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Sporadic outbreaks of influenza A virus (IAV) infections have been reported in pinnipeds in the United States and Europe, most commonly in harbor (Phoca vitulina) and gray (Halichoerus grypus) seals [...]

Sub-Saharan Africa has the highest HIV infection incidence and prevalence in the world (1,2). Although incidence is declining (3), more progress is needed to reduce transmission to a sufficient level [...]

Lassa fever is an acute viral hemorrhagic illness caused by Lassa virus (LASV), an enveloped RNA virus of the Arenaviridae family (1). Lassa fever is endemic to West Africa, causing [...]

INTRODUCTION In 2020, 29.8% of Australia's population was born overseas and over 7.6 million migrants were living in Australia [1]. In 2019, there were 2.43 million temporary migrants in Australia [...], : Introduction:: Overseas‐born gay and bisexual men (GBM) are overrepresented in HIV diagnoses in Australia. We assessed social and sexual behaviours, and the use of HIV prevention and testing, by region of birth and length of residence in Australia. We sought to identify similarities and differences between recently arrived and non‐recently arrived GBM from non‐English‐speaking countries to improve targeting and engagement with HIV testing and prevention. Methods:: Data were collected in national repeated, behavioural surveillance surveys conducted across Australia during 2019–2021. Logistic regression was used to identify factors that differentiated between recently arrived ( Results: Among 24,707 participants in 2019–21, 2811 (11.4%) were from high‐income English‐speaking countries, 714 (2.9%) were recently arrived overseas‐born GBM and 3833 (15.5%) were non‐recently arrived migrants. Recently arrived GBM were most likely to be born in Asia (36.1%) and Europe (21.1%). Compared with non‐recently arrived GBM, recently arrived GBM from non‐English‐speaking countries were younger (aOR = 0.95, 95% CI = 0.94–0.96, p Conclusions: Recently arrived GBM from non‐English‐speaking countries reported similar levels of risk of HIV acquisition to longer‐term residents in Australia, but lower levels of PrEP awareness and use, and more reliance on HIV testing services which are free or low cost. It is necessary to enhance access to HIV testing and prevention among recently arrived GBM in Australia.

INTRODUCTION In 2021, the global population of children who are perinatally HIV exposed but HIV negative (CHEU) was almost 16 million, with another one million CHEU born annually [1, 2]. [...], : Introduction: Several HIV‐related syndemics have been described among adults. We investigated syndemic vulnerability to hazardous drinking (HD), intimate partner violence (IPV) and household food insecurity (HFIS) in breastfed children born without HIV in urban South Africa. We compared those who were perinatally HIV exposed (CHEU) to those who were not (CHU), under conditions of universal maternal antiretroviral therapy (ART) and breastfeeding. Methods: A prospective cohort of pregnant women living with HIV (WLHIV), and without HIV, were enrolled and followed with their infants for 12 months postpartum (2013–2017). All WLHIV initiated antenatal efavirenz‐based ART. Measurements of growth (∼3 monthly), infectious cause hospitalisation, ambulatory childhood illness (2‐week recall) and neurodevelopment (BSID‐III, measured at ∼12 months’ age) were compared across bio‐social strata using generalised linear regression models, with interaction terms; maternal data included interview‐based measures for HD (AUDIT‐C), IPV (WHO VAW) and HFIS. Results: Among 872 breastfeeding mother‐infant pairs (n = 461 CHEU, n = 411 CHU), WLHIV (vs. HIV negative) reported more unemployment (279/461, 60% vs. 217/411, 53%; p = 0.02), incomplete secondary education (347/461, 75% vs. 227/411, 55%; p < 0.0001), HD (25%, 117/459 vs. 7%, 30/411; p < 0.0001) and IPV (22%, 101/457 vs. 8%, 32/411; p < 0.0001) at enrolment; and HFIS at 12 months (45%, 172/386 vs. 30%, 105/352; p > 0.0001). There were positive interactions between maternal HIV and other characteristics. Compared to food secure CHU, the mean difference (95% CI) in weight‐for‐age Z‐score (WAZ) was 0.06 (−0.14; 0.25) for food insecure CHU; −0.26 (−0.42; −0.10) for food secure CHEU; and −0.43 (−0.61; −0.25), for food insecure CHEU. Results were similar for underweight (WAZ < −2), infectious‐cause hospitalisation, cognitive and motor delay. HIV‐IPV interactions were evident for ambulatory diarrhoea and motor delay. There were HIV‐HD interactions for odds of underweight, stunting, cognitive and motor delay. Compared to HD‐unexposed CHU, the odds ratios (95% CI) of underweight were 2.31 (1.11; 4.82) for HD‐exposed CHU; 3.57 (0.84; 15.13) for HD‐unexposed CHEU and 6.01 (2.22; 16.22) for HD‐exposed CHEU. Conclusions: These data suggest that maternal HIV‐related syndemics may partly drive excess CHEU health risks, highlighting an urgent need for holistic maternal and family care and support alongside ART to optimise the health of CHEU.

Presenters Anna Gilbert, BS, Elisabeth Callen, PhD, Cory Lutgen, BS, BSc, Sanjay Batish, MD, Daijah Jones, [...], Context: Adverse Childhood Experiences (ACEs) are a set of early life events associated with toxic stress and long-term health consequences. The more ACEs a person has experienced, the greater their risk of physical and mental illness later in life. It has been proposed that gun violence, an increasingly common experience for children in the United States, should be considered an ACE due to its lifelong physical and psychosocial impacts. The SaFETy Score is a set of four questions that can be used in clinical settings to predict an adolescent&apos;s risk of gun violence exposure. Objective: This study evaluated the relationship between ACEs and lifetime gun violence exposure, as well as future gun violence risk as measured by the SaFETy Score. Study Design and Analysis: Longitudinal quantitative study. Multivariate linear regression with gun violence exposure and SaFETy score as the independent variables and ACE score as the dependent variable. Setting: Four semi-urban to rural primary care practices in eastern North Carolina. Population Studied: Patients age 14-24 at participating practices. Intervention/Instrument: Surveys at baseline and six months post-baseline assessed patient demographics, SaFETy score, ACE score, violence exposure, peer influences, and parental support. Outcome Measures: ACE score, SaFETy score, and lifetime gun violence exposure Results: The majority of the patients were female (69%), non-Hispanic or Latinx (73%), and had at least a high school diploma or GED (63%). In terms of race, 45% were white and 36% were Black or African-American. The majority (58%) had an ACE Score of one to three, which indicates intermediate risk for adverse health outcomes. One-quarter (25%) had an ACE score of four or more, indicating a high level of risk. Over half (55%) reported being exposed to gun violence in their lifetime. ACE Score was associated with both lifetime gun violence exposure and SaFETy Score (p=0.001 for both). Conclusions: In this study, ACEs were correlated with both lifetime gun violence exposure and SaFETy score, suggesting that gun violence exposure is more common in rural and suburban North Carolina youth who have also experienced other childhood traumas.

The traditional model of laboratory testing in healthcare starts with the patient recognizing the need to see a physician (Figure 1). In nonemergent cases, the patient must make an appointment [...], * Context.--Convenience, avoidance of doctor&apos;s appointments, curiosity, and the desire to take control of one&apos;s health are driving interest toward direct-to-consumer (DTC) testing. DTC is laboratory testing that is initiated by the consumer without a physician order. The results are reported back directly to the consumer. DTC testing is an exciting addition to the traditional healthcare model for consumers who want knowledge of their health status and disease risk, ancestry, and their body&apos;s expected response to certain medications based on their genotype. Objectives.--To discuss the perceived and potential benefits and risks involved in DTC testing. Data Sources.--Recent published literature on DTC testing. Conclusions.--The benefits of DTC testing are enticing and are driving the DTC testing market. Consumers must weigh the perceived benefits with the potential risks, including privacy concerns, the possibility of receiving confusing health information, and/or information that could generate unexpected emotions, misdiagnosis, and over-testing.

Author(s): Elizabeth V. Robilotti [sup.1] [sup.2] [sup.3] , N. Esther Babady [sup.1] [sup.4] , Peter A. Mead [sup.1] [sup.3] , Thierry Rolling [sup.1] , Rocio Perez-Johnston [sup.5] , Marilia Bernardes [...], As of 10 April 2020, New York State had 180,458 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 9,385 reported deaths. Patients with cancer comprised 8.4% of deceased individuals.sup.1. Population-based studies from China and Italy suggested a higher coronavirus disease 2019 (COVID-19) death rate in patients with cancer.sup.2,3, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-19.sup.4. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. From 10 March to 7 April 2020, 423 cases of symptomatic COVID-19 were diagnosed at Memorial Sloan Kettering Cancer Center (from a total of 2,035 patients with cancer tested). Of these, 40% were hospitalized for COVID-19, 20% developed severe respiratory illness (including 9% who required mechanical ventilation) and 12% died within 30 d. Age older than 65 years and treatment with immune checkpoint inhibitors (ICIs) were predictors for hospitalization and severe disease, whereas receipt of chemotherapy and major surgery were not. Overall, COVID-19 in patients with cancer is marked by substantial rates of hospitalization and severe outcomes. The association observed between ICI and COVID-19 outcomes in our study will need further interrogation in tumor-specific cohorts. Analysis of a large, single-center cohort of patients with cancer who were infected with COVID-19 uncovers factors associated with disease severity and interactions with anti-cancer therapies

INTRODUCTION Human papillomavirus (HPV) is the leading sexually transmitted infection (STI) worldwide. Most sexually active people become infected with HPV at some point in their lives [1?3]. HPV types with [...], : Introduction: As the leading sexually transmitted infection worldwide, human papillomavirus (HPV) may disproportionately affect transwomen. We aimed to estimate anal HPV prevalence, especially focusing on high?risk (hr)?HPV types and evaluate their associated factors among transwomen living in Rio de Janeiro, Brazil. Methods: Transwomen enrolled in a respondent?driven sampling (RDS)?based survey conducted between August 2015 and January 2016 self?collected anal samples, which were promptly stored at minus 80°C. After DNA extraction, HPV detection and genotyping were performed using the PapilloCheck test. We estimated HPV prevalences and evaluated the correlates of anal hr?HPV infection using a regression logistic model. Results: Out of 345 transwomen, 272 (78.8%) were included in this analysis (122 [44.9%] HIV?positive). No participant had ever received HPV vaccination. Among participants enrolled, 212 (77.9%) were positive for any anal HPV type and 165 (60.7%) for hr?HPV. Most common hr?HPV were as follows: HPV16 (17.6%), HPV68 (14.7%), HPV39 (14.3%), HPV56 (12.5%), HPV51 (11.4%) and HPV52 (11.0%). HIV?positive transwomen had three times the odds of having an hr?HPV compared to HIV?negative transwomen. Participants who had a current rectal Neisseria gonorrhoeae infection had 3.7 times the odds of being coinfected with hr?HPV. Among HIV?positive transwomen, neither antiretroviral therapy use, undetectable viral load, current and nadir CD4 counts were associated with anal hr?HPV infection. Conclusions: Brazilian transwomen in our study exhibit some of the highest population?specific rates of HPV and hr?HPV. There is an urgent need to elucidate the burden of HPV infection, prevalence of HPV?related diseases and access to and uptake of HPV vaccination among transwomen, especially from low? and middle?income settings.

I. INTRODUCTION The consequences of trauma can be devastating and long-term. Children, trauma, victimization, and the legal system are complex topics and can become overwhelming when combined. Yet, due to [...]

Background: We report longitudinal trends in alcohol and recreational drug use and their associations with clinical outcomes in a Thai cohort of people living with HIV who are men who [...]

Introduction Biomedical HIV prevention technologies, such as antiretroviral pre?exposure prophylaxis (PrEP), hold enormous potential to substantially reduce HIV acquisition in high?risk populations globally. To maximize impact and minimize costs, PrEP [...], : Introduction: To maximize impact and minimize costs, antiretroviral pre?exposure prophylaxis (PrEP) interventions should be offered to those at highest risk for HIV infection. The risk score derived from the VOICE trial is one tool currently being utilized to determine eligibility in adolescent PrEP trials in sub?Saharan Africa. This study is aimed at evaluating the utility of the risk score in predicting HIV incidence among a cohort of adolescent girls in rural South Africa. Methods: We utilized data from HIV Prevention Trials Network (HPTN) 068, a phase III randomized controlled trial conducted in rural Mpumalanga province, South Africa. School?attending young women aged 13 to 20 years were enrolled into the trial from 2011 to 2012 and followed for up to three years. A risk score based on individual?level risk factors measured at enrolment was calculated for HPTN 068 participants who completed a one?year follow?up visit and were HIV seronegative at enrolment. Possible scores ranged from 0 to 10. A proportional hazards model was then used to determine if risk score at enrolment was predictive of incident HIV infection at follow?up and an area under the curve analysis was used to examine the predictive ability of the score. Results and Discussion: The risk score had limited variability in the HPTN 068 sample. Scores ?5 identified 85% of incident infections from 94% of the sample, compared to the VOICE sample in which scores ?5 identified 91% of incident infections from only 64% of participants. The risk score did not predict HIV incidence after one year of follow?up (hazard ratio = 1.029; 95% confidence interval (CI): 0.704, 1.503, p =.884) and showed poor predictive ability (area under the curve = 0.55; 95% CI: 0.44, 0.65). Certain individual risk factors that comprise the risk score may be context specific or not relevant for adolescent populations. Additional factors should be considered when assessing risk for the purposes of determining PrEP eligibility. Conclusions: The VOICE risk score demonstrated low utility to predict HIV incidence in the HPTN 068 sample. Findings highlight the need for an age and developmentally appropriate tool for assessing risk for HIV infection among adolescents. Use of the VOICE risk score for determining PrEP eligibility in younger populations should be carefully considered.

Abbreviations Introduction While there is an urgency to bring newer and more potent antiretroviral drugs developed in resource?rich settings to resource?limited settings as quickly as possible, evaluation of the safety [...], : Introduction: The unexpected identification of a neural tube defect (NTD) safety signal with preconception dolutegravir (DTG) exposure in the Botswana Tsepamo birth outcomes study brought into sharp focus the need for reliable data on use of new antiretrovirals in pregnancy, improved pharmacovigilance systems to evaluate safety of new drugs being introduced into populations including women of reproductive potential, and balanced risk?benefit messaging when a safety signal is identified. Discussion: The Tsepamo study NTD safety signal and accompanying regulatory responses led to uncertainty about the most appropriate approach to DTG use among women of reproductive potential, affecting global DTG roll?out plans, and limiting DTG use in adolescent girls and women. It also revealed a tension between a public health approach to antiretroviral treatment (ART) and individual choice, and highlighted difficulties interpreting and messaging an unexpected safety signal with uncertainty about risk. This difficulty was compounded by the lack of high?quality data on pregnancy outcomes from women receiving ART outside the Tsepamo surveillance sites and countries other than Botswana, resulting in a prolonged period of uncertainty while data on additional exposures are evaluated to refute or confirm the initial safety signal. We discuss principles for evaluating and introducing new drugs in the general population that would ensure collection of appropriate data to inform drug safety in adolescent girls and women of reproductive potential and minimize confusion about drug use in this population when a safety signal is identified. Conclusions: The response to a signal suggesting a possible safety risk for a drug used in pregnancy or among women who may become pregnant needs to be rapid and comprehensive. It requires the existence of appropriately designed surveillance systems with broad population coverage; data analyses that examine risk?benefit trade?offs in a variety of contexts; guidance to transform this risk?benefit balance into effective and agreed?upon policy; involvement of the affected community and other key stakeholders; and a communication plan for all levels of knowledge and complexity. Implementation of this proposed framework for responding to safety signals is needed to ensure that any drug used in pregnancy can be rapidly and appropriately evaluated should a serious safety alert arise.

Public health surveillance of key maternal health indicators is critical for monitoring and assessing the effectiveness of policy and programmatic efforts for maternal and infant health. The Pregnancy Risk Assessment [...], To assess the validity of self-reported maternal and infant health indicators reported by mothers an average of 4 months after delivery. Three validity measures--sensitivity, specificity and positive predictive value (PPV)--were calculated for pregnancy history, pregnancy complications, health care utilization, and infant health indicators self-reported on the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire by a representative sample of mothers delivering live births in New York City (NYC) (n = 603) and Vermont (n = 664) in 2009. Data abstracted from hospital records served as gold standards. All data were weighted to be representative of women delivering live births in NYC or Vermont during the study period. Most PRAMS indicators had >90 % specificity. Indicators with >90 % sensitivity and PPV for both sites included prior live birth, any diabetes, and Medicaid insurance at delivery, and for Vermont only, infant admission to the NICU and breastfeeding in the hospital. Indicators with poor sensitivity and PPV ( Keywords Validation * Pregnancy * Preterm * HIV test Introduction

Osteoarthritis (OA) is among the most common conditions affecting elderly individuals. (1) As a result, hip and knee arthroplasty have become widely performed elective procedures for patients with degenerative joint [...], Background: Knee and hip arthroplasty constitutes a large percentage of hospital elective surgical procedures. The Blaylock Risk Assessment Screening Score (BRASS) was designed to identify patients in need of discharge planning. The purpose of this study was to evaluate whether the BRASS was associated with length of stay (LOS) in hospital following elective arthroplasty. Methods: We retrospectively reviewed the charts of individuals undergoing primary elective arthroplasty for knee or hip osteoarthritis who had a documented BRASS score. Results: In our study cohort of 241, both BRASS (p < 0.001) and replacement type (hip v. knee; p = 0.048) were predictive of LOS. Higher BRASS was associated with older patients (p < 0.001), higher American Society of Anesthesiologists score (p < 0.001) and longer LOS (p < 0.001). We found a specificity of 83% for a BRASS greater than 8 and a hospital stay longer than 5 days and a specificity of 92% for a BRASS greater than 10. Conclusion: The BRASS represents a novel and significant predictor of LOS following elective arthroplasty. Patients with higher BRASS are more likely to stay in hospital 5 days or more and should receive pre-emptive social work consultations to facilitate timely discharge planning and hospital resources. Contexte : Les arthroplasties du genou et de la hanche representent un fort pourcentage des interventions chirurgicales non urgentes pratiquees dans les hopitaux. Le score BRASS (Blaylock Risk Assessment Screening Score) a ete concu pour reconnaitre les patients dont il faut planifier le conge de l'hopital. Le but de la presente etude etait de verifier s'il y a un lien entre le score BRASS et la duree du sejour hospitalier (DSH) apres une arthroplastie non urgente. Methodes : Nous avons analyse retrospectivement les dossiers de patients soumis a une arthroplastie primaire non urgente du genou ou de la hanche dont le score BRASS avait ete documente. Resultats : Dans la cohorte de 241 patients de notre etude, le score BRASS (p < 0,001) et le type d'arthroplastie (hanche c. genou, p = 0,048) ont ete des facteurs predicteurs de la DSH. Un score BRASS plus eleve etait associe a un age plus avance des patients (p < 0,001), a un score plus eleve a l'echelle de l'American Society of Anesthesiologists (p < 0,001) et a une DSH plus longue (p < 0,001). Nous avons observe une specificite de 83 % pour un score BRASS superieur a 8 et un sejour hospitalier de plus de 5 jours, et une specificite de 92 % pour un score BRASS superieur a 10. Conclusion : Le score BRASS constitue un nouveau predicteur important de la DSH apres une arthroplastie non urgente. Les patients dont le score BRASS est plus eleve, risquent davantage de sejourner plus de 5 jours a l'hopital et devraient beneficier de consultations preventives aupres du personnel des Services sociaux afin de faciliter la planification des conges en temps opportun et d'assurer l'utilisation efficace des ressources hospitalieres.

RIA SMIT, Department of Sociology, University of Johannesburg, P.O. Box 524, Auckland Park, Johannesburg 2006, South Africa HIV and AIDS: Are All Women Equally at Risk? Afrikaans-Speaking Married Women's Perceptions of Self-Risk The ever-growing concern about AIDS worldwide has increases the importance of understanding the disproportionate way in which the epidemic affects the lives of women. A cause for concern is the findings of a number of studies which indicate that the level of HIV infection among married women in sub-Saharan Africa has increased dramatically in comparison to the infection rate of those who are single. This article focuses on findings from a qualitative study done in South Africa during 2005/2006, which aimed to shed light on the perceptions and experiences of Afrikaans-speaking married women with regard to living in a society characterized by a high HIV prevalence rate. The main focus of the study fell on the women's perceptions of self-risk of becoming HIV infected. It was found that, although the respondents in the study saw themselves to be at some risk of contracting the virus through unforeseen circumstances, such as receiving contaminated blood through blood transfusions, they viewed themselves as having no susceptibility to HIV within the context of their marital relationships. The rationale for having this view is the fact that they consider their marriages to be characterized by trust and fidelity, and therefore free from any form of unsafe sexual practices. Keywords: HIV, risk, married women, fidelity Le virus VIH: toutes les femmes s' exposent-elles au meme risque? Les perceptions de femmes mariees de langue afrikaans face au risque du SIDA. La preoccupation mondiale croissante suscitee par le SIDE a necessite une comprehension plus en profondeur de al facon disproportionnee dont less femmes sont touchees par l'epidemie. Une alerte particuliere a ete sonnee par les nombreuses etudes recentes signalant, en Afrique au sud du Sahara, une augmentation dramatique dans le taux d' infection VIH parmiles femmes mariees relatif a celuides femmes celibataire. Cet article a pour object les resultats d' une etude qualificative menee en Afrique du Sud dans les annees 2005-2006, dont l' objectif etait de mettre en relief les perceptions et experiences de femmes mariees de langue afrikaans devant la realite de vivre dans une societe a taux de prevalence VIH eleve. L'etude s' interessait surtout aux perceptions des femmes concernant leur propre risque d'infection. La conclusion de l' etude montre que les femmes interrogees, tout en percevant un certain risque de contamination du a des circonstances imprevues, notamment la transfusion de sang contamine, ne s' estimaient aucunement susceptibles d' infection dans le cadre de leurs relations conjugales. Cette perceptions' explique par le fait que les femmes consideraient leur mariage comme etant caracterise par la confiance et la fidelite, le mettant a l' abride toute relation risquee. Mots-cle's: HIV, risque, femmes mariees, fidelite RIA SMIT, Department of Sociology, University of Johannesburg, P.O. Box 524, Auckland Park, Johannesburg 2006, South Africa VIH y SIDA: ? Todas las mujeres corren el mismo riesgo? La perception del propio riesgo segun las mujeres casadas que hablan Afrikaans La preocupacion creciente a nivel internacional sobre el SIDA ha incrementado la importancia de la comprension de la forma desproporcionada en la que la epidemia afecta las vidas de las mujeres. Un motivo de preocupacion son los descubrimientos de una gran cantidad de estudios que indican que el nivel de infection de VIH entre las mujeres casadas del Africa Subsahariana ha aumentado drasticamente en comparacion con la tasa de infection de las mujeres solteras. El artfculo se concentra en los descubrimientos de un estudio cualitativo hecho en Sudafrica durante los anos 2005/2006, que intentaba develar las percepciones y experiencias de las mujeres casadas que hablan Afrikaans, con respecto a la vida en una sociedad caracterizada por una elevada tasa de predominio de VIH. El principal foco del estudio recayo sobre las percepciones de las mujeres en lo que respecta al propio riesgo de infection por VIH. Se descubrio que, a pesar de que las personas que respondieron en el estudio se consideraban a simismas en riesgo de contraer el virus a traves de circunstancias imprevistas, como por ejemplo, recibir sangre contaminada a traves de transfusiones, tambien consideraban que no eran susceptibles al VIH dentro del contexto de sus relaciones maritales. El fundamento de este punto de vista es el hecho que consideran sus matrimonios como caracterizados por la confianza y la fidelidad y, por consiguiente, libre de cualquier forma de practica sexual que no sea segura. Palabras clave: VIH, riesgo, mujeres casadas, fidelidad, INTRODUCTION Living in South Africa, one is constantly reminded of the reality of HIV and AIDS. Messages on billboards propagate safe sex; parliamentarians debate AIDS policy on live television; people […]

Preliminary research suggests that pediatric overweight is associated with increased eating disorder pathology, however, little is known about which overweight youth are most vulnerable to eating disorder pathology. We therefore investigated 122 overweight treatment-seeking youth to describe eating disorder pathology and mental health correlates, and to identify psychopathological constructs that may place overweight youth at increased risk for eating disorder pathology. Youth participated in a comprehensive assessment of eating disorders, mood and anxiety disorders, general psychopathology, and risk variables involving semi-structured clinical interviews and self- and parent-report questionnaires prior to the initiation of weight-loss treatment. Ten youth met criteria for an eating disorder, and over one-third endorsed recent binge eating. Eating disorder pathology was associated with depressive and anxious symptoms (p's Keywords: Pediatric overweight; Eating disorder; Binge eating; Structural equation modeling; Risk modeling

We examined whether adolescent sexual abstinence predicts better adult mental health. A total of 1,917 adolescents, recruited from middle schools at age 13, were surveyed at ages 13, 18, 23, [...]

Introduction. Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals. Design-related bias in evaluations of tool predictive accuracy could lead to overoptimistic results, which would then contribute to program failure in practice. Methods. A systematic review was undertaken. Two blind reviewers assessed the methodology of relevant publications into a four-point classification system adapted from multiple sources. The association between study design classification and reported results was examined using linear regression with clustering based on screening tool and robust variance estimates with point estimates of Youden Index (= sensitivity + specificity - 1) as the dependent variable. Meta- analysis was then performed pooling data from prospective studies. Results. Thirty-five publications met inclusion criteria, containing 51 evaluations of fall risk screening tools. Twenty evaluations were classified as retrospective validation evaluations, 11 as prospective (temporal) validation evaluations, and 20 as prospective (external) validation evaluations. Retrospective evaluations had significantly higher Youden Indices (point estimate [95% confidence interval]: 0.22 [0.11, 0.33]). Pooled Youden Indices from prospective evaluations demonstrated the STRATIFY, Morse Falls Scale, and nursing staff clinical judgment to have comparable accuracy. Discussion. Practitioners should exercise caution in comparing validity of fall risk assessment tools where the evaluation has been limited to retrospective classifications of methodology. Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular settings, but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment.

OBJECTIVE: To derive risk models for percutaneous coronary intervention (PCI) outcomes from clinical and laboratory variables available before the procedure so they can be used for preprocedure risk stratification. PATIENTS [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2005.09.048 Byline: Donna B. Johnson, Dana E. Gerstein, Alexandra E. Evans, Gail Woodward-Lopez Abstract: Traditional approaches to treating overweight and obese adults by focusing on individual weight loss have not been effective in stemming the tide of obesity in the population. Recent research has identified critical factors that, as they accumulate and interact over an individual's life span, may put a person at risk for obesity. These factors include rapid weight gain in infancy and childhood, early puberty, and excessive weight gain in pregnancy. Based on this research, a life cycle perspective can be used to develop comprehensive interventions that address the multiple determinants of obesity. Because obesity tracks across generations, it is essential to adopt effective obesity prevention measures now to prevent even higher rates of obesity in future generations. Dietetics professionals can reduce individual risks by providing nutritional services that support appropriate weight gain in childhood and pregnancy. We can also advocate for policies in communities, schools, and worksites that support breastfeeding, ensure access to health-promoting foods, and provide opportunities to be physically active.

Introduction Current risk assessment frameworks are designed primarily for the evaluation of one chemical at a time (Clahsen et al. 2019; Lebret 2015), even though most human exposures, especially in [...], Background: Risk assessment of chemical mixtures or complex substances remains a major methodological challenge due to lack of available hazard or exposure data. Therefore, risk assessors usually infer hazard or risk from data on the subset of constituents with available toxicity values. Objectives: We evaluated the validity of the widely used traditional mixtures risk assessment paradigms, Independent Action (IA) and Concentration Addition (CA), with new approach methodologies (NAMs) data from human cell-based in vitro assays. Methods: A diverse set of 42 chemicals was tested both individually and as mixtures for functional and cytotoxic effects in vitro. A panel of induced pluripotent stem cell (iPSCs)-derived models (hepatocytes, cardiomyocytes, endothelial, and neurons) and one primary cell type (HUVEC) were used. Bayesian concentration-response modeling of individual chemicals or their mixtures was performed for a total of 47 phenotypes to derive point-of-departure (POD) values. Probabilistic IA or CA was conducted to estimate the mixture effects based on the bioactivity profiles from the individual chemicals and compared with mixture bioactivity. Results: All mixtures showed significant bioactivity, even though some were constructed using individual chemical concentrations considered "low" or "safe." Even though CA is much more accurate as a predictor of mixture effects in comparison with IA, with CA-based POD typically within an order of magnitude of the actual mixture, in some cases, the bioactivity of the mixtures appeared to be much greater than that of their components under either additivity assumption. Discussion: These results suggest that CA is a preferred first approximation for predicting mixture toxicity when data for all constituents are available. However, because the accuracy of additivity assumptions varies greatly across phenotypes, we posit that mixtures and complex substances need to be directly tested for their hazard potential. NAMs provide a practical solution that rapidly yields highly informative data for mixtures risk assessment. https://doi.org/10.1289/EHP7600