Inequities in PrEP use according to Medicare status in a publicly funded sexual health clinic; a retrospective analysis.

New HIV diagnoses continue to disproportionately affect overseas-born men who have sex with men (MSM). A retrospective study of all pre-exposure prophylaxis (PrEP)-eligible MSM attending Sydney Sexual Health Centre for the first time in 2021 analysed self-reported PrEP-use, PrEP prescribed at the initial consult, and PrEP taken during 2021 using binomial logistic regression models. A total of 1367 clients were included in the analysis, 716 (52.4%) were born overseas and 414 (57.8%) were Medicare-ineligible. Medicare-ineligible clients were less likely to be on PrEP at initial visit (OR 0.45, 95% CI 0.26-0.77). This study suggests inequities in PrEP access and/or awareness in Medicare-ineligible MSM in Australia.

Potential impacts of climate change on agriculture and fisheries production in 72 tropical coastal communities.

Climate change is expected to profoundly affect key food production sectors, including fisheries and agriculture. However, the potential impacts of climate change on these sectors are rarely considered jointly, especially below national scales, which can mask substantial variability in how communities will be affected. Here, we combine socioeconomic surveys of 3,008 households and intersectoral multi-model simulation outputs to conduct a sub-national analysis of the potential impacts of climate change on fisheries and agriculture in 72 coastal communities across five Indo-Pacific countries (Indonesia, Madagascar, Papua New Guinea, Philippines, and Tanzania). Our study reveals three key findings: First, overall potential losses to fisheries are higher than potential losses to agriculture. Second, while most locations (> 2/3) will experience potential losses to both fisheries and agriculture simultaneously, climate change mitigation could reduce the proportion of places facing that double burden. Third, potential impacts are more likely in communities with lower socioeconomic status.

Accelerating crop genetic gains with genomic selection.

KEY MESSAGE: Genomic prediction based on additive genetic effects can accelerate genetic gain. There are opportunities for further improvement by including non-additive effects that access untapped sources of genetic diversity. Several studies have reported a worrying gap between the projected global future demand for plant-based products and the current annual rates of production increase, indicating that enhancing the rate of genetic gain might be critical for future food security. Therefore, new breeding technologies and strategies are required to significantly boost genetic improvement of future crop cultivars. Genomic selection (GS) has delivered considerable genetic gain in animal breeding and is becoming an essential component of many modern plant breeding programmes as well. In this paper, we review the lessons learned from implementing GS in livestock and the impact of GS on crop breeding, and discuss important features for the success of GS under different breeding scenarios. We highlight major challenges associated with GS including rapid genotyping, phenotyping, genotype-by-environment interaction and non-additivity and give examples for opportunities to overcome these issues. Finally, the potential of combining GS with other modern technologies in order to maximise the rate of crop genetic improvement is discussed, including the potential of increasing prediction accuracy by integration of crop growth models in GS frameworks.

Perceptions of confidence among Saudi nursing interns during internship program: a cross-sectional study.

BACKGROUND: Saudi nursing students are trained in theoretical and clinical nursing competencies for four years before transition to newly graduated nurses through a one-year internship program. The transition period is crucial as nursing students have low confidence without adequate clinical experience. OBJECTIVES: Validate and culturally adapt the Arabic version of the Self-Efficacy for Clinical Evaluation Scale (SECS) and explore nursing interns perceived confidence (self-efficacy). DESIGN: Cross-sectional. SETTING: Four public tertiary training hospitals in Riyadh, Saudi Arabia. METHODS: A survey was conducted among nursing interns. Validity, reliability, and the cultural relevance of the Arabic-translated instrument was determined. Tests for differences and correlations were undertaken. MAIN OUTCOME MEASURES: Perceived self-efficacy and impor.tance of learning objectives. SAMPLE SIZE: 300 Saudi nursing interns. RESULTS: The Arabic version of SECS was successfully adapted cross-culturally and was valid. Reliability tests showed Cronbach's a=.95 for confidence and Cronbach's a=0.96 for the importance subscales. The overall mean (SD) for perceived confidence and importance of clinical evaluation were 3.7 (0.9) and 4.1 (0.8), respectively. Gender (P less than .001), length of internship (P=.009), and training hospital (P less than .001) were significantly correlated and had a medium effect size with perceived self-efficacy. CONCLUSION: Gaining knowledge that the gender, length of intern.ship and area of training affect the perceptions of the Saudi nursing interns towards self-efficacy can help preceptors formulate better strategies in developing nursing intern competence and gaining self-efficacy as they move from the academic to clinical nursing practice. The knowledge gathered in this study should be beneficial to nursing administrators, faculty, and mentors/preceptors. LIMITATIONS: Results may not be generalizable due to the limitations in the setting and there are other factors not included in the study that may have explained variances in perceived self-efficacy. CONFLICT OF INTEREST: None.

Psychosocial profiles of adolescent nonsmokers in the Pacific.

Studies examining adolescent smoking have focused on at-risk individuals, while overlooking the psychosocial profiles of those adolescents who have managed to remain nonsmokers. Accumulating evidence suggests that positive emotions such as happiness may be associated with the adoption of healthy practices, but limited evidence has emerged from developing countries. This study examined the association between non-smoking and positive emotions and psychosocial correlates in 3 large population samples of Pacific youths (N = 5659) living in Tonga, Vanuatu, and Pohnpei in the Federated States of Micronesia. Across all 3 samples, being confident was significantly associated with nonsmoking and being happy (Tonga, odds ratio [OR] = 1.39, 95% confidence interval [CI] = 1.12-1.73; Vanuatu, OR = 1.29, 95% CI = 1.02-1.63; Pohnpei, OR = 2.34, 95% CI = 1.60-3.34). Some cross-country differences in relationships were found in the associations between societal factors (ie, perceived connections with school, teachers, and peers, and perceived community importance and involvement) and nonsmoking and happiness. Findings have implications for developing innovative strategies aimed at preventing smoking uptake and suggest the need for focusing on identifying the determinants of nonsmoking and measuring positive emotions.

Screening of microsatellite markers in penile cancer reveals differences between metastatic and nonmetastatic carcinomas.

Penile cancer, observed only rarely in the western world, represents a carcinoma that may be cured by resection of primary lesion and in case of lymph node metastasis by early lymph node dissection. This early inguinal lymphadenectomy bares a significant better survival even in cases of nonpalpable lymph nodes, but carries also a high risk of overtreatment, especially in lower tumor stages. Due to the low incidence, only few data are available on the molecular genetic background of this tumor, especially concerning tumor progression and metastasis. Therefore, we studied 62 microsatellite markers in 28 penile carcinomas searching for markers predicting progression or outcome. LOH in more than 25% of primary tumors was found on six different chromosomes, including 2q, 6p, 8q, 9p, 12q and 17p13. Statistically significant correlations could be established in D6S260 to clinical outcome and in markers from chromosomes 6, 9 and 12 to tumor stage and metastasis. These regions are worthy for further analysis concerning tumor suppressor genes and metastasis suppressor genes.