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Sugar-sweetened beverages (SSBs) are a major source of calories in the diets of American children and adolescents. These beverages, which contain mainly sugar and few beneficial nutrients, have been linked to overweight, obesity, type 2 diabetes, heart disease, dental caries, and other adverse conditions. Children of all ages consume SSBs, and schools, aided by the knowledge and direction of school nurses, can help students understand the health harms of SSBs, implement programs to discourage SSB intake, and play important roles in school and community efforts to limit SSBs.While existing studies have examined the effectiveness of school-based child sexual abuse (CSA) prevention programs in China, there is currently little qualitative evidence on how stakeholders view these programs and research on CSA in China more generally. To address this research gap, the aims of this study were to explore stakeholders' perspectives on (a) school-based CSA prevention programs in China; (b) the components of these programs; (c) CSA research in China. Qualitative semi-structured interviews were conducted with 21 participants in Beijing and a county under Lanzhou City, China. Interview transcripts were systematically coded and emerging themes were developed from the codes. An inductive thematic analysis approach was utilized to analyze the interview data. Participants' perspectives on school-based CSA prevention programs included (a) recognition of the importance of school-based CSA prevention programs; (b) fear about a possible negative impact on children participating in such programs; (c) assessment that school-based CSA prevention programs alone are not enough to prevent CSA. Components that participants thought needed to be part of Chinese school-based CSA prevention programs were (a) content regarding online-facilitated CSA; (b) the use of a rights-based approach; and (c) greater parental and community involvement. Participants also identified factors that have both fostered the implementation of CSA research (e.g., the growing awareness of CSA in the central government) and prevented researchers from effectively conducting CSA research (a) lack of national data; (b) inadequate government support; and (c) barriers to research collaboration among organizations. The findings indicate that while CSA prevention programs are on the whole regarded positively by key stakeholders in China, a number of important concerns were identified. Our study highlighted a number of ways in which future CSA prevention programs and research on CSA could be strengthened in the Chinese context.Due to collaborative relationships fostered with school staff and the ability to form long-term trusting relationships with students, school nurses are uniquely situated to address the issue of child abuse detection and prevention in this age of online education brought about by coronavirus disease 2019 (COVID-19). School nurses can and should champion the cause of child safety in their schools, even during school closures through the implementation of key nursing interventions such as staff education on detecting child abuse in online environments. ULK-101 solubility dmso School nurses can also protect children by supporting parents who are dealing with great stressors due to the current global pandemic. Providing resources for families, encouraging parental self-care, educating families about online safety, and encouraging family discussion about child abuse all help to prevent abuse and maltreatment of children. When child abuse goes unreported because of school closures, school nurses can bridge the gap and advocate for detection and prevention in online education.School nurses are essential members of the school community. Their ability to collaborate with other school team members promotes a system's approach to the identification and management of students' mental health thereby promoting students' academic success. By enhancing the students' abilities to cope with the long-term impacts of chronic medical conditions as well as academic stress and other contributing factors that affect their mental health, school nurses are in a unique position to positively affect the long-term health of students. This article is the fourth in a series focusing on the Framework for the 21st Century School Nursing PracticeTM (Framework) and describes the practice component of systems-level leadership, in the principle of Leadership. This article describes the process to institute systematic change after identifying a need to improve nursing care for the students who frequented the health office for mental health issues during the school year. While utilizing the National Association of School Nurses' (NASN) Framework, this nurse created a program to address the mental health needs of the students while focusing on the essential selfmanagement and self-awareness skills required to manage and cope with the stress of childhood today.Femoral shaft nonunion after the intramedullary nailing has been successfully treated with advances in surgical technique. Nonetheless, the techniques cause morbidity to periosteum at the fracture site. We report the case of a 67-year-old man who underwent endoscopic surgery for refractory nonunion following the fracture of the distal femoral shaft, despite two fixations using an interlocking nail. In addition, the patient had uncontrolled diabetic mellitus. Endoscopy allowed us to acquire a clear view of the nonunion site, in which the resection of scar tissues and the packing of the cancellous bone were performed. At the final follow-up, bone healing was observed, and the patient was able to return to normal daily and social activity.The use of nanotechnology has become a promising approach in the treatment of cancer. However, most intravenously injected nanoparticles (NPs) do not effectively reach the tumor mass due to the biological barriers in the body. In an attempt to unify clinical criteria and basic research, we have collected the latest studies and described novel alternatives such as the use of NPs covered with cell membranes to increase NP delivery efficiency. Furthermore, we focus on the prospect of using the cell's natural messengers, exosomes, as vehicles to transport anti-cancer agents and we discuss the technical complications involved. Finally, we propose novel approaches to produce engineered exosomes which may overcome such technical limitations in order to achieve a proper anti-cancer nanotherapy.Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.

The objective of this study was to improve the three-dimensional (3D) understanding of optimal lateral cortical hinge in medial open-wedge high tibial osteotomy (MOWHTO) via a computational cadaveric simulation of actual size.

The computed tomography data of 117 adult cadavers were imported into Mimics® software to design 3D models of tibia and fibula. To simulate the MOWTHO, a virtual cutting plane was developed inside the safe zone based on established landmarks. After splitting and distracting through the cutting plane, the 10-mm cylinder (Ø 30 mm; height 10 mm) was placed vertically to be occupied properly in the nonosteotomized lateral cortex. The cross points between the round cylinder and cutting plane represented the anterior and posterior hinge points, which were used to validate the 3D position and direction of cortical hinge.

A 10-mm cylinder did not violate the proximal tibiofibular joint (PTFJ) and the protruding segment of the condylar area was less than 2 mm in 115 models. The connecting line between anterior and posterior hinge points was an average of 12.1° (range 0-24.1°, SD 4.64) to the lateral side. In the nonoverlapping anteroposterior projection between proximal fibula and tibia, the posterior hinge point was laid over the PTFJ as close as possible. Based on free 360° rotation and magnification without any tilt, no posterior cortical disruption of PTFJ was observed while securing a minimum width of 10 mm.

If the posterior hinge point was placed immediately above the PTFJ without involvement, the nonosteotomized portion carried sufficient width greater than 10 mm, despite lateral rotation at an average hinge direction of 12.1°.

If the posterior hinge point was placed immediately above the PTFJ without involvement, the nonosteotomized portion carried sufficient width greater than 10 mm, despite lateral rotation at an average hinge direction of 12.1°.Osteoporosis is a growing epidemic that leads to significant morbidity and mortality among the elderly population due to associated fractures that lead to disabilities and reduced quality of life. Bisphosphonates are well-established as a first-line and cost-effective treatment for osteoporosis. Unfortunately, clinicians are often uncertain as to how to select treatments when bisphosphonates are ineffective as initial treatment or contraindicated. Romosozumab and abaloparatide are 2 alternative agents that have been recently FDA approved for the treatment of osteoporosis in postmenopausal women at high risk for fracture or patients who have failed or are intolerant to other osteoporosis therapies. Currently, the National Osteoporosis Foundation (NOF) has no formal recommendations in regard to these 2 novel agents. The purpose of this review is to help guide pharmacists on how to ensure appropriate utilization of these 2 novel bone-forming agents as potential alternatives to bisphosphonate therapy by providing evidence-based recommendations according to the current literature and key counseling points.This study analyzed the relationships between exposure to interparental violence and adolescents' adjustment problems. It also explored the mediating role of emotional insecurity and the moderating role of parental warmth in these relationships. Five hundred and seventy-eight early adolescents from three migrant primary schools and one public school in Beijing participated in this survey, reporting on their perceived interparental violence, emotional insecurity, post-traumatic stress symptoms (PTSS), and internalizing and externalizing behavioral problems. The results revealed that emotional insecurity partially mediated the association between interparental violence and all three indicators of adjustment problems, with stronger mediating effects on PTSS and internalizing problems than on externalizing problems; parental warmth buffered the association between emotional insecurity and internalizing/externalizing problems. This study adds insights to present literature on how interparental violence contributes to different aspects of adolescents' adjustment problems in the Chinese context.