METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.

RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36).

OBJECTIVE: The study aimed to explore youth perceptions of the My-Elderly-Care-Skills Module intervention and its perceived feasibility.

METHODS: This study involved youth respondents (18-30 years old) from low-income households who are accountable to providing care for independent older people (60 years or above) living in the same house. A qualitative study using a case study design was used to assess youth perceptions based on the content of the My-Elderly-Care-Skills module, by focusing on its implementation usage and usefulness for the care of the elderly. A total of 30 youths voluntarily participated in the online training workshop during the COVID-19 pandemic movement restriction order period. There were multiple sources of data, such as video recorded on reflection of care given at home, text messages in a WhatsApp group, and in-depth interviews during small group online meetings. Data were recorded and transcribed verbatim for common themes before a theme analysis was conducted. Inductive content analysis was performed after the saturation point was met.

RESULTS: Thematic analysis derived two domains of feasibility: operational and technical feasibility. There were three themes under operational practicality (improving awareness, addressing the caregiving skills needs, and seeking resources for knowledge) and three themes for technical practicality (easily used and informative, skill in effective communication, and program fulfillment).

METHODS: Data from 75 adolescents aged 11 or 12 years and 2,061 teeth without dental caries were analyzed in this study. Annual dental examinations to assess dental caries were conducted between 2018 and 2021. Salivary cotinine and Dentocult SM-Strip level were measured at baseline. Information on the smoking habits of parents, snack frequency, regular dental visits, and use of fluoride toothpaste was collected at baseline from parent-reported questionnaires.

RESULTS: During the 3-year follow-up, dental caries was noted in 21 adolescents and 43 teeth. Participants exposed to parental smoking had higher salivary cotinine levels than those whose parents did not smoke. The multilevel Cox regression model showed that a high salivary cotinine level was associated with the incidence of dental caries, after adjusting for potential confounding factors (hazard ratio, 3.39; 95% confidence interval 1.08-10.69).

METHODS: This qualitative study used vignettes and think-aloud methods. We recruited patients from a primary care clinic who were at least 18 years old, had high cardiovascular risk and had previously sought OHI. Participants were given two statin-related vignettes: Vignette 1 (low-quality information) and Vignette 2 (high-quality information). Participants voiced their thoughts aloud when reading the vignettes and determined the trust level for each vignette using a 5-point Likert scale. This was followed by a semi-structured interview which was audio-recorded and transcribed verbatim. The transcripts were coded and analysed using thematic analysis.

RESULTS: A total of 20 participants were recruited, with age ranging from 38-74 years. Among all the high cardiovascular-risk participants, eight had pre-existing cardiovascular diseases. For Vignette 1 (low-quality information), five participants trusted it while nine participants were unsure of their trust. 17 participants (85%) trusted Vignette 2 (high-quality information). Five themes emerged from the analysis of how patients evaluated OHI: (1) logical content, (2) neutral stance and tone of OHI content, (3) credibility of the information source, (4) consistent with prior knowledge and experience, and (5) corroboration with information from other sources.

METHODS: A total of 48 adolescents with mild to moderate mental disabilities were recruited. The participants were randomly divided into four groups: control group (C), Traditional Chinese Medicine acupuncture group (M), moderate-intensity aerobic exercise group (E) and exercise and acupuncture combined intervention group (J). Before and after the experimental intervention, the participant's height, weight and attention ability were measured.

RESULTS: The improved range of attention total duration of the J group after the intervention was significantly higher than that of the E and M groups (0.05), whereas that of the latter groups was significantly higher compared to that of the C group ( 0.05). The J group showed significantly higher ( 0.05) attention span values after the intervention compared to the E, M and C groups. The C group did not show a significant difference in attention transfer at 12 weeks compared to before intervention (0.05), whereas the E, M and J groups increased significantly ( 0.05) after intervention than the C group.

METHODS: This study aimed to compile and synthesize the existing studies on the effects of PT on healthy athletes' technical skill performance. A comprehensive search of SCOPUS, PubMed, Web of Science Core Collection, and SPORTDiscus databases was performed on 3rd May 2023. PICOS was employed to establish the inclusion criteria: 1) healthy athletes; 2) a PT program; 3) compared a plyometric intervention to an active control group; 4) tested at least one measure of athletes' technical skill performance; and 5) randomized control designs. The methodological quality of each individual study was evaluated using the PEDro scale. The random-effects model was used to compute the meta-analyses. Subgroup analyses were performed (participant age, gender, PT length, session duration, frequency, and number of sessions). Certainty or confidence in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS: Thirty-two moderate-high-quality studies involving 1078 athletes aged 10-40 years met the inclusion criteria. The PT intervention lasted for 4 to 16 weeks, with one to three exercise sessions per week. Small-to-moderate effect sizes were found for performance of throwing velocity (i.e., handball, baseball, water polo) (ES = 0.78; p < 0.001), kicking velocity and distance (i.e., soccer) (ES = 0.37-0.44; all p < 0.005), and speed dribbling (i.e., handball, basketball, soccer) (ES = 0.85; p = 0.014), while no significant effects on stride rate (i.e., running) were noted (ES = 0.32; p = 0.137). Sub-analyses of moderator factors included 16 data sets. Only training length significantly modulated PT effects on throwing velocity (> 7 weeks, ES = 1.05; ≤ 7 weeks, ES = 0.29; p = 0.011). The level of certainty of the evidence for the meta-analyzed outcomes ranged from low to moderate.

OBJECTIVES: This study adopts a systematic literature review to (1) examine the effects of resistance training on the performance of adolescent swimmers, and (2) summarize their training methods and intensity.

METHODS: The literature search was undertaken in five international databases: the SCOUPS, PubMed, EBSCOhost (SPORTDiscus), CNKL, Web of Science. The searches covered documents in English and Chinese published until 30th December 2020. Electronic databases using various keywords related to "strength training" and "adolescent swimmers" were searched. Sixteen studies met the inclusion and exclusion criteria where the data was then systematically reviewed using the PRISMA guideline. Furthermore, the physical therapy evidence database (PEDro) scale was used to measure each study's scientific rigor.

RESULTS: This review found that to improve the swimming performance of adolescents, two types of resistance training were used, specifically in water and on land, where both types of training can improve swimming performance. In addition, training with two types of resistance machines were better in the water than with one equipment. Resistance training can improve the swimming performance of adolescent swimmers at 50 m, 100 m, 200 m and 400 m distances. However, most studies only focused on the swimming performance at 50 m and 100 m lengths. A low-intensity, high-speed resistance training programme is recommended for adolescent swimmers to obtain the best training results.

CONCLUSION: Water or land resistance training can improve the swimming performance. Given that both types of exercises have their strengths and weaknesses, combining these methods may enhance the swimmers' performance. In addition, despite the starting and turning phases consuming up to one-third of the total swimming time for short distances, literature in this area is limited.

OBJECTIVE: This study aims to identify the determinants of non-adherence to unintentional home injury prevention practice among parents of under-five children in the North Seberang Perai district, Penang.

METHODS: This sequential explanatory mixed-methods study consists of two phases consisting of a quantitative study which looks into respondents and their child's sociodemographic status, their home injury prevention practice and the independent variables, followed by a qualitative study that interviews parents with non-adherence to home injury prevention practice and explore their barriers. In phase I, the parent or primary caregiver of a child age less than five years old who age 18 or older and is a Malaysian will be included in the study while being disabled or having a severe psychiatric disorder or having the index child diagnosed with chronic disease will make them not eligible to participate in the study. Derived using the two-group proportion formula, a sample size of 453 parents will be sampled among those with under-five children following up at the Maternal Child Health Department in the health clinics of North Seberang Perai using stratified systematic sampling. Chi-square/Fisher Exact test, simple logistic regression and multiple logistic regression will be used for data analysis. The sample will be stratified according to household income to look for associated factors and determinants of low prevention practice. In phase II, parents with a low score from the quantitative study will be selected to participate in the qualitative study using purposive sampling. A semi-structured interview using the help of an interview guide will be carried out and recorded with a voice recorder. The thematic analysis approach will be used to analyse the qualitative data.

RESULTS: The study has been registered under the National Medical Research Registry.

METHODS: From March to September 2021, a multidisciplinary team in Lao PDR was involved in the costing exercise of the National Deployment and Vaccination Plan for COVID-19 vaccines to develop potential scenarios and gather inputs using the CVIC tool. Financial costs of introducing COVID-19 vaccines for 3 years from 2021 to 2023 were projected from the government perspective. All costs were collected in 2021 Lao Kip and presented in United States dollar.

RESULTS: From 2021 to 2023, the financial cost required to vaccinate all adults in Lao PDR with primary series of COVID-19 vaccines (1 dose for Ad26.COV2.S (recombinant) vaccine and 2 doses for the other vaccine products) is estimated to be US$6.44 million (excluding vaccine costs) and additionally US$1.44 million and US$1.62 million to include teenagers and children, respectively. These translate to financial costs of US$0.79-0.81 per dose, which decrease to US$0.6 when two boosters are introduced to the population. Capital and operational cold-chain costs contributed 15-34% and 15-24% of the total costs in all scenarios, respectively. 17-26% went to data management, monitoring and evaluation, and oversight, and 13-22% to vaccine delivery.

METHOD: The DERS-18 underwent forward-backward translation and assessment of face and content validity. Both Malay version of the DERS-18 and DASS-21 were completed by 701 adolescents (44.4% boys) aged 13 and 14 years old. To assess its dependability, a floor and ceiling effect evaluation and Cronbach's analysis were both performed. A series of confirmatory factor analyses (CFA), bivariate correlation, and regression were performed to evaluate the construct and criterion validity, respectively.

RESULTS: The Malay version of DERS-18, after excluding "Awareness", indicated excellent reliability (Cronbach's α = 0.93), and acceptable internal consistency for each subscale (range of α from 0.63 to 0.82). Floor or ceiling effects were observed at item level and subscale level, but not at total level. CFA results revealed that the Malay version of the DERS-18 bifactor model (excluding "Awareness") portrayed the best construct validity (χ2/df = 2.673, RMSEA = 0.049, CFI = 0.977, TLI = 0.968) compared to a single factor, a correlated factor, and a higher-order factor model. The DERS-18 subscales (except "Awareness") and DERS-18 total scores were significantly correlated with stress, anxiety, and depression in a positive direction (r ranged from 0.62 to 0.64, p < 0.01). The general factor of the DERS-18 and its specific factors ("Clarity", "Goals", and "Non-Acceptance") significantly predicted the symptoms of stress, anxiety, and depression (R2 ranged from 0.44 to 0.46, p < 0.001).