Unplanned hysterectomy: a comprehensive analysis of race, ethnicity, sociodemographic factors, pregnancy complications, and cardiovascular disease risk factors.

OBJECTIVE: To understand the risk of unplanned hysterectomy (UH) in pregnant women better in association with maternal sociodemographic characteristics, cardiovascular disease (CVD) risk factors, and current pregnancy complications. DESIGN: Using Florida birth data from 2005 to 2014, we investigated the possible interactions between known risk factors of having UH, including maternal sociodemographic characteristics, maternal medical history, and other pregnancy complications. Logistic regression models were constructed. Adjusted odds ratios and 95% confidence intervals were reported. RESULTS: Several interactions were observed that significantly affected odds of UH. Compared to non-Hispanic White women, Hispanic minority women were more likely to have an UH. The overall risk of UH for women with preterm birth (<37 weeks) and concurrently had premature rupture of membranes (PRoM), uterine rupture, or a previous cesarean delivery was significantly higher than women who delivered to term and had no pregnancy complications. Women who delivered via cesarean who also had preeclampsia, PRoM, or uterine rupture had an overall increased risk of UH. Significantly decreased risk of UH was seen for Black women less than 20 years old, women of other minority races with either less than a high school degree or a college degree or greater, women of other minority races with PRoM, and women with preterm birth and diabetes compared to respective reference groups. CONCLUSIONS: Maternal race, ethnicity, CVD risk factors, and current pregnancy complications affect the risk of UH in pregnant women through complex interactions that would not be seen in unadjusted models of risk analysis.

Methodologies used in studies examining substance abuse, violence and HIV/AIDS (SAVA) constructs using a syndemic framework: a scoping review.

The syndemic theoretical framework has been used in health disparities research to explain several co-occurring epidemics, particularly in populations facing disparate health conditions. A prominent example of this is seen in Singer's Substance Abuse, Violence and HIV/AIDS (SAVA) syndemic theory. However, even though numerous studies support some of the theoretical underpinnings of the SAVA syndemic, the empirical applications of the theory remain methodologically underdeveloped. The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), to present the state of the science of methodologies examining SAVA constructs using the syndemic framework. Seven bibliographic databases were searched with no language or date restrictions. Studies were synthesized by author, year of publication, study location, total sample size, study population, SAVA outcomes, analytic method of SAVA measurement, intervention type, level of influence, disease interaction and concentration, main findings of the study, and possible future areas of research. Our search yielded a total of 967 articles, and 123 were included in the review. Methodologic and statistical innovation is needed to elevate the impact of syndemic theory for elucidating the synergistic effects of determinants leading to health disparities.

Precision and reliability study of hospital infusion pumps: a systematic review.

BACKGROUND: Infusion Pumps (IP) are medical devices that were developed in the 1960s and generate fluid flow at pressures higher than that of normal blood pressure. Various hospital sectors make use of them, and they have become indispensable in therapies requiring continuity and precision in the administration of medication and/or food. As they are classified Class III (high risk) equipment, their maintenance is crucial for proper performance of the device, as well as patient and operator safety. The principal consideration of the pump is the volume infused, and the device demands great attention to detail when being calibrated. A lack of necessary care with this equipment can lead to uncertainty in volume and precision during the administration of substances. Because of this, it is essential to evaluate its reliability, to prevent possible failures at time of execution. This control aims at the quality of the intended infusion result, becoming an indication of quality. METHODS: This systematic review summarizes studies done over the last 10 years (2011 to December 2021) that address the reliability and accuracy of hospital infusion pumps, in order to identify planning of maintenance and/or other techniques used in management of the equipment. The Prisma method was applied and the databases utilized were Embase, MEDLINE/Pubmed, Web of Science, Scopus, IEEE Xplore, and Science Direct. In addition, similar reviews were studied in Prospero and the Cochrane Library. For data analysis, softwares such as Mendeley, Excel, RStudio, and VOSviewer were used, and Robvis helped in plotting risk of bias results for studies performed with Cochrane tools. RESULTS: The six databases selected produced 824 studies. After applying eligibility criteria (inclusion and exclusion), removing duplicates, and applying filters 1 and 2, 15 studies were included in the present review. It was found that the most relevant sources came from the Institute of Electrical and Electronics Engineers (IEEE) and that the most relevant keywords revolved around the terms ("device failure", "infusion pumps", "adverse effects", "complications", etc.). These results made clear that there remains substantial room for improvement as it relates to the study of accuracy and reliability of infusion. CONCLUSIONS: We verified that the reliability and precision analysis of hospital infusion pumps need to be performed in a more detailed and consistent way. New developments, considering the model and IP specification, are intended, clearly explaining the adopted methodology.

A qualitative community health assessment of HIV prevention awareness in a semi-rural Latinx seasonal farm working community in South Florida.

This article explores HIV awareness and prevention in a Latinx seasonal farmworker community of south Miami-Dade County in the USA. The study took place as part of a larger community assessment that aimed to determine community needs and resources related to substance abuse, violence and HIV in the Latinx seasonal farmworker communities of south Miami-Dade County, with a particular focus on fathers' and their male sons' relationships. The study collected data on HIV knowledge and prevention, healthcare-seeking behaviours, cultural norms, and communication barriers about HIV prevention between fathers and sons. Data were collected through in-depth interviews with community leaders, two focus groups with social and health services providers, and four focus groups involving fathers and their adolescent sons. A deductive approach to data analysis was undertaken. Five major themes were identified: (1) HIVrelated knowledge and perception; (2) HIV prevention strategies; (3) barriers and needs for tailored preventive health and care services in the community; (4) stress over sex-related communication; and (5) the dominance of traditional masculine gender norms in the household and the community.

Alcohol use among adult recent Latino/a immigrants: the role of stress, forced migration, and adherence to traditional gender roles.

Background: Previous research conducted among Latino/a immigrants has shown the underlying effect that exposure to stress after immigrating to the U.S. (i.e. health access, racial/ethnic discrimination, and language barriers) has on alcohol use patterns. However, given the demographic shifts in recent immigrants, understanding the influence of stress before (i.e. poverty, healthcare, and educational opportunities) and after immigration on their alcohol use (i.e. alcohol consumption and drinking behaviors in the past 12 months) in the context of migration and traditional gender roles is warranted.Objectives: To examine the (a) cumulative effects of pre- to post-immigration stress, (b) respective moderating effects of traditional gender roles, and (c) forced migration on alcohol use for men and women.Methods: Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 529 (N = 268 men, N = 261 women) adult (18-34 years) from recent Latino/a immigrants in South Florida.Results: Gender had a statistically significant difference on alcohol use, (F 527) = 18.68, p < .001, with men (p = 4.36 ± SE =.22) reporting higher alcohol use than women (p = 3.08 ± SE =.20). Post-immigration stress (ß = .12, p = .03) but not pre-migration stress had a statistically significant association with alcohol use. There is no interaction effect by traditional gender roles and forced migration on the associations between pre- to post-immigration stress and alcohol use.Conclusion: Results suggest that post-immigration stress may be a reasonable intervention target to mitigate alcohol use among recent Latino/a immigrants, particularly among men.

Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework.

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

Vibration-Based Smart Sensor for High-Flow Dust Measurement.

Asphalt mixes comprise aggregates, additives and bitumen. The aggregates are of varying sizes, and the finest category, referred to as sands, encompasses the so-called filler particles present in the mixture, which are smaller than 0.063 mm. As part of the H2020 CAPRI project, the authors present a prototype for measuring filler flow, through vibration analysis. The vibrations are generated by the filler particles crashing to a slim steel bar capable of withstanding the challenging conditions of temperature and pressure within the aspiration pipe of an industrial baghouse. This paper presents a prototype developed to address the need for quantifying the amount of filler in cold aggregates, considering the unavailability of commercially viable sensors suitable for the conditions encountered during asphalt mix production. In laboratory settings, the prototype simulates the aspiration process of a baghouse in an asphalt plant, accurately reproducing particle concentration and mass flow conditions. The experiments performed demonstrate that an accelerometer positioned outside the pipe can replicate the filler flow within the pipe, even when the filler aspiration conditions differ. The obtained results enable extrapolation from the laboratory model to a real-world baghouse model, making it applicable to various aspiration processes, particularly those involving baghouses. Moreover, this paper provides open access to all the data and results used, as part of our commitment to the CAPRI project, with the principles of open science.

Alcohol use severity among recent Latino immigrants: Associations of acculturation, family history of alcohol use and alcohol outcome expectancies.

Having a family history of alcohol (FH+) use is a well-documented risk factor for alcohol use and alcohol related problems. However, there are limited studies examining the impact of FH + on current alcohol use among Latino immigrants. This study aimed to determine the influence of having a FH + on current alcohol use among Latino immigrants and the influence of alcohol outcome expectancies (AOEs) and acculturation on this relationship. This is a longitudinal secondary data analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine pre- to post-immigration alcohol use trajectories of young adult Latino immigrants. Linear mixed models were performed to assess the association between various pre- and post-immigration factors and alcohol use among Latino immigrants. There were 518 young adult Latino immigrants with 18.7% reporting a FH + with those with a FH + having higher mean AUDIT score compared to those without (4.74 vs. 3.81; p = 0.028). Positive AOEs were associated with increase AUDIT scores. FH + individuals with greater positive AOEs experienced higher AUDIT scores compared to FH- individuals. Family cohesion was protective against alcohol use while endorsement of Americansism was associated with increased alcohol use. Theses results provide the framework for more in-depth exploration regarding the influences of FH+, AOEs, and acculturation have on the alcohol use among Latino immigrants. Future longitudinal research studies should account for whether traditional cultural values mediate or moderate the relationship between a FH+, AOE, and alcohol use of Latino immigrants.

Ethnic Discrimination and Self-rated Health among Hispanic Emerging Adults: Examining the Moderating Effects of Self-esteem and Resilience.

Exposure to ethnic discrimination has been conceptualized as a sociocultural stressor that is associated with lower self-rated health. However, this association remains understudied among Hispanics and less is known about constructs that may mitigate the effects of ethnic discrimination on self-rated health. Accordingly, this study aimed to (a) examine the association between ethnic discrimination and self-rated health among Hispanic emerging adults (ages 18-25), and (b) examine the extent to which self-esteem and resilience may moderate this association. A convenience sample of 200 Hispanic emerging adults from Arizona (n=99) and Florida (n=101) was recruited to complete a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Results indicate that higher ethnic discrimination was associated with lower self-rated health. Moderation analyses indicated that self-esteem functioned as a moderator that weakened the association between ethnic discrimination and self-rated health; however, resilience did not function similarly as a moderator. This study adds to the limited literature on ethnic discrimination and self-rated health among Hispanics and highlights that psychological factors, such as enhancing self-esteem, may help buffer the adverse effects of ethnic discrimination on health outcomes.

Effects of vaccine registration on disease prophylaxis: a systematic review.

BACKGROUND: The impact of the pandemic caused by the coronavirus (SARS-CoV-2), causing the disease COVID-19, has brought losses to the world in terms of deaths, economic and health problems. The expected return of the public to activities adapted to the new health situation led to discussions about the use of vaccination and its effects. However, the demand for proof of vaccination showed how inconsistent, unregistered, and uncontrolled this health process is with current technologies. Despite the proven effectiveness of vaccines in reducing infection rates, mortality, and morbidity, there are still doubts about their use in preventing certain infections and injuries, as well as the use of digital medical records for identification at public events and disease prevention. Therefore, this review aims to analyze the use of digital immunization cards in disease prevention in general. METHODS: A systematic review of Science, PubMed/MEDLINE, LILACS /BSV, CINALH, and IEEE and Xplore was performed using PRISMA guidelines. The authors summarized the studies conducted over the last decade on the impacts of prophylaxis by control through immunization cards. Studies were selected using the following terms: Vaccination; Mobile Applications; Health Smarts Cards; Immunization Programs; Vaccination Coverage. For data analysis, we used Mendeley, Excel, RStudio, and Bibliometrix software among others. RESULTS: A total of 1828 publications were found. After applying eligibility criteria (Articles published in Portuguese, Spanish or English in the last 10 years). Studies that only dealt with paper or physical records were excluded, as well as studies that were not linked to their country's health Department, as a possibility of bias exists with these types of information). After removing duplicates and applying filters 1 and 2, we included 18 studies in this review. This resulted in 18 papers that met our priori inclusion criteria; it was found that the most relevant sources were from the databases of the Institute of Electrical and Electronics Engineers (IEEE). CONCLUSIONS: Considering the selected studies, we found that scientific evidence and epidemiological surveillance are essential tools to characterize the efficiency and effectiveness of immunization passport protection intervention and to ethically justify them. Technological development of digital vaccine passports can assist in vaccination programs and positively impact disease prophylaxis.

Depressive symptoms among recent Latinx immigrants in South Florida: The role of premigration trauma and stress, postimmigration stress, and gender.

In the past decade, recent Latinx immigrants (RLIs) from South and Central America have arrived in the United States seeking asylum from countries affected by war, political upheaval, and high crime and poverty rates. The premigration stress and trauma they experience are further compounded by postimmigration stress due to discrimination, lack of access to health care, and financial instability. Evidence suggests RLIs who experience such stress and trauma have an increased risk of developing depressive symptoms. We examined the combined effect of premigration stress and trauma and postimmigration stress on postimmigration depressive symptoms; we also explored the moderating effect of gender. Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 540 young adult RLIs (age range: 18-34 years, 50.2% men) in South Florida. Higher levels of postimmigration stress, ß = .37, p < .001, were associated with increased postimmigration depressive symptoms. No significant associations emerged between premigration stress and trauma and postimmigration depressive symptoms. Moderation analyses revealed no significant interaction effect of gender. Post hoc analyses indicated that country/region of origin moderated the relation between postimmigration stress and depressive symptoms such that the association was stronger among Venezuelan, ß = 1.51, p < .001; other South American, ß = 1.06, p < .001; and Central American/Mexican RLIs, ß = 1.38, p < .001, compared with Caribbean RLIs, ß = .45, p  = .122. These findings suggest that interventions focused on addressing postimmigration stress early in the immigration process can potentially lower subsequent depressive symptoms among RLIs.

Associations between gender norms and HIV self-efficacy among Latina immigrants in a farmworker community.

Latina immigrant farmworkers are a vulnerable and understudied population that face a host of socio-cultural and structural barriers that place them at risk for HIV infection. Cultural factors, including traditional gender roles (egalitarian and marianismo) that frequently inhibit communication between partners and promote rigid roles, may particularly affect self-efficacy for HIV prevention among this population.Objective: This study examines the impact of women's gender norms on HIV knowledge and safe sex negotiation skills, along with the moderating influence of HIV self-efficacy among Latina immigrants in a farmworker community.Design: The current cross-sectional analysis study examines data from a sample (N = 157) of mostly undocumented Latina immigrant farmworkers in South Miami-Dade County, Florida. Analysis was performed on secondary data obtained from baseline collected on an intervention pilot study. Measures of traditional American (egalitarian) and Latina (marianismo) gender norms, HIV self-efficacy, and HIV knowledge, as well as key demographic variables were collected.Results: Findings revealed higher American (egalitarian) gender norms directly and indirectly predict higher HIV prevention factors. Additionally, HIV self-efficacy did not mediate effects of marianismo on HIV risk.Conclusion: Findings conclude that HIV prevention can be especially challenging due to socio-cultural and traditional gender norms faced by Latinas in farm working communities and that such norms should be taken into account when developing and adapting culturally appropriate interventions to reduce HIV related risk behaviors for Latinas residing in urban or farm working communities.

Management of hand osteoarthritis: from an US evidence-based medicine guideline to a European patient-centric approach.

Hand osteoarthritis is the most common joint condition and is associated with significant morbidity. It is of paramount importance that patients are thoroughly assessed and examined when complaining of hand stiffness, pain, deformity or disability and that the patient's concerns and expectations are addressed by the healthcare professional. In 2019 the American College of Rheumatology and Arthritis Foundation (ACR/AF) produced guidelines which included recommendations for the treatment of hand osteoarthritis. An ESCEO expert working group (including patients) was convened and composed this paper with the aim to assess whether these guidelines were appropriate for the treatment of hand osteoarthritis therapy in Europe and whether they met with the ESCEO patient-centered approach. Indeed, patients are the key stakeholders in healthcare and eliciting the patient's preference is vital in the context of an individual consultation but also for informing research and policy-making. The patients involved in this working group emphasised the often-neglected area of aesthetic changes in hand osteoarthritis, importance of developing pharmacological therapies which can alleviate pain and disability and the need of the freedom to choose which approach (out of pharmacological, surgical or non-pharmacological) they wished to pursue. Following robust appraisal, it was recommended that the ACR/AF guidelines were suitable for a European context (as described within the body of the manuscript) and it was emphasised that patient preferences are key to the success of individual consultations, future research and future policy-making.

Management of patients at very high risk of osteoporotic fractures through sequential treatments.

Osteoporosis care has evolved markedly over the last 50 years, such that there are now an established clinical definition, validated methods of fracture risk assessment and a range of effective pharmacological agents. Currently, bone-forming (anabolic) agents, in many countries, are used in those patients who have continued to lose bone mineral density (BMD), patients with multiple subsequent fractures or those who have fractured despite treatment with antiresorptive agents. However, head-to-head data suggest that anabolic agents have greater rapidity and efficacy for fracture risk reduction than do antiresorptive therapies. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) convened an expert working group to discuss the tools available to identify patients at high risk of fracture, review the evidence for the use of anabolic agents as the initial intervention in patients at highest risk of fracture and consider the sequence of therapy following their use. This position paper sets out the findings of the group and the consequent recommendations. The key conclusion is that the current evidence base supports an "anabolic first" approach in patients found to be at very high risk of fracture, followed by maintenance therapy using an antiresorptive agent, and with the subsequent need for antiosteoporosis therapy addressed over a lifetime horizon.

Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group.

Vitamin D is a key component for optimal growth and for calcium-phosphate homeostasis. Skin photosynthesis is the main source of vitamin D. Limited sun exposure and insufficient dietary vitamin D supply justify vitamin D supplementation in certain age groups. In older adults, recommended doses for vitamin D supplementation vary between 200 and 2000 IU/day, to achieve a goal of circulating 25-hydroxyvitamin D (calcifediol) of at least 50 nmol/L. The target level depends on the population being supplemented, the assessed system, and the outcome. Several recent large randomized trials with oral vitamin D regimens varying between 2000 and 100,000 IU/month and mostly conducted in vitamin D-replete and healthy individuals have failed to detect any efficacy of these approaches for the prevention of fracture and falls. Considering the well-recognized major musculoskeletal disorders associated with severe vitamin D deficiency and taking into account a possible biphasic effects of vitamin D on fracture and fall risks, an European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group convened, carefully reviewed, and analyzed the meta-analyses of randomized controlled trials on the effects of vitamin D on fracture risk, falls or osteoarthritis, and came to the conclusion that 1000 IU daily should be recommended in patients at increased risk of vitamin D deficiency. The group also addressed the identification of patients possibly benefitting from a vitamin D loading dose to achieve early 25-hydroxyvitamin D therapeutic level or from calcifediol administration.

Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US.

Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 - 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.

Influences of immigration stress and occupational exploitation on Latina seasonal workers' substance use networks: a qualitative study.

US female Latina seasonal farm workers (LSW) are a medically underserved community experiencing severe health disparities. We explored the relationship between alcohol and prescription medication, and LSW social networks using a qualitative approach. In 2015, this study used convenience sampling to recruit 28 LSWs in South Florida for three focus group discussions in Spanish. Focus groups were translated to English for analysis, which employed a general inductive approach. Themes included prescription medication distribution within networks, spirituality/religion practice with friends and family, and alcohol use with friends. Substance abuse prevention and treatment interventions should account for the unique needs of LSW.

The Risk of Mortality Associated With Opioid Use in Patients With Acute Heart Failure: Systematic Review and Meta-analysis.

AIMS: The impact of opioids in acute heart failure (AHF) is unclear. This systematic review with meta-analysis aimed to evaluate the mortality risk associated with opioid use in AHF. METHODS AND RESULTS: An electronic search was performed in MEDLINE, CENTRAL, Web of Science Core Collection, and SCIELO (December 2019) for randomized controlled trials and observational studies evaluating the impact of opioids in in-hospital and 30-day mortality in patients with AHF. Data were screened, extracted, and appraised by 2 independent reviewers. A random-effects meta-analysis to estimate the pooled odds ratios (OR) with 95% confidence intervals (CI) was performed and heterogeneity was evaluated using the I2 statistics. Six observational retrospective studies with 151,735 participants were included. Pooled results showed a statistical significant association between morphine and in-hospital mortality (OR 1.78; 95% CI 1.01-3.13; I2 = 92%; 6 studies) and 30-day mortality (OR 1.56; 95% CI 1.14-2.15; I2 = 0; 2 studies). Both outcomes were rated as having a serious risk of bias and had a very low Grading of Recommendation, Assessment, Development, and Evaluation evidence. CONCLUSIONS: Opioids seem to be associated with an increased risk of short-term mortality in AHF patients; however, the confidence in the estimated effect is very low, which highlights the need of further research to evaluate this question.

HIV testing intentions and cognitive reappraisal among Latino emerging adults.

Negative emotions related to HIV testing may influence an individual's intentions to test for HIV. However, emotion regulation strategies such as cognitive reappraisal which involves reframing the meaning of an event to modify one's emotional response to it may potentially help to regulate these emotions and facilitate decisions to get tested for HIV. In this exploratory study, we examined the association between cognitive reappraisal and HIV testing intentions and whether this association differs by gender. Cross-sectional data were collected from a convenience sample of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida through an online survey. Hierarchical logistic regression models were used to analyze the data. Results indicated that cognitive reappraisal was significantly associated with HIV testing intentions (aOR: 1.44, 95% CI:1.04-1.99) and that this association was specific to females (aOR: 2.48, 95% CI: 1.39-4.43). Our results demonstrate the potential of cognitive reappraisal to facilitate HIV testing intentions among females. HIV prevention interventions should incorporate cognitive reappraisal training to regulate and adapt to the negative emotions associated with HIV testing in efforts to increase HIV testing.

Update on the ESCEO recommendation for the conduct of clinical trials for drugs aiming at the treatment of sarcopenia in older adults.

BACKGROUND: In 2016, an expert working group was convened under the auspices of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and formulated consensus recommendations for the conduct of clinical trials for drugs to prevent or treat sarcopenia. AIMS: The objective of the current paper is to provide a 2020 update of the previous recommendations in accordance with the evidence that has become available since our original recommendations. METHODS: This paper is based on literature reviews performed by members of the ESCEO working group and followed up with face to face meetings organized for the whole group to make amendments and discuss further recommendations. RESULTS: The randomized placebo-controlled double-blind parallel-arm drug clinical trials should be the design of choice for both phase II and III trials. Treatment and follow-up should run at least 6 months for phase II and 12 months for phase III trials. Overall physical activity, nutrition, co-prescriptions and comorbidity should be recorded. Participants in these trials should be at least 70-years-old and present with a combination of low muscle strength and low physical performance. Severely malnourished individuals, as well as bedridden patients, patients with extremely limited mobility or individuals with physical limitations clearly attributable to the direct effect of a specific disease, should be excluded. Multiple outcomes are proposed for phase II trials, including, as example, physical performance, muscle strength and mass, muscle metabolism and muscle-bone interaction. For phase III trials, we recommend a co-primary endpoint of a measure of functional performance and a Patient Reported Outcome Measure. CONCLUSION: The working group has formulated consensus recommendations on specific aspects of trial design, and in doing so hopes to contribute to an improvement of the methodological robustness and comparability of clinical trials. Standardization of designs and outcomes would advance the field by allowing better comparison across studies, including performing individual patient-data meta-analyses, and different pro-myogenic therapies.