implementation of the programme. Summary statement: What is already known about this topic? Otago exercises are an evidence‐based, home‐based programme for improving balance.What this paper adds? Otago exercises can improve the balance, lower‐extremity strength, elderly empowerment score and timed up‐go test score of older people living in nursing homes.The Otago exercise programme did not improve the fear of falling, the strength of the upper extremities and the 6‐min walk test results for older people living in nursing homes.The implications of this paper: Health personnel and administrators should be aware of the potential benefits of Otago exercises and can recommend implementation of the programme.Nurses working in nursing homes can be taught how to deliver the programme and to plan training to roll out the programme. [ABSTRACT FROM AUTHOR]

This paper examines retirement by older workers with intellectual disability. Much research and intervention about retirement and intellectual disability in the last decade or so emanates from Australia, although there are some current cross-sectional and descriptive studies from other developed countries. The Australian literature stands out as the forerunner in the development and controlled evaluation of interventions to support the process of preparing for, practising, and then experiencing retirement. Therefore, this paper begins by briefly describing retirement-related aspects of employment for people with intellectual disability in Australia. Next, we present a critical summary of Australian research on the retirement of people with intellectual disability, supported by a briefer analysis of international literature. Then, key issues, such as financial factors, age of retirement, the time course of retirement (sudden or gradual), and self-determination regarding the decision to retire, are explored. Finally, to help guide future research and policy, we identify a number of retirement-related research questions that are currently under-researched or unexamined. [ABSTRACT FROM AUTHOR]

The extent to which dengue virus has been circulating globally and especially in Africa is largely unknown. Testing available blood samples from previous cross-sectional serological surveys offers a convenient strategy to investigate past dengue infections, as such serosurveys provide the ideal data to reconstruct the age-dependent immunity profile of the population and to estimate the average per-capita annual risk of infection: the force of infection (FOI), which is a fundamental measure of transmission intensity. In this study, we present a novel methodological approach to inform the size and age distribution of blood samples to test when samples are acquired from previous surveys. The method was used to inform SERODEN, a dengue seroprevalence survey which is currently being conducted in Ghana among other countries utilizing samples previously collected for a SARS-CoV-2 serosurvey. The method described in this paper can be employed to determine sample sizes and testing strategies for different diseases and transmission settings. Author summary: The historical circulation of dengue virus is still poorly understood in many parts of the world, and age-stratified seroprevalence surveys can provide the data to quantify population exposure to dengue and its transmission intensity. In this work, we developed a simulation-based method that can be used to identify the sample sizes and age-distribution of the samples needed to obtain informative estimates of dengue force of infection from existing blood samples. We apply this method to data obtained from a SARS-CoV-2 serological survey, previously conducted in three cities in Ghana. The methods and code developed in this paper can be used to design serological surveys for dengue and other pathogens when using existing blood samples with accompanying information on age and location. [ABSTRACT FROM AUTHOR]

People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder is a public health concern in Australia. Opioid agonist treatment (OAT) is effective at treating and minimising harm from opioid use disorder, yet is underused in Australia due to client barriers. Although these barriers have been reported, the barriers that are most important to clients is unclear. The aim of this paper was to determine the most important OAT barriers to Australian clients. Methods: A cross-sectional, self-completed survey was given to 204 opioid-dependent clients who attended needle and syringe sites in Australia. Participants were given 15 OAT barrier statements, which they answered using a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree). The Likert scale data are presented using the count method and the mean Likert scores (for the whole sample and for subgroups). Results: The two methods determined that the four most important barriers to OAT were stigma, lack of support services, no flexibility and enjoy using opioids. Furthermore, those who used prescription opioids (compared with heroin) were female or non-binary (compared with male), were not currently using OAT (compared with current OAT), were younger (compared with older) and had high dependence scores (compared with low dependence scores) were impacted more by certain OAT barriers. Conclusions: Policies around improving support services, reducing stigma and increasing flexibility would be beneficial to reduce barriers to OAT in Australia. Second, certain groups were more vulnerable to OAT barriers, emphasising the importance to better tailor opioid treatment programs to these specific populations to increase treatment engagement. The aim of this paper was to determine the most important opioid agonist treatment barriers to Australian clients via a cross-sectional survey using a Likert scale. Results found that the most important barriers to opioid agonist treatment were stigma, lack of support services, no flexibility and enjoy using opioids. Furthermore, those who used prescriptions opioids were female or non-binary, were not currently using opioid agonist treatment, were younger and had high dependence scores were impacted more by certain treatment barriers. [ABSTRACT FROM AUTHOR]

Background With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection. Methods This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. traditional paper forms to complete self-report psychiatric symptoms. Geriatric psychiatry outpatients (n = 72) and adult psychiatry inpatients (n = 50) were recruited to complete the Brief Symptom Inventory (BSI-53), the Activities of Daily Living (ADL), and Patient Health Questionnaire (PHQ-9) questionnaires. Results Geriatric psychiatry outpatients completed the iPad and paper questionnaires at similar rates (91.7% vs. 97.2%, Fisher's Exact p = .61). In two-way ANOVA, including patients aged ≥ 60 (n = 85), outpatient status (F(1,81) = 4.48, p = .037) and iPad format (F (1,81) = 8.96, p = .04) were associated with a shorter time to completion. The effect of questionnaire formats was especially prominent in the inpatient group on time to completion. Conclusions Older adults with mental illness demonstrate a similar ability to complete self-report questionnaires whether iPads or paper forms. iPad questionnaires may even require less time to complete in geriatric psychiatry inpatients. Patients also found iPad questionnaires to be easy to use and read. Tablets could potentially be used for psychiatric symptom assessment for clinical, research, and population health purposes. [ABSTRACT FROM AUTHOR]

Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with 152 Italian patients admitted to the same wards during the same time period by age, gender, and diagnosis. We also investigated sociodemographic and clinical characteristics of the two samples including psychiatric diagnosis, age of illness onset, duration of illness, previous hospitalizations, length of hospitalization, previous suicide attempts, and substance and alcohol abuse. There were no differences between immigrant and Italian patients in either suicidal ideation (previous or current) or suicide attempts (previous or current). Immigrant patients were more likely to have a shorter duration of illness than the Italian patients and Italian patients were more likely to report substance abuse than were immigrant patients. Despite similar suicide rates between immigrants and Italian psychiatric inpatients, appropriate assessment of suicide risk in these patients is essential in implementing therapeutic suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Introduction: Many older people experience memory concerns; a minority receive a diagnosis of Mild Cognitive Impairment (MCI) or Subjective Cognitive decline (SCD). There are concerns that medicalisation of MCI and memory concern may fail to acknowledge subjective experiences. Aim: We explore the meaning individuals give to their memory concerns, with or without a diagnosis of MCI and SCD. Method: We scoped literature exploring subjective experiences of memory concern, with or without a diagnosis of MCI or SCD. We searched CINAHL, PsycINFO and MEDLINE in March 2020, and updated in Sept 2021.We used (Arksey & O'Malley, 2005) framework to guide our scoping review method and thematic analysis to analyse our findings. Results: We screened 12,033 search results reviewing the full texts of 92 papers. We included 24 papers, including a total of 453 participants, the majority of whom were female, from White ethnic majority populations (or from studies where ethnicity was not identified) with high levels of education. In 15 out of 24 studies, 272 participants were diagnosed with MCI. We identified two themes; Making a diagnosis personal and Remembering not to forget. We found that subjective experiences include normative comparison with others of the same age and responses including fear, relief, and acceptance, but culminating in uncertainty. Conclusion: Drawing upon sociology, we highlight the subjective experiences of living with memory concerns, SCD and an MCI diagnosis. We identify a gap between the intended purpose of diagnostic labels to bring understanding and certainty and the lived experiences of those ascribed them. [ABSTRACT FROM AUTHOR]

Current speech-language pathology (SLP) services in Cambodia are limited in scope, service accessibility and integration into government systems. However, momentum is growing to develop an internationally recognised profession. This paper examines the depth and breadth of SLP support available to people with communication and/or swallowing difficulties in relation the Sustainable Development Goals (SDGs). Qualitative interview data collected from service facilities (n = 13) and speech therapy practitioners (n = 27) were mapped and analysed for accessibility and scope of SLP services. Data revealed a workforce density of 0.16:100 000. Disparity in service accessibility was identified between provincial and urban locations, adult and paediatric populations and range of practice areas. The findings demonstrate the importance of partnerships (SDG 17) among government departments, non-government organisations and private sector entities to establish a sustainable and culturally responsive SLP profession in Cambodia. Although there is no Cambodian university training program, there is a growing momentum and local commitment to establishing a workforce to support Cambodians with communication and/or swallowing difficulties. This commentary paper focuses on good health and well-being (SDG 3), decent work and economic growth (SDG 8), reduced inequalities (SDG 10), and also addresses no poverty (SDG 1), quality education (SDG 4) and partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

Depersonalization-Derealization disorder (DDD) is a psychiatric condition characterized by persistent feelings of detachment from one's self and of unreality about the outside world. This review aims to examine the prevalence of DDD amongst different populations. A systematic review protocol was developed before literature searching. Original articles were drawn from three electronic databases and included only studies where prevalence rates of DDD were assessed by standardized diagnostic tools. A narrative synthesis was conducted. Twenty-three papers were identified and categorized into three groups of participants: general population, mixed in/outpatient samples, and patients with specific disorders. The prevalence rates ranged from 0% to 1.9% amongst the general population, 5–20% in outpatients and 17.5–41.9% in inpatients. In studies of patients with specific disorders, prevalence rates varied: 1.8–5.9% (substance abuse), 3.3–20.2% (anxiety), 3.7–20.4% (other dissociative disorders), 16.3% (schizophrenia), 17% (borderline personality disorder), ~50% (depression). The highest rates were found in people who experienced interpersonal abuse (25–53.8%). The prevalence rate of DDD is around 1% in the general population, consistent with previous findings. DDD is more prevalent amongst adolescents and young adults as well as in patients with mental disorders. There is also a possible relationship between interpersonal abuse and DDD, which merits further research. [ABSTRACT FROM AUTHOR]

Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor event. Frailty is most frequently assessed in the old using the Clinical Frailty Scale (CSF) which ranks frailty from 1 to 9. This assessment typically takes less than one minute and is not validated in patients with learning difficulties or those under 65 years old. The National Institute for Health and Care Excellence (NICE) developed guidelines that use "frailty" as one of the priority-setting criteria for how scarce, but potentially lifesaving, health care resources should be allocated during the COVID-19 pandemic. Similar guidelines have been developed elsewhere. This paper discusses the ethical implications of such rationing and argues that this is an unproven and ethically problematic form of health care rationing. It specifically discusses: (1) how the frailty ascription becomes a self-fulfilling prophecy, (2) the problematic use of "frailty" in COVID-19 "triage," (3) the circularity of the link between age and frailty, (4) indirect discrimination because of the use of a seemingly neutral criterion in health care rationing, and (5) the difficult link between comorbidities and frailty. It is found that there was no research into the use of global frailty scores as a criterion for access to acute treatment before January 2020 and so it is concerning how readily frailty scoring has been adopted to ration access to potentially lifesaving treatments. Existing gerontological frailty scoring systems have not been developed for this purpose, and repurposing them creates significant ethical issues. [ABSTRACT FROM AUTHOR]

This article presents a list of books received for review by the "Journal of Health Politics, Policy & Law." Some of the books are as follows: "Challenges of an Aging Society: Ethical Dilemmas, Political Issues," edited by Rachel A. Pruchno and Michael A. Smyer; "Old Age in a New Age: The Promise of Transformative Nursing Homes," by Beth Baker; and "The Healthcare Executive's Guide to Allocating Capital," by Jason Sussman; "Can a Health Care Market be Moral? A Catholic Vision," by Mary J. McDonough; and "Defending Life: A Moral and Legal Case Against Abortion Choice," by Francis J. Beckwith.

Objectives: As people remain physically active later in life, there is an increased incidence of anterior cruciate ligament (ACL) injuries in patients 50 years of age and older. Historically, ACL reconstructions have not been recommended for patients over 50 years of age. While there is abundant literature on the outcomes of ACL reconstruciton in patients under 40 years of age, little has been published on the outcomes in this age group. The purpose of this study was to investigate whether ACL reconstruction in patients fifty years of age and older rwill esult in an improvement in function, stability, and quality of life at 5-year follow up. We also study the indications, outcomes, and tips for success. Methods: A retrospective review was performed of patients fifty years or older with a minimum follow up of two years who underwent an ACL reconstruction using a bone patellar tendon bone (BPTB) allograft by a single fellowship trained orthopedic sports medicine surgeon over a sixyear period. Patients were excluded from the study if they had significant radiographic osteoarthritic changes, or concurrent ligamentous or bony procedures performed. Patients were asked to return for an evaluation, including physical examination and KT-2000 instrumented stability measurements. Both the operative and non-operative knees were evaluated for range of motion, tenderness, stability on anterior drawer, Lachman, and pivot shift testing. Bilateral KT-2000 measurements which were taken at 10, 20, and 30 pounds as well as maximum manual testing. Each measurement was taken three times and averaged. The following scores were used pre- and post-operatively to assess function and pain: Lysholm, International Knee documentation Committee (IKDC), Tegner Activity, and SF-12. A physical examine including KT-2000 measurements was performed in a subset of these patients. Results: Fifty patients with an average follow-up of 5 years (range 2-8 years) underwent an ACL reconstruction using BPTB allograft. The average age at surgery was 55 years (range 50-68 years). Tegner scores improved from a pre-operative score of 3.3 to a post-operative score of 5.3 (p =.0001, 95% CI 2.2-3.5). The average post-operative IKDC score was 81.3 (SD 16.4), Lysholm score 88.5 (SD 16.3), SF-12 physical 54.3 (SD 6.6) and SF-12 mental 51.8 (SD 8.3). Forty (80%) patients reported good to excellent results, six (12%) patients reported fair results and four (8%) patients reported poor results. The patients that returned for a physical examinaiton had a range of motion that averaged flexion to 135 (SD 5.4), and all achieved full extension. There was one patient (2%) that had greater than 4mm translation on Lachman testing, and no patients had a positive pivot shift. There were no identified surgical complications. Conclusions: An anterior cruciate ligament reconstruction using BTB allograft successfully restores stability and allows return to pre-injury level of activity with few complications in patients 50 years or older at an average of 5 years follow-up. Our data set represents the largest case series of ACL reconstructions for this age demographic in the literature, using validated outcome tools, and complimented with a physical examination in a sub-set of the cohort. We have found no comparison that yields a clinically significant difference (based on MCID of 10 on theLysholm scale). Thus, older patients can be counseled to expect a functional return close to their pre-injury level, similar to younger patient cohorts. [ABSTRACT FROM AUTHOR]