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Background Botulinum toxin type A (BoNT-A) injections continue to be widely used as a common treatment for both males and females. According to a recent survey conducted by the International Society of Plastic Aesthetic Surgeons, the majority of patients receiving these injections are females between the ages 35 and 50. Objectives A post hoc analysis was conducted to examine whether there were variances in the effectiveness and safety of letibotulinumtoxinA for treating vertical glabellar lines between the broader female study population and a particularly defined group of female participants aged 35 to 50. Methods For this post hoc analysis, data from females aged 35 to 50 were extracted and analyzed from the BLESS III study. In this Phase 3 clinical trial, 355 participants with moderate-to-severe glabella frown lines received either 20 U of letibotulinumtoxinA or a placebo. The study evaluated Glabella Line Severity (GLS) score, treatment onset, duration of effects, time to retreatment, and adverse events. A positive response was determined by achieving a GLS score of 0 or 1, as assessed by both patients and investigators, along with at least a 2-point improvement in GLS score relative to baseline at Week 4 after the injections. Results Composite responder rates for patients aged 35 to 50 receiving active treatment were significantly higher than for the remaining female population receiving active treatment at Weeks 1, 2, and 4. Females aged 35 to 50 showed higher rates of GLS improvement of ≥1 at Weeks 1, 2, 4, 8, 12, 16, and 20 compared with the remaining female population receiving active treatment. At Week 4, a higher percentage of females aged 35 to 50 achieved a GLS score of 0 upon maximum frowning compared with the remaining females. Females aged 35 to 50 had a shorter median time to onset of GLS improvement compared with the remaining female population. Safety assessments showed a low incidence of treatment-related adverse events in females aged 35 to 50. Conclusions LetibotulinumtoxinA showed significantly higher response rates in females aged 35 to 50 compared with other female patients at Weeks 1, 2, and 4. Response rates remained higher up to Week 16. The treatment demonstrated efficacy and safety in treating vertical glabellar lines in this patient group. Level of Evidence: 2

Botulinum toxin serotype-A (BoNT-A) preparations are widely used to improve the appearance of wrinkles. While effective and well tolerated, patients require retreatment over time to re-establish the effects. There is growing interest from patients as to whether higher doses can prolong response without significantly increasing side effects. We reviewed the efficacy and safety evidence for high-dose BoNT-A treatment of glabellar lines, by evaluating high-dose studies published since 2015. Toxins approved for glabellar line treatment in the US or Europe were considered. “High-dose” indicated doses above the licensed dose for each BoNT-A preparation. Five studies met the inclusion criteria and most were randomized, double-blind trials; designs and population sizes varied. Findings suggested that higher-dose BoNT-A treatment is feasible and may improve response duration without increased safety issues. Around 9 months’ median duration was achieved with a 2–2.5-fold increase of the abobotulinumtoxinA on-label dose, or with a 5-fold increase in incobotulinumtoxinA dose. A 2–4-fold increase of the onabotulinumtoxinA on-label dose yielded a median duration of around 6 months. Importantly, patient satisfaction and natural look remained with increasing abobotulinumtoxinA doses. While more data are needed, these findings may lead to more effective, individually tailored treatment plans to meet patient expectations.

Cannulas are increasingly used for injecting hyaluronic acid fillers, as they are thought to improve patient comfort safety and treatment tolerability. This study aimed to demonstrate the non-inferiority of a Resilient Hyaluronic Acid 4 (RHA 4) filler injected with a cannula versus a needle for the treatment of moderate to severe nasolabial folds (NLF). A total of 50 subjects were included in a randomized, evaluator-blinded, split-face trial. The NLF were injected with RHA 4 using a cannula on one side of the face and using a needle on the other side on Day 0. A touch-up could be performed 4 weeks later. The subjects were followed up for 12 weeks after the last injection, ie, injection on Day 0 or touch-up. Efficacy was evaluated using a Wrinkle Severity Rating Scale (WSRS), the Global Aesthetic Improvement Scale (GAIS), and patient-reported outcomes. Safety assessments included the injection-site pain, common treatment reactions (CTRs), and adverse events (AEs). Twelve weeks after the last injection, the efficacy of the cannula treatment was found to be non-inferior to that of the needle treatment, based on the WSRS score improvements. The other study endpoints showed the equivalent efficacy and safety of the two methods. No serious or unexpected AEs were reported. RHA 4 may be effectively and safely injected into the NLF using a cannula or a needle, provided it is administrated by a trained practitioner.

In the contemporary public health workforce environment, public health social workers (PHSW) bring integrated skills, from both fields, to meet the needs of vulnerable and underserved populations. They receive training in their Master of Public Health/Master of Social Work dual-degree programs, such as the one at New Mexico State University, which serves the U.S./Mexico border region. During their studies, dual-degree students are equipped to address health and human service issues at the micro, mezzo, and macro levels and complete field experience and practicum hours in their communities. Along with practical skills, these students learn culturally responsive/humble ways of being with communities of color and marginalized individuals. After graduation, these emerging career PHSWs enter the workforce in a variety of settings: nonprofit, educational, government, primary care, and more. In this article, the field of public health social work is described in its historic and present forms, followed by PHSWs’ utility to the U.S./Mexico border region, in particular. Finally, we make the call to action for future career PHSWs to engage with this integrated, dynamic, innovative field, and its unique combination of community- and individual-based services and rewards.

Beer K, Biesman B, Cox SE, Smith S, Picault L, Trevidic P. Clin Cosmet Investig Dermatol. 2023;16:959-972. The authors advised an inadvertent error at the time of figure assembly led to the selection of incorrect versions of graphs displayed in Figure 1 on page 964 (ie, needle and cannula legends were switched) and Figure 4B on page 965 (ie, incorrect label values for timepoint V3). Consequently, result description and discussion associated with Figure 1 in this publication were opposite to what is actually observed. Page 963, Injection Volume and Technique section, second paragraph, last sentence, the text \"However, there were slightly more \"very easy\" versus \"easy\" answers for the cannula-treated side (Figure 1)\" should read \"However, there were slightly more \"very easy\" versus \"easy\" answers for the needle-treated side (Figure 1)\". Page 969, second paragraph from the bottom, last sentence, the text \"For some practitioners, cannula injections may be seen as an \"advanced\" technique, yet the higher \"ease of injection\" scores obtained in the present study show that this technique is easier to use than a needle injection\" should be deleted. The interpretation of results shown in Figure 4B remain accurate. The authors apologize for these errors. The correct Figures 1 and 4 are shown below. Figure 1 Ease of injection of RHA 4 into the nasolabial fold with a cannula or a needle, according to the treating investigator. Figure 4 Percentage of subjects rated \"improved\" or \"much improved\" on the Global Aesthetic Improvement Scale at each visit by the treating investigator (A) and the subjects (B).

Forster et al (2009) contend that the practice of recommending antenatal expressing and storing of colostrum by mothers with Type 1 diabetes should cease until its efficacy can be tested in a randomised controlled trial (RCT). This contention raises an ethical dilemma. The authors of the article conclude that considering that antenatal expression and storage of colostrum by pregnant Type 1 diabetic women gives their babies an extra amount of fluid that biochemically compares with colostrum if needed for hypoglycaemia, and that nipple stimulation has not been shown to induce labour, the practice should continue and women should be educated about this easy, positive and empowering practice.

Infraorbital hollows are one of the most common target areas for facial aesthetic treatment; however, they are often perceived to be challenging to treat due to the complex anatomy of the periorbital area, concurrent deformities, and risk of complications. Treatment options include surgical (eg, lower eyelid blepharoplasty with fat transposition or injections) and nonsurgical approaches (eg, fillers). Among these approaches, filler injections have become common practice because they are minimally invasive and provide long-term patient satisfaction. In particular, hyaluronic acid (HA) fillers have been shown to be safe and effective for infraorbital hollow rejuvenation. This review provides an overview of infraorbital hollows, including periorbital anatomy, etiology, clinical assessment, and overlapping deformities, such as malar mounds, festoons, and dark circles under the eyes. Patient and HA filler product selection, injection techniques, as well as potential adverse events, such as bruising/swelling, lower eyelid and malar edema, and vascular occlusions, are discussed. This review also highlights the importance of midfacial volumization to improve outcomes in the infraorbital region and in the overall aesthetic appearance. By selecting appropriate patients and attaining proficiency in periorbital anatomy and infraorbital hollow rejuvenation techniques, clinicians can safely and successfully perform HA filler injections that result in high patient satisfaction. Level of Evidence: 5

Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.–Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

Since the UN Convention on the Rights of the Child, there has been an increasing recognition globally that children need to have more say in their education.Children as Decision Makers in Education looks at how children can actively participate in decision-making.