Search results

Both the government and local service providers in the UK are becoming increasingly aware of the possibility of improving child outcomes through the delivery of parenting programmes. Government initiatives, such as Sure Start, Pathfinders and Flying Start are a positive step forward, yet programmes sometimes fail to work in service settings. This article describes the components necessary to deliver effective interventions, exploring the need to choose an evidence‐based parent programme, implement it with fidelity and evaluate the outcome. It describes the steps taken in North and Mid Wales to do this and reports briefly on the successful outcomes achieved by delivering the Incredible Years Basic Parenting Programme to the parents of high‐risk children in Sure Start areas.

The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in relation to men who have sex with men (MSM), meaning other high-risk populations, such as prisoners, are often side-lined. The authors wanted to consider how it could prove beneficial beyond the MSM community.

First, the authors discuss whether the common objections to existing HIV harm reduction interventions in prisons, such as needle exchanges, are applicable to PrEP. The authors then apply common objections to the provision of PrEP in the general population to the provision of PrEP in a prison context in order to assess their strength. Finally, the authors discuss what the authors anticipate to be a key objection to PrEP in prisons: post-incarceration access.

The authors argue that both sets of common objections considered are easily refuted in the case of PrEP in prisons. The unique setting and nature of the intervention are such that it is without immediately apparent flaws. In addressing post-incarceration access, the authors suggest that a longitudinal consideration of a prisoner’s HIV risk undermines the objection.

This discussion is of importance due to the significantly heightened risk of HIV infection prisoners are subject to. Not only do effective HIV prevention interventions in prisons contribute to fair access to health for incarcerated individuals, but also to the wider fight against HIV. The authors demonstrate that PrEP has potential as a new approach and call for further research in this area.

This paper aims to estimate the prevalence of intimate partner violence (IPV) in the UK general population and in the low-risk clinical population and to identify the methodological challenges presented by this task.

A rapid review of the evidence was conducted. Data were extracted with the help of pre-designed tools and were synthesised to answer the two study aims. The data extracted was both qualitative and quantitative.

In the general population, crime survey data gave a range of past-year IPV prevalence from 1.8% to 4.5%. This was higher in women than men (2.5%–6.3% vs 0.9%–2.7%). In both the general and low-risk clinical population, there was little data on pregnant women or gay men and lesbians. No significant relationships between IPV and ethnicity were found. Different surveys used different definitions of IPV and domestic violence, making it difficult to give an accurate estimate. There were also problems with data accuracy.

This research is original and contributes to the knowledge about IPV screening and if prevalence studies help.

Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing. The paper aims to discuss these issues.

As a result of identifying four new HIV cases, targeted BBV testing across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken.

A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest the four original cases of HIV were linked.

Embedding universal BBV screening within prison health provision will ensure timely identification of cases. Further research is needed to better understand BBV transmission risks within subsets of the prison population such as the VP and sex offending groups.

Little is known about the prevalence of BBVs in vulnerable prison populations. The findings add to the knowledge available for practitioners in the field.

The purpose of this paper is to examine the non‐communicable disease (NCD) known as gestational diabetes mellitus (GDM). Specifically, this paper aims to examine the influence of NCDs on health outcomes both worldwide and throughout the Islamic Republic of Iran, to discuss the current issues surrounding GDM and its impact on pregnant women and their children, and to present a new multi‐faceted approach for preventing future occurrences of GDM.

The paper examines the current issues surrounding NCDs and GDM, in terms of its prevalence and risk factors, and the efforts taken by the Iranian government to address the growing problem of GDM, through a comprehensive literature review. Further, this paper presents the basis for a new multi‐faceted approach for addressing and preventing GDM.

GDM is an NCD that can damage the health of both mothers and children. The disease has been linked to macrosomia, congenital cardiac and central nervous system abnormalities, and skeletal muscle deformities among neonates. Pregnant women who develop GDM are more likely to have induced labor, require caesarean section, and develop type 2 diabetes later in life. In the most severe cases, GDM can even result in fetal and maternal mortality. Worldwide prevalence of GDM varies by country, but Iranian women are a particularly high‐risk population. In fact, approximately one of every 20 pregnancies in Iran will be affected by complications and outcomes related to GDM.

In response to growing concerns surrounding the current prevalence of GDM both worldwide and within the Islamic Republic of Iran, along with the associated impact of GDM on health outcomes, the paper presents a multi‐faceted approach for addressing this NCD. This approach will involve a consolidated program of prevention and control with a focus on health‐care solutions which promote both awareness and education.

Numerous randomized clinical studies have shown that psyllium fiber lowers serum cholesterol in patients with hyperlipidemia and is thus recognized by the US Food and Drug Administration (FDA) as a dietary fiber that may help reduce the risk of coronary heart disease (CHD) by lowering cholesterol. The purpose of this paper is to assess the potential economic implications for health-care cost savings and quality of life productivity gains if the cholesterol-lowering effect of psyllium, consumed daily as a fiber supplement, could be applied to a broad at-risk population.

A cost-benefit analysis tool was used to examine evidence that the use of psyllium as a cholesterol-lowering agent can reduce overall CHD-attributed medical care service costs in the USA among those at high risk of experiencing disease-related events.

Results of the analysis showed that the potential net annual avoided medical care service costs and annual quality of life productivity gains among US adults 45 and older with low-density lipoprotein (LDL) cholesterol levels = 130 mg/dL could be up to an average of $870m per year from 2013 to 2020 if everyone in the target population used seven grams of soluble fiber from psyllium daily, corresponding to a net benefit-cost ratio of $1.19 savings in annual medical service cost and annual productivity gains per $1 spent on a psyllium regimen.

Thus, the use of psyllium fiber as a daily supplement could be recommended as a means to help control the risk for potentially costly cardiovascular-related medical events and to maximize the economic potential for an improved quality of life in adults 45 and older with LDL cholesterol levels =130 mg/dL.

This study is a formative evaluation of an adolescent online e-cigarette prevention program (Clearing the Vapor) giving attention to identifying higher risk adolescent populations, confirming the theory of change, and assessing short-term outcomes.

The evaluation was conducted using online pre-test and post-test survey data collected from adolescent program participants age 10–18 from 2019 to 2021. Analyses included risk ratios on perceived risk, self-efficacy, and behavioral intentions across demographic variables. Pre-test and post-test comparisons were conducted with analysis involving the t-test and the McNemar test.

Prevalence of e-cigarette use was higher among males, older adolescents, and in racial/ethnic groups other than Whites and Asians. Adolescents with lower confidence to say “no” were more likely to use e-cigarettes. Greater perception of harm by using e-cigarettes increased the likelihood of adolescents feeling competent to explain to peers the harmful effects of e-cigarettes. Mean change in commitment levels to not use e-cigarettes increased for males and females, all ages, and racial/ethnic groups other than non-Hispanic Blacks and American Indians. Improvement in non-Hispanic Whites was significantly greater than for non-Hispanic Blacks, American Indians, and Hispanics.

Improvement in programming should give careful attention to the incorporation of more prevention activities and to materials tailored specifically to racial/ethnic participants. As a theory of change, findings support the utility of the Clearing the Vape prevention programming to address perceptions of harm that e-cigarettes are safe, confidence in explaining the harmful effects of use, and the development of skills to resist use.

This paper seeks to build understanding of the evaluation of sponsorships involving high human mortality risk. Examples of risky sponsees are presented, with two assessed as in-depth case studies. Based on this research, a sponsorship evaluation framework for sponsors is presented that includes: sponsee selection, risk management, strategic tactics, contingency planning, contract elements and post-contract tactics.