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These include the need for additional data on opioid use before clinically recognized pregnancy; accurate measurement of opioid exposure by multiple means with detailed information on the types and quantity of opioids used; assessment of important confounders, including opioid use indication, comorbidities, and use of other medications and substances; and studies of paternal opioid use, fertility, and pregnancy outcomes. A primary limitation of this review targeting studies of nonchronic opioid exposure is the possibility that selected studies included populations with unspecified chronic or dependent opioid use. Efforts to understand the impact of the prescription opioid epidemic should address potential reproductive harms of these medications among people of reproductive age.

Chronic pain is a leading cause of disability in low- and middle-income countries; however, pain assessment tools have generally been developed and validated in high-income countries. Selleckchem GF120918 This study examines the psychometric properties of a set of translated pain (and distress) questionnaires in Mongolia and documents the characteristics of people seeking treatment for chronic pain in Mongolia, compared with those in New Zealand, which is representative of high-income countries.

Cross-sectional, observational.

Hospital-based pain treatment centers in New Zealand and Mongolia.

People seeking treatment for chronic pain in Mongolia (N = 142) and New Zealand (N = 159).

The Brief Pain Inventory, the Depression Anxiety Stress Scale-21, the Pain Catastrophizing Scale, and the Pain Self-Efficacy Questionnaire were translated into Mongolian and administered to patients attending a hospital-based pain service. Questionnaires that were completed by patients in New Zealand were used for comparisons. Internal reliability, convergent validity, and factor structure were assessed in both groups.

Patients in Mongolia were older and reported lower pain intensity, interference, and distress and higher pain self-efficacy than those in New Zealand. The translated questionnaires had good internal consistencies, and the relationships between pain variables were similar across both groups. The factor structure for the Pain Catastrophizing Scale was consistent across both groups, but this was not the case for the Brief Pain Inventory or the Depression Anxiety Stress Scale-21.

Findings indicate that some pain outcome measures may be appropriate for use in Mongolia and should be investigated in other low- and middle-income countries.

Findings indicate that some pain outcome measures may be appropriate for use in Mongolia and should be investigated in other low- and middle-income countries.

Vaccination of healthcare workers (HCWs) reduces the risk of occupational vaccine-preventable diseases (VPDs), prevents their nosocomial transmission and preserves healthcare delivery during outbreaks. Extensive implementation of vaccination programmes for HCWs allowed the elimination or control of several VPDs within healthcare facilities; despite these, the vaccine adherence rates among HCWs are persistently suboptimal.

A questionnaire was self-administered by HCWs to assess their vaccination rates against several VPDs and self-reported immunity in two university hospitals of Southern Italy (Catania and Palermo).

A total of 2586 questionnaires were analysed. More than 50% of HCWs did not know their own immunization status against diphtheria, tetanus and pertussis. More than half of the HCWs interviewed at University Hospital (UH) of Catania (UHC) was immune against measles (72.1%), in contrast with data reported at the UH of Palermo (UHP) (45.9%). Immunization status against mumps (67.5% UHC vs. 40.6%l outbreaks, confirming data from previous national and international studies.

Evidence from the scientific literature shows a significant variation in greenhouse gas (GHG) emissions from the diet, according to the type of food consumed. We aim to analyze the relationship between the daily dietary GHG emissions according to red meat, fruit and vegetables consumption and their relationship with risk of total mortality, and incident risk of chronic diseases.

We examined data on the EPIC-Spain prospective study, with a sample of 40621 participants. Dietary GHG emission values were calculated for 57 food items of the EPIC study using mean emission data from a systematic review of 369 published studies.

Dietary GHG emissions (kgCO2eq/day), per 2000kcal, were 4.7 times higher in those with high red-meat consumption (>140g/day) than those with low consumption (<70g/day). The average dietary GHG emissions were similar in males and females, but it was significantly higher in youngest people and in those individuals with lower educational level, as well as for northern EPIC centers of Spain. We found a significant association with the risk of mortality comparing the third vs. the first tertile of dietary GHG emissions [hazard ratio (HR) 1.095; 95% confidence interval (CI) 1.007-1.19; trend test 0.037]. Risk of coronary heart disease (HR 1.26; 95% CI 1.08-1.48; trend test 0.003) and risk of type 2 diabetes (HR 1.24; 95% CI 1.11-1.38; trend test 0.002) showed significant association as well.

Decreasing red-meat consumption would lead to reduce GHG emissions from diet and would reduce risk of mortality, coronary heart disease and type 2 diabetes.

Decreasing red-meat consumption would lead to reduce GHG emissions from diet and would reduce risk of mortality, coronary heart disease and type 2 diabetes.

Because studies have suggested that atropine might slow the progression of myopia in children, randomized clinical trials are warranted to understand this potential causal relationship.

To evaluate the efficacy and safety of atropine, 0.01%, eyedrops on slowing myopia progression and axial elongation in Chinese children.

This was a randomized, placebo-controlled, double-masked study. A total of 220 children aged 6 to 12 years with myopia of -1.00 D to -6.00 D in both eyes were enrolled between April 2018 and July 2018 at Beijing Tongren Hospital, Beijing, China. Cycloplegic refraction and axial length were measured at baseline, 6 months, and 12 months. Adverse events were also recorded.

Patients were randomly assigned in a 11 ratio to atropine, 0.01%, or placebo groups to be administered once nightly to both eyes for 1 year.

Mean changes and percentage differences in myopia progression and axial elongation between atropine, 0.01%, or placebo groups.

Of 220 participants, 103 were girls (46.8%), andannot be determined from this trial, these 1-year results, limited by approximately 70% follow-up, suggest that atropine, 0.01%, eyedrops can slow myopia progression and axial elongation in children and warrant future studies to determine longer-term results and potential effects on slowing sight-threatening pathologic changes later in life.

http//www.chictr.org.cn Identifier ChiCTR-IOR-17013898.

http//www.chictr.org.cn Identifier ChiCTR-IOR-17013898.

Parents often provide advice to their adult children during their everyday interactions. This study investigated young adult children's daily experiences with parental advice in U.S. families. Specifically, the study examined how receiving advice and evaluations of parental advice were associated with children's life problems, parent-child relationship quality, and daily mood.

Young adult children (aged 18-30; participant N = 152) reported whether they received any advice and perceived any unwanted advice from each parent (parent N = 235) for seven days using a daily diary design (participant-day N = 948). Adult children also reported their positive and negative mood on each interview day.

Results from multilevel models revealed that adult children who reported a more positive relationship with their parents were more likely to receive advice from the parent, whereas adult children who had a more strained relationship with their parents were more likely to perceive advice from the parent as unwanted. Receiving advice from mother was associated with increased positive mood, whereas unwanted advice from any parent was associated with increased negative mood. Further, the link between unwanted advice and negative mood varied by children's life problems and parent-child relationship quality.

Indeed, parental advice is not "the more the better," especially when the advice is unsolicited. This study highlights the importance of perceptions of family support for emerging adults' well-being.

Indeed, parental advice is not "the more the better," especially when the advice is unsolicited. This study highlights the importance of perceptions of family support for emerging adults' well-being.Obesity and overweight in early childhood have detrimental impacts on children's health and development. Changing policy, system and environmental features focused on physical activity and healthy eating behaviors as part of health promotion interventions can play a key role in prevention strategies in early childhood education settings. These types of changes can have broad reach and are often sustained over time, which allows for impact on children who enter the early childhood education setting year after year. However, there is currently a gap between the generation of evidence for health promotion programs and their application into practice. link2 This study used qualitative methods to evaluate intervention-, organizational- and individual-level factors within a dissemination and implementation framework that may be related to the implementation of a health-promoting intervention in early childhood education settings. link3 Intervention-level factors, including feasibility and adaptability, organizational-level factors, including staff and leadership engagement, and individual-level factors, including attitudes, skills and knowledge, were identified as constructs that impacted the successful implementation of the intervention. These findings provide insight into core dissemination and implementation constructs that should be targeted by obesity prevention interventions in early childhood education settings to ensure maximum impact on sustainable behavior change.

Cynical hostility is a cognitive schema according to which people cannot be trusted, and it has associations with individuals' loneliness. The present study takes a dyadic approach to examine whether cynical hostility is related to one's own and their spouse's loneliness. We further explore whether friendship factors serve as a mediator between individuals' and spouses' cynical hostility and loneliness.

We used 2 waves of the Health and Retirement Study (N = 1,065 couples) and Actor-Partner Interdependence Models (APIMs) with mediation to examine the proposed model. Mediation was tested with the construction of path models and significance levels were reached using bootstrapping.

For both husbands and wives, cynical hostility was significantly associated with loneliness. Husband's loneliness was also significantly associated with his wife's cynical hostility, but wife's loneliness was not associated with her husband's cynical hostility. We further found that the association between wife's own cynical hostility and loneliness was mediated by lower levels of contact with, and support from friends. Friendship factors did not serve as mediators for husbands.

Husbands and wives who have higher levels of cynical hostility may be more vulnerable to loneliness. High levels of cynical hostility in women may be related to deficits in their quantity and quality of friendship, and thus be associated with loneliness. Men who are married to women with a higher level of cynical hostility may experience increased loneliness, but this relationship is not explained by men's friendships.

Husbands and wives who have higher levels of cynical hostility may be more vulnerable to loneliness. High levels of cynical hostility in women may be related to deficits in their quantity and quality of friendship, and thus be associated with loneliness. Men who are married to women with a higher level of cynical hostility may experience increased loneliness, but this relationship is not explained by men's friendships.