House of Representatives

To identify and prioritise research uncertainties regarding the assessment, management and rehabilitation of patients with problematic hip replacements through a national Priority Setting Partnership (PSP). A national PSP using the James Lind Alliance (JLA) methodology. UK. Patients, carers and healthcare professionals (HCPs) involved in the care of patients with problematic hip replacements. A steering group was established. The James Lind Alliance methodology was followed throughout. A nationwide survey was conducted to collect unanswered questions. These were refined, prioritised through an interim survey and ranked at a final consensus workshop. The initial survey yielded 201 questions, refined to 32. The interim survey had 191 respondents, leading to 19 questions at the final workshop. The top 10 research priorities were agreed on. This PSP identified key research priorities for problematic hip replacements, focusing on diagnosis, pain management, perioperative optimisation and infection. These priorities can inform researchers and funders to improve outcomes for affected patients.

Lay Summary Alopecia areata (AA) is a long-term condition that can occur in both children and adults. AA can appear as patches of baldness on the scalp. Sometimes, nail growth is also affected. Hair on other parts of the body may also fall out, such as the beard, eyebrows and eyelashes. Alopecia totalis is the name for total loss of scalp hair. Alopecia universalis is complete loss of scalp, facial and body hair. This is the second version of the guideline. The British Association of Dermatologists gathered a group of experts in managing people of all ages with AA. The group consisted of eight consultant dermatologists, one dermatology specialist registrar, one general practitioner, one psychologist, two people with AA and a team with expertise in preparing guidelines. This group of experts reviewed relevant studies published until 11 July 2025. Using the evidence, the group produced recommendations using rigorous standards for guideline development. The guideline development group produced 56 recommendations for management of people with AA. They also made 9 recommendations for future research and suggested 11 audit points for hospitals. Based on the guideline, a patient information leaflet is also available on the British Association of Dermatologists’ website (https://www.skinhealthinfo.org.uk/condition/alopecia-areata).

Protocol (2009): https://doi.org/10.1002/14651858.CD007798 Original review (2010): https://doi.org/10.1002/14651858.CD007798.pub2 Review update (2013): https://doi.org/10.1002/14651858.CD007798.pub3 Review update (2015): https://doi.org/10.1002/14651858.CD007798.pub4 Review update (2019): https://doi.org/10.1002/14651858.CD007798.pub5.

Pain is prevalent in young people, and can significantly impact their physical, social, and psychological health during adolescence and potentially throughout their life. Despite this, there are no well-resourced public health initiatives educating adolescents about pain. Delivering pain education in schools ensures all adolescents have access to evidence-based information about pain. Few studies have delivered pain education to schoolchildren, and none have considered their preferences for learning about pain. We aimed to identify adolescents' (1) understanding of pain, (2) preferences for content of pain education, and (3) preferences for delivery of pain education at school, to inform the development of a school-based pain education module. We conducted an online cross-sectional survey of 501 Australian students in grades 7-10 (mean age = 14 [SD 1.3]; 50.9% male) about their knowledge of pain using the Conceptualization of Pain Questionnaire, and their preferences for learning about pain at school. Participants were asked about their preferences for pain education content, who they would like to deliver the pain education and using which delivery mode (in-person, online or a combination, with branching logic for specific options). Free-text options were included for preferences not listed. Data were analysed using descriptive statistics; measures of central tendency (depending on the distribution of data) for continuous variables and proportions for categorical variables. Aim 1) on average, participants scored approximately half (mean=7.4 [SD 2.5]) of the fifteen pain knowledge items correct. Aim 2) participants preferred to learn about ways to treat pain (70.5%), different types of pain (67.1%) and the role of the brain and nerves in pain (62.1%).Aim 3) most preferred to be taught about pain by health professionals (84.4%), followed by teachers (48.3%). Nearly half (48.7%) preferred to be taught using a combination of online and in-person approaches with the highest preference for educational video and class discussion (67.6%). Adolescents have some beliefs about pain and injury that do not align with current scientific understanding of pain. These misconceptions could be addressed in pain education at school. School-based pain education programs should include content that aligns with their preferences and use a combination of online and in-person approaches to engage adolescents.

<title>Abstract</title> <bold>Introduction:</bold> Female genital mutilation (FGM) remains a deeply rooted tradition in Guinea, particularly in the Boké region. Recognized by the World Health Organization as a violation of human rights, this practice necessitates targeted interventions informed by a clear understanding of local perceptions. This study aimed to analyze the factors influencing how adolescents and young people (aged 10-24) perceive FGM in Boké. <bold>Methodology:</bold> We conducted a cross-sectional study from November 20 to December 4, 2024, across nine localities in the Boké administrative region. A sample of 1,623 adolescents and young people was surveyed using standardized questionnaires administered via REDCap. Statistical analyses, performed with R software, included descriptive statistics, bivariate analysis (chi-square test), and correspondence analysis (CA) to explore the relationships between perceptions and sociodemographic factors. <bold>Results:</bold> A significant majority of respondents (80%) perceive FGM as a necessary tradition. This view is particularly prevalent in urban areas (87%) and among high school students (93%). Conversely, 20% of participants, predominantly rural adolescents, advocate for its abandonment. The CA revealed nuanced profiles: young, unmarried rural individuals are most opposed to FGM. In contrast, perceptions among young, unmarried urban individuals are divergent. While young urban women tend to see a positive impact, young urban men are more likely to view it as a violation of human rights. <bold>Conclusion:</bold> This study reveals a paradoxical reinforcement of FGM support among urban and more educated youth in the Boké region, challenging conventional assumptions. Our findings highlight the urgent need to strengthen educational initiatives, particularly in rural areas, and to tailor public policies to the socio-cultural specificities of Boké. Interventions must address the distinct perceptions of different sociodemographic profiles to effectively promote the gradual abandonment of FGM.

Cardiac amyloidosis is frequently overlooked, leading to delayed diagnosis and underestimation of its true impact on cardiac mortality. Using CDC WONDER (1999-2020), we identified U.S. decedents aged ≥ 25 years with amyloidosis (ICD-10 E85) as the underlying cause of death and at least one cardiac-related condition as a contributing cause. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, and trends were analyzed using Joinpoint regression and autoregressive integrated moving average (ARIMA) forecasting through 2040. Among 16,673 deaths, the AAMR rose from 0.261 in 1999 to 0.608 in 2020, with inflection points in 2012 and 2017 and an overall annual increase of 3.96%. Mortality was higher in men (0.537 vs. 0.210) and Black individuals (0.83 vs. 0.32), with a sharp post-2017 rise, especially among Black decedents. Geographic disparities were also observed, with the highest rates in the Northeast and urban areas. Most deaths occurred in hospitals (43.2%) or at home (31.4%), and mortality rates peaked in those aged 85 and older. Forecasting models project continued increases in AAMR through 2040, reaching approximately 2.0 overall, with especially elevated rates among Black (≈ 5.9) and male (≈ 3.8) decedents. Cardiac mortality in amyloidosis has risen sharply since 2017, likely driven by improved ATTR-CM detection through non-biopsy imaging and guideline adoption. Disparities by sex, race, and geography persist, reflecting uneven diagnostic capacity concentrated in urban and Northeastern centers. Forecasts project continued increases, particularly among Black and male individuals, underscoring the need for more equitable access to diagnosis and treatment.