No abstract

News media can shape public opinion about child adversity and influence the translation of research into public policy. Research about adverse childhood experiences (ACEs) and toxic stress has increased dramatically in recent years, but little is known about how these concepts are covered in news media. We reviewed how newspapers in the United States have portrayed the consequences of, causes of, and solutions to address ACEs and toxic stress, examined trends in newspaper coverage, and assessed differences in coverage of ACEs versus toxic stress. Quantitative content analysis was conducted of 746 newspaper articles mentioning “adverse childhood experience(s)” and/or “toxic stress” published in 25 U.S. newspapers between January 1, 2014, and May 30, 2020. κ statistics of interrater reliability were calculated, and variables with κ ≥ .60 were retained for quantitative analysis. We found that newspaper coverage of ACEs and toxic stress increased dramatically between 2014 and 2018 and then sharply declined. Only 13.3% of articles mentioned both ACEs and toxic stress. There were many statistically significant ( p < .05) differences in the causes, consequences, and solutions identified in articles focused on ACEs versus toxic stress. Coverage of both concepts predominantly focused on consequences for individuals, not society. However, 54.6% of articles identified a structural cause of ACEs and/or toxic stress. Increased volume in newspaper coverage about ACEs and toxic stress could increase public awareness about the relationship between childhood adversity and adult outcomes. There is a need to portray ACEs and toxic stress as complementary concepts more coherently in news media.

Objective Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men’s community-based HIV testing services (CB-HTS) outcomes. Design Systematic review and meta-analysis. Methods We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models. Results 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75–86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13–1.71). Over 69% (CI: 64–71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men ( n = 18), 96% were newly diagnosed (CI: 77–100%). Across studies reporting linkage to HIV care ( n = 8), 70% (CI: 36–103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men’s uptake was high (80%; CI: 70–88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94–100%; and 94%; CI: 88–100%, respectively). Conclusion CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services.

Rugby Union (RU) has a high incidence of injuries. The predominant focus of the epidemiological data has been on elite RU players. There is limited specific incidence data for semi-professional players. Effective injury prevention strategies have focused on primary prevention including warm up, safe playing techniques and rule changes. This prospective audit aimed to: i) establish the incidence (per 1000 player match hours) and severity of injuries (time lost) at a semi-professional rugby union club (SPRUC) ii) assess the introduction of an injury prevention strategy. Over the season of 2013/14, injury information regarding event, type, playing position and severity (days missed through injury) for all senior male first team players was recorded using the Benchmark 54 injury analytics software. Any injury resulting in 8 days or greater absence from match play was recorded as a time loss injury (TLI). Following initial findings, recommendations including the addition of a strength and conditioning coach to the multi-disciplinary team, changes to the players warm up and specific conditioning exercises were implemented. In the following season of 2014/15 the audit was repeated. The number of TLIs fell from 35 (1.06/match) in 2013/14 to 23 (0.69/match) in 2014/15. The overall match injury incidence reduced from 54.1 to 35.7/1000 playing hours. However, the median time to return to play from injury remained comparable, 30 days (2013/14) and 34 days (2014/15). In both seasons the most common injury sites were ankle, knee and shoulder. Contact events accounted for 67% (39/58) of all injuries, of these 64% (25/39) were sustained in the tackle. These findings show that there was a reduction in injury rate between seasons but not severity. We postulate that this may have been influenced by our interventions. Future studies should focus on a larger cohort of SPRUC auditing injuries undergoing specific preventative strategies in order to reach firmer conclusions.