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Jörger P, Nigg C, Žarković M, Sommer G, Kompis M, Michel G, Ansari M, Waespe N, Kuehni CE. Awareness about the risk of hearing loss after ototoxic treatments in Swiss childhood cancer survivors. PATIENT EDUCATION AND COUNSELING 2025; 136:108764. [PMID: 40179545 DOI: 10.1016/j.pec.2025.108764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 02/21/2025] [Accepted: 03/20/2025] [Indexed: 04/05/2025]
Abstract
OBJECTIVES The International Guideline Harmonization Group recommends childhood cancer survivors (CCS) exposed to ototoxic treatments be aware of the risk of hearing loss. We assessed awareness among adult CCS. METHODS We identified adults diagnosed with cancer < 20 years who received ototoxic treatments through the Swiss Childhood Cancer Registry (ChCR) and invited them to the HEAR-study. Participants completed a questionnaire and underwent pure-tone audiometry. Cancer and treatment data were obtained from the ChCR. We used logistic regression to explore factors influencing awareness. RESULTS Of 424 invited, 105 CCS participated (25 %). Fifty-seven percent did not remember receiving information on hearing loss prior to the study. CCS who remembered being informed were more likely diagnosed after 1995 (OR: 4.5, 95 % CI: 1.3-15.4), reported hearing problems (10.9, 2.6-45.1) and other late effects (4.1, 1.3-13.2), and treated with platinum chemotherapy only (10.8, 2.2-53.2) versus cranial radiotherapy only. 44 % of participants presented clinically relevant hearing loss. CONCLUSIONS Over half of CCS exposed to ototoxic treatments were unaware of their risk of hearing loss. PRACTICE IMPLICATIONS Educating CCS about potential late effects of ototoxic treatments is important to allow early diagnosis and treatment, especially for those who had cancer longer ago and those exposed to cranial radiation.
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Affiliation(s)
- Philippa Jörger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Carina Nigg
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Maša Žarković
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Grit Sommer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Martin Kompis
- Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marc Ansari
- CANSEARCH research platform in pediatric oncology and hematology, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland; Department of Women, Child and Adolescent, Division of Pediatric Oncology and Hematology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Nicolas Waespe
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; CANSEARCH research platform in pediatric oncology and hematology, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland; Division of Pediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Division of Pediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Barans S, Saavedra JL, Lardier DT, Tohen M, Lenroot R, Bustillo J, Halperin D, Friedman B, Loewy R, Murray-Krezan C, McIver S, Crisanti AS. Characteristics Associated with Engagement in the Early Detection Cascade of Care for Psychosis at a College Counseling Center. Community Ment Health J 2025; 61:913-922. [PMID: 39757309 DOI: 10.1007/s10597-024-01430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 12/04/2024] [Indexed: 01/07/2025]
Abstract
Using the Cascade of Care framework, we explored the demographic and clinical characteristics of students at six stages in an early psychosis detection program at a college counseling center, with a focus on the transition between stages with the highest disengagement. We detailed and compared the demographic and clinical characteristics of those who (1) completed the Prodromal Questionnaire-Brief (PQ-B, N = 1588); (2) met the PQ-B cutoff score (n = 486); (3) were referred for secondary phone screening (n = 404); (4) completed secondary phone screening (n = 198); (5) completed a Coordinated Specialty Care (CSC) eligibility assessment (n = 51); and (6) were enrolled in CSC (n = 21). Education level and gender identity were associated with engagement at multiple stages of the early detection cascade. Graduate education level, transgender or gender diverse gender identity, alcohol use, and depressive symptoms predicted student follow-through with referral to secondary phone screenings.
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Affiliation(s)
- Sam Barans
- Department of Psychology, Drexel University, Philadelphia, PA, USA.
| | - Justine L Saavedra
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - David T Lardier
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Mauricio Tohen
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Rhoshel Lenroot
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Juan Bustillo
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Dawn Halperin
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Bess Friedman
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Rachel Loewy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Cristina Murray-Krezan
- School of Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie McIver
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Annette S Crisanti
- Health Sciences Center, Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, USA
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Omonaiye O, Mekonnen A, Gilfillan C, Wong R, Rasmussen B, Holmes-Truscott E, Namara KM, Manias E, Lai J, Considine J. Evaluation of diabetes mellitus medication-taking behavior among first- and second-generation Australians of Chinese heritage: A nationwide cross-sectional study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2025; 18:100600. [PMID: 40322562 PMCID: PMC12050001 DOI: 10.1016/j.rcsop.2025.100600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 03/17/2025] [Accepted: 03/31/2025] [Indexed: 05/08/2025] Open
Abstract
Aim To investigate the association of health literacy, illness perceptions, and beliefs about medications on medication-taking behavior among first- and second-generation Australians of Chinese heritage living with type 2 diabetes mellitus (T2DM). Method A nationwide cross-sectional online survey of (N = 455) of whom 196 responded, was conducted among adults (≥18 years) with T2DM of Chinese heritage residing in Australia. Participants were recruited via direct invitation (national registry and specialist clinic). Data collection utilized four validated questionnaires: The Brief Medication Questionnaire, Beliefs about Medicines Questionnaire Specific (BMQ-Specific), Brief Illness Perception 9 Questionnaire (BIPQ), and a 12-item short-form health literacy (HL) questionnaire (HLS-SF12). Bivariate and multivariate analyses were conducted to explore the factors associated with medication-taking. Results Overall, 27 % of participants reported missing diabetes medication(s) in the past week, with access barriers most cited (38 %), followed by belief (27 %) and recall (24 %) barriers. Median scores for health literacy, illness perception and beliefs about medications showed problems with health literacy (General Health Literacy Index, median [IQR] =31.94 [26.39ꟷ38.89], a moderate threat to illness perception (BIPQ:= 38.56 ± 10.52) and higher perceived necessity of taking diabetes medications relative to concern (BMQ-Specific Necessity: = 3.80 [3.20-4.20]; BMQ-Specific Concern: = 3.00 [2.50-3.67]). Better medication-taking was seen in people with high necessity beliefs and with low concerns in the use of medications. Health literacy and illness perceptions were not significantly associated with medication-taking behavior. Conclusion Medication beliefs play a role in sub-optimal medication-taking behavior among Chinese adults with T2DM. Increased attention needs to be placed on examining and enhancing understanding of diabetes medications while addressing concerns among individuals of Chinese backgrounds to better understand the complexities of medication-taking behavior. Culturally relevant clinical discussion and structured diabetes education may support the development of health promoting medication beliefs potentially supporting optimal medication-taking behavior.
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Affiliation(s)
- Olumuyiwa Omonaiye
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
- Deakin University Centre for Quality and Patient Safety Research–Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Alemayehu Mekonnen
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Christopher Gilfillan
- Department of Endocrinology, Eastern Health, Box Hill, Victoria 3128, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Rosemary Wong
- Department of Endocrinology, Eastern Health, Box Hill, Victoria 3128, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, Denmark
| | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Carlton, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kevin Mc Namara
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
| | - Elizabeth Manias
- Deakin Rural Health, Deakin University, Geelong, Victoria, Australia
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Jerry Lai
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
- Deakin University Centre for Quality and Patient Safety Research–Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
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Msosa TC, Kabaghe A, Twabi HH, Mpinganjira S, Mzumara W, Sumari-De Boer M, Aarnoutse R, Wit TRD, Chipungu G, Ngowi K, Kalata N, Mukoka M, Msefula C, Swai I, Zimba B, Semphere R, Makhumba G, Nliwasa M. Prevalence and Determinants of Viral Suppression in Young People Living with HIV on Antiretroviral Therapy in Southern Africa: A Cross-Sectional Analysis of HIV Survey Data of 2020 and 2021. AIDS Behav 2025; 29:1962-1972. [PMID: 40029578 PMCID: PMC12075269 DOI: 10.1007/s10461-025-04662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2025] [Indexed: 03/05/2025]
Abstract
Young People Living with HIV (YPLHIV, 15-24 years) are an important demographic of Persons Living with HIV (PLHIV) globally and in Southern Africa. However, YPLHIV experience poor outcomes across the HIV diagnostic and treatment cascade due to multiple factors. We estimated the prevalence and determinants of HIV viral suppression in YPLHIV on antiretroviral therapy (ART) in selected Southern African countries. We used publicly available data from Malawi, Zimbabwe, Mozambique, Lesotho, and Eswatini collected during the Population-based HIV Impact Assessments (PHIAs) of 2020 to 2021. Weighted proportions, and 95% confidence intervals (CI) were computed to estimate the prevalence of viral suppression (< 1000c/ml) and bivariate and multivariate analyses were conducted to identify determinants of viral suppression. A total of 855 records of YPLHIV on ART were included in the analysis. The prevalence of viral suppression in YPLHIV on ART was 82.4% (95% CI: 76.7, 86.9). Residing in Mozambique and duration on ART were inversely associated with viral suppression; adjusted odds ratios (AORs) of 0.37 (95% CI: 0.14, 0.95), and 0.87 (95% CI: 0.80, 0.94), respectively. A negative result in the depression screen, being married/cohabitating, and ever switching an ART regimen were positively associated with viral suppression: AORs of 5.78 (95% CI: 2.21, 15.11), 3.72 (95% CI: 1.44, 9.63), and 3.44 (95% CI: 1.69, 7), respectively. YPLHIV had suboptimal viral suppression lower than the UNAIDS 95% targets and may benefit from further research and tailored interventions addressing modifiable factors associated with viral suppression such as depression.
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Affiliation(s)
- Takondwa Charles Msosa
- Amsterdam UMC, Department of Global Health, Location University of Amsterdam, Amsterdam, The Netherlands.
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi.
| | - Alinune Kabaghe
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Hussein Hassan Twabi
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Samuel Mpinganjira
- Department of Global Health, University of Washington, Seattle Campus, US
| | - Wongani Mzumara
- Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi
| | | | - Rob Aarnoutse
- Department of Pharmacy, Radboud University Medical Center, Research Institute for Medical Innovation, Nijmegen, The Netherlands
| | - Tobias Rinke De Wit
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Geoffrey Chipungu
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Kennedy Ngowi
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Newton Kalata
- Division of Global HIV and TB, US Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Madalo Mukoka
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Chisomo Msefula
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Iraseni Swai
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Boston Zimba
- The World Health Organisation, Malawi Country Office, Lilongwe, Malawi
| | - Robina Semphere
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Glory Makhumba
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Marriott Nliwasa
- Helse Nord Tuberculosis Initiative, Department of Pathology, Kamuzu University of Health Sciences, Blantyre, Malawi
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Bhaumik S, Wogu AF, Finck L, Jamison M, Xiao M, Finn J, Lategan H, Verster J, de Vries S, Wylie C, Hodson L, Mayet M, Wagner L, Snyders L, Doubell K, Erasmus E, Oosthuizen G, Rees C, Schauer SG, Dixon J, Mould-Millman NK. Factors associated with mortality among patients with penetrating non-compressible torso hemorrhage in South Africa: A retrospective cohort study. Afr J Emerg Med 2025; 15:613-620. [PMID: 40420869 PMCID: PMC12104639 DOI: 10.1016/j.afjem.2025.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 01/10/2025] [Accepted: 02/17/2025] [Indexed: 05/28/2025] Open
Abstract
Introduction Non-compressible torso haemorrhage (NCTH), resulting from penetrating trauma to the chest, abdomen, or pelvis, places patients at high risk of death. The objectives of this study are to characterize the injury profile of patients with penetrating NCTH who receive care within a tiered public trauma system in South Africa and to identify factors associated with mortality. Methods This is a secondary analysis of clinical data collected from Sept-2021 through Dec-2023 across 6 hospitals, 4 ambulance bases, and 2 mortuaries in the Western Cape Province that form a cohesive trauma referral pathway. The study included patients age ≥18 years with penetrating NCTH who arrived at the hospital within 3 h and received blood products within 6 h of injury. NCTH was defined as Abbreviated Injury Scale (AIS) ≥ 2 to chest, abdomen or pelvis, with a systolic blood pressure ≤ 100 mm Hg. Data were analysed using multivariable logistic regression and Cox proportional hazards modelling. Results There were 202 patients with penetrating NCTH; median age was 29 years, 94 % male, injured by stab wounds (66 %) and gunshot wounds (31 %). Most patients (85 %) sustained injuries to the chest, 33 % to the abdomen, and 1.5 % to the bony pelvis. In a multivariable logistic regression model, elevated Triage Early Warning Score (TEWS ≥7) (OR 4.45, 95 % CI 1.58-13.90), elevated New Injury Severity Score (NISS >25) (OR 4.35, 95 % CI 1.45-16.30), anatomic injury to the abdomen/pelvis (OR 2.76, 95 % CI 1.03-7.74), and receipt of acute airway intervention (OR 4.97, 95 % CI 1.94-13.20) were significantly associated with 7-day in-hospital mortality. Conclusion Among patients with penetrating injuries to the torso, high triage scores, high injury severity, early airway interventions, and penetrating abdominal trauma were associated with elevated mortality risk.
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Affiliation(s)
- Smitha Bhaumik
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Adane F. Wogu
- Colorado School of Public Health, Department of Biostatistics and Informatics, Fitzsimons Building, 4th Floor, Mail Stop B119 13001 E. 17th Place, Aurora, CO, 80045, USA
| | - Lani Finck
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Maria Jamison
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Mengli Xiao
- Colorado School of Public Health, Department of Biostatistics and Informatics, Fitzsimons Building, 4th Floor, Mail Stop B119 13001 E. 17th Place, Aurora, CO, 80045, USA
| | - Julia Finn
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Hendrick Lategan
- Stellenbosch University, Division of Surgery, Department of Surgical Sciences, Francie Van Zijl Drive, Parow, Cape Town, 7500, South Africa
| | - Janette Verster
- Stellenbosch University, Division of Forensic Medicine, Department of Pathology, P.O. Box 241, Cape Town 8000, South Africa
| | - Shaheem de Vries
- Collaborative for Emergency Care in Africa, 8A Innesfree Way, Constantia, Cape Town 7806, South Africa
| | - Craig Wylie
- Western Cape Government Health and Wellness, Emergency Medical Services, ESC Private Bag x 24, Bellville, Cape Town 7535, South Africa
| | - Lesley Hodson
- Western Cape Government Health and Wellness, P.O. Box 2060, Cape Town 8000, South Africa
| | - Mohammet Mayet
- Western Cape Government Health and Wellness, P.O. Box 2060, Cape Town 8000, South Africa
| | - Leigh Wagner
- Western Cape Government Health and Wellness, P.O. Box 2060, Cape Town 8000, South Africa
| | - L'Oreal Snyders
- Western Cape Government Health and Wellness, P.O. Box 2060, Cape Town 8000, South Africa
| | - Karlien Doubell
- Western Cape Government Health and Wellness, P.O. Box 2060, Cape Town 8000, South Africa
| | - Elaine Erasmus
- Stellenbosch University, Division of Emergency Medicine, Department of Family and Emergency Medicine, P.O. Box 17, Stellenbosch, Cape Town, 7599, South Africa
| | - George Oosthuizen
- Stellenbosch University, Division of Surgery, Department of Surgical Sciences, Francie Van Zijl Drive, Parow, Cape Town, 7500, South Africa
| | - Christiaan Rees
- University of Colorado, Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Steven G Schauer
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
- University of Colorado, Department of Anesthesiology, Aurora, CO, USA
- US Army Medical Center of Excellence, JBSA Fort Sam Houston, Texas, USA
| | - Julia Dixon
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
| | - Nee-Kofi Mould-Millman
- University of Colorado, Department of Emergency Medicine, Academic Office 1, Mail Stop C-326, 12631 E. 17th Ave, Aurora, CO, 80045, USA
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Sylwander C, Haglund E, Larsson I, Andersson MLE. Health-related quality of life, lifestyle habits and chronic pain in individuals with knee pain - a 2-year follow-up study. Scand J Prim Health Care 2025; 43:422-433. [PMID: 39831683 PMCID: PMC12090272 DOI: 10.1080/02813432.2025.2452916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 01/08/2025] [Indexed: 01/22/2025] Open
Abstract
INTRODUCTION Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain. METHODS A two-year longitudinal cohort study including 251 individuals aged 30-60 years reporting knee pain at baseline. HRQoL was measured via the Short-Form General Health Survey (SF-36), and lifestyle habits included questions on overweight, physical activity, diet, alcohol and tobacco use. Pain was assessed with a pain mannequin. Differences in health status and lifestyle habits over time in groups with unchanged no chronic pain (NCP), transitioned to less and more pain, and unchanged CWP were analysed using Wilcoxon's, McNemar's and Friedman's tests. Multinominal regression analysis was performed to study associations with reporting chronic pain at follow-up. RESULTS Reporting better HRQoL across various SF-36 concepts and normal weight at baseline was associated with reporting NCP after two years. A few changes were made regarding HRQoL and lifestyle habits over the course of two years, but an increase in general health was associated with transitioning to less pain. CONCLUSIONS During primary care visits for knee pain with a combination of overweight or lower HRQoL, individuals should receive comprehensive attention to prevent the development of CWP. Future studies should investigate the associations further.
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Affiliation(s)
- Charlotte Sylwander
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Emma Haglund
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Department of Environmental and Biosciences School of Business, Innovation and Sustainability, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Maria L. E. Andersson
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Department of Environmental and Biosciences School of Business, Innovation and Sustainability, Halmstad University, Halmstad, Sweden
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Neuenschwander P, Norcini Pala A, Altice FL, Remien RH, Mergenova G, Rozental E, Gulyayev V, Davis A. Impact of multi-level factors and partner characteristics on antiretroviral therapy adherence and access to HIV care during the COVID-19 pandemic. Int J STD AIDS 2025; 36:568-576. [PMID: 40155324 DOI: 10.1177/09564624251329626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2025]
Abstract
BackgroundAdherence to antiretroviral therapy (ART) remains a challenge for many people with HIV and was exacerbated during the COVID-19 pandemic. This paper examines factors associated with ART adherence among people with HIV who inject drugs (PWHWID) in Almaty, Kazakhstan during the COVID-19 pandemic.MethodsA cross-sectional survey was conducted from October 2020 to August 2022 with 66 PWHWID and their treatment support partners (n = 66) to assess associations between ART adherence and sociodemographic, COVID-19 related, social support, and other factors. Multilevel generalized linear mixed models were used to examine factors associated with optimal (≥90%) and standard (≥80%) adherence levels.ResultsWe found low medication adherence rates: only 55.8% took ≥80% of their doses, and just 14.7% took ≥90%. People were more likely to take their medication consistently if they had a partner with HIV, experienced less household conflict during COVID-19, or met with addiction professionals. Poor mental health and negative emotional impacts from COVID-19 were associated with low adherence.ConclusionThese findings suggest that HIV treatment programs should consider the importance of patients' relationship factors, mental health, and home environment impacts during public health crises.
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Affiliation(s)
- Paige Neuenschwander
- School of Public Health, State University of New York-Downstate Health Science University, Brooklyn, NY, USA
| | - Andrea Norcini Pala
- School of Public Health, State University of New York-Downstate Health Science University, Brooklyn, NY, USA
| | - Fredrick L Altice
- Section of Infectious Diseases, Department of Medicine, Yale University, New Haven, CT, USA
| | - Robert H Remien
- Division of Gender, Sexuality & Health, HIV Center, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | | | - Elena Rozental
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - Valeriy Gulyayev
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - Alissa Davis
- School of Social Work, Columbia University, New York, NY, USA
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8
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ElNemer W, Elsabbagh Z, Cartagena-Reyes MA, Nazario-Ferrer G, Park S, Mikula JD, Jain A, Best MJ. Impact of anterior cruciate ligament tears on player efficiency ratings and salary in National Basketball Association over the past 20 years: a retrospective case control study. PHYSICIAN SPORTSMED 2025; 53:203-211. [PMID: 39659049 DOI: 10.1080/00913847.2024.2441108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 11/29/2024] [Accepted: 12/09/2024] [Indexed: 12/12/2024]
Abstract
OBJECTIVES Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary. METHODS This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified. Controls, without ACL tears, were matched by age, BMI, position, race, and average minutes played before the injury date to uninjured controls. Return to NBA, pre-injury and post-return player efficiency ratings (PER), and salary change after injury were analyzed by multivariate analyses. RESULTS A total of 67 players suffered an ACL tear. Fifty-six (83.6%) players returned to the NBA at some point after their injury, while 11 (16.4%) did not. Multivariate logistic regression showed that older age and the presence of multi-ligament injury predicted retiring from the NBA (ß = 1.4 and 10.7). Older age and greater minutes played before surgery to be the only significant predictors of decreased PER after return to the NBA (ß = -0.5 and -0.2). Players with a multiyear contract and with improvements in PER after injury tended to have greater salary increases (ß = 6.5 and 0.7). All p < 0.05. PER in players with ACL tears decreased by about 3 points (13.1 to 9.9) compared to controls without ACL tears (13.2 to 12.9). CONCLUSION Older age and multiligament injuries are associated with retiring for the NBA; older and increased minutes played are associated with a decreased PER upon return; and, PER decreases are associated with decreased salary. Players with ACL tears, even when case-control matched, showed decreased PER upon return. These results can be attributed to age-related changes in athleticism and health.
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Affiliation(s)
- William ElNemer
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Zaid Elsabbagh
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Sangjun Park
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Jacob D Mikula
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Amit Jain
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Matthew J Best
- Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
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9
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Raghavan G, Siddiqui N, Whittle W, Downey K, Ye XY, Carvalho JCA. Predictors of GA in CD: a response to Townsend et al. J Anesth 2025; 39:478-479. [PMID: 40009186 DOI: 10.1007/s00540-025-03464-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Accepted: 02/03/2025] [Indexed: 02/27/2025]
Affiliation(s)
- G Raghavan
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, 600 University Ave, Room 7-400, Toronto, ON, M5G 1X5, Canada.
| | - N Siddiqui
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, 600 University Ave, Room 7-400, Toronto, ON, M5G 1X5, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - W Whittle
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - K Downey
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, 600 University Ave, Room 7-400, Toronto, ON, M5G 1X5, Canada
| | - X Y Ye
- Department of Biostatistics, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - J C A Carvalho
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, 600 University Ave, Room 7-400, Toronto, ON, M5G 1X5, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
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10
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Murphy BE, Anderson G, Phocas A, Bains J, Larimore A, Singh N, Starnes BW, Zettervall SL. Cause of death among patients following repair of juxtarenal aneurysm with physician-modified endografts. J Vasc Surg 2025; 81:1298-1308. [PMID: 39984145 DOI: 10.1016/j.jvs.2025.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 02/09/2025] [Accepted: 02/13/2025] [Indexed: 02/23/2025]
Abstract
OBJECTIVE The use of physician-modified endografts (PMEGs) to treat juxtarenal aortic aneurysms has increased significantly over the past 10 years. However, there exists a paucity of data beyond 5 years. This study compares long-term outcomes and cause of death between patients who did and did not survive beyond 5 years after PMEG for juxtarenal aneurysm. METHODS All patients with >5 years of follow-up data enrolled in a prospective, physician-sponsored investigational device exemption clinical trial treated with PMEG for juxtarenal aneurysm were included. Univariate analysis was used to compare demographics, anatomical and operative characteristics, late outcomes, and cause of death between patients who survived beyond 5 years and those who did not. Death on hospice, clinical follow-up status, and whether patients declined a secondary intervention were also evaluated. Survival was assessed with Kaplan-Meier analysis. Predictors of overall mortality and mortality before 5 years were determined using Cox regression analysis. RESULTS We included 98 patients with juxtarenal aneurysm wgo underwent PMEG from 2011 to 2018; 64 (65.3%) survived beyond 5 years and 34 (34.7%) did not. Patients who survived beyond 5 years were younger (73 years vs 78 years; P = .04) with a greater prevalence of preoperative antiplatelet use (81.3% vs 61.8%; P = .047). There were no differences in comorbidities, symptomatic presentation, or anatomical or operative characteristics. Patients who survived beyond 5 years were less likely to experience a perioperative adverse event (10.9% vs 38.2%; P < .01) and pulmonary complication (1.6% vs 17.7%; P = .01). There were no differences in late outcomes, including reintervention, aortic sac behavior, endoleak, or visceral patency. Patients who survived beyond 5 years more frequently died on hospice (58.6% vs 17.6%; P < .01), were lost to aortic-specific clinical follow-up (48.4% vs 5.9%; P < .01), and declined a secondary intervention (9.4% vs 2.9%; P = .04). For the entire study cohort, aortic-related mortality was 9.5%. Survival was 87% at 1 year, 65% at 5 years, and 10% at 10 years. Cardiac comorbidities (15.9%), systemic decline (15.9%), stroke (14.2%), and cancer (12.9%) accounted for the leading causes of death, with no differences between the two cohorts. On adjusted analysis, sac regression was associated with reduced mortality for the entire patient cohort (hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.18-0.76) and those who died before 5 years (HR, 0.37; 95% CI, 0.16-0.92). Meanwhile, congestive heart failure (HR, 6.02; 95% CI, 1.60-22.65) was associated with increased mortality for patients who did not survive beyond 5 years. CONCLUSIONS Patients who undergo PMEG for juxtarenal aneurysm are more likely to die from underlying medical comorbidities; aortic-related mortality accounts for <10% of total deaths. Patients who do not survive beyond 5 years are older and experience more perioperative complications, whereas patients who survive beyond 5 years are more likely to die on hospice, be lost to clinical follow-up, and decline a secondary intervention. These findings reflect the high degree of chronic disease burden for this patient population, even after successful treatment of their aortic pathology.
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Affiliation(s)
- Blake E Murphy
- Division of Vascular Surgery, University of Washington, Seattle, WA
| | | | - Alexandra Phocas
- Division of Vascular Surgery, University of Washington, Seattle, WA
| | - Jasleen Bains
- University of Washington School of Medicine, Seattle, WA
| | - Allison Larimore
- Division of Vascular Surgery, University of Washington, Seattle, WA
| | - Niten Singh
- Division of Vascular Surgery, University of Washington, Seattle, WA
| | | | - Sara L Zettervall
- Division of Vascular Surgery, University of Washington, Seattle, WA.
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Ligue-Sabio KDB, Lacaba MFT, Mijares JEC, Murao LAE, Alviola PA. Spatiotemporal patterns and risk factors for African swine fever-affected smallholder pig farms in Davao Region, Southern Philippines. Prev Vet Med 2025; 239:106495. [PMID: 40049025 DOI: 10.1016/j.prevetmed.2025.106495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 02/24/2025] [Accepted: 02/27/2025] [Indexed: 04/29/2025]
Abstract
African swine fever (ASF) has severely disrupted the Philippine pig industry, necessitating a thorough understanding of its local epidemiology to develop effective mitigation strategies. The outbreak has particularly impacted smallholder farmers, who face substantial economic losses, livelihood threats, and psychological distress due to ASF. This study examined the ASF outbreak in Davao Region, Southern Philippines, by analyzing its spatiotemporal patterns and identifying risk factors. The investigation involved three parts: determining spatiotemporal patterns using spatial autocorrelation and hotspot analysis, conducting Key Informant Interviews (KIIs) with government veterinarians to identify local risk factors, and fitting a conditional logistic regression model to estimate the effects of biosecurity and farming practices on the likelihood of ASF occurrence. A sharp decline in incidence rates and non-recurring hotspots of ASF-affected barangays (villages) were observed, which may have been influenced by community quarantines and 1-7-10 zoning protocols. However, ASF hotspots continuously shifted towards the northeast provinces of the region. Thematic analysis of collected data from KIIs highlighted six general areas of ASF management and control that have posed challenges: farm biosecurity, traders' roles, farmers' capabilities, slaughterhouse practices, veterinary services, and response gaps. Regression analysis revealed that biosecurity measures for trade vehicles and cleaning practices were associated with a decreased likelihood of ASF risk, while swill feeding, inadequate waste management, and improper disposal of diseased pigs were associated with an increased likelihood of ASF risk. These findings provide critical insights for managing ASF spread while supporting smallholder farmers, strengthening the livestock industry's resilience against similar diseases.
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Affiliation(s)
- Kim Dianne B Ligue-Sabio
- Department of Mathematics, Physics, and Computer Science, College of Science and Mathematics, University of the Philippines Mindanao, Davao City, Region XI 8000, Philippines.
| | - Mark Frederick T Lacaba
- Department of Biological Sciences and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City, Region XI 8000, Philippines
| | - Jasper Elvin C Mijares
- Department of Biological Sciences and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City, Region XI 8000, Philippines
| | - Lyre Anni E Murao
- Department of Biological Sciences and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City, Region XI 8000, Philippines
| | - Pedro A Alviola
- School of Management, University of the Philippines Mindanao, Davao City, Region XI 8000, Philippines
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12
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Agunbiade S, Gbaja-Biamila T, Oladele D, Obiezu-Umeh C, Musa AZ, Blessing LA, Tahlil KM, Akinsolu FT, Conserve DF, Adeoti E, Xian H, Kuriakose K, Iwelunmor J, Ezechi O, Tucker J. Drug use and needle sharing among adolescents and young adults in Nigeria: A cross-sectional secondary analysis of data from a multi-site clinical trial. Drug Alcohol Depend 2025; 271:112666. [PMID: 40239446 DOI: 10.1016/j.drugalcdep.2025.112666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 03/08/2025] [Accepted: 03/23/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND Adolescents and young adults (AYA, 14-24 years old) have the highest rates of drug use in most low- and middle-income countries. Little is known about the drivers of drug use among AYA in Nigeria and harm reduction services are limited. METHODS A secondary data analysis was performed of the baseline survey of the 'I-TEST' study involving AYA in Nigeria. The two primary outcomes of interest were lifetime measures of drug use and needle sharing. Logistic regression analyses were performed to obtain odds ratios for the associations between socio-demographic exposures and the two primary outcomes. Odds ratios were subsequently adjusted for age and sex. RESULTS 1500 AYA survey responses were analysed. Respondents were mostly unemployed, students, and living in southern Nigeria. Drug use was reported by 301/1500(20.3 %) AYA. Among these, 213/301(71.5 %) reported needle sharing. Drug use did not vary by age (OR:0.94, 95 %CI:0.73-1.22) or sex (OR:1.00, 95 %CI:0.77-1.28). AYA in the North-Central zone had higher odds of drug use (OR:1.86, 95 %CI:1.28-2.69) and needle sharing (OR:2.51, 95 %CI:1.07-5.91) compared to AYA in the South-West zone of Nigeria. AYA aged 14-19 had higher odds of needle sharing compared to those aged 20-24 (OR:3.49, 95 %CI:1.94-6.26). Female AYA had higher odds of needle sharing compared to males (OR:5.05, 95 %CI:2.85-8.95). CONCLUSIONS Drug use and needle sharing are common among AYA in Nigeria. There is an urgent need for harm reduction services and research informed by AYA.
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Affiliation(s)
- Simisola Agunbiade
- London School of Hygiene and Tropical Medicine, London SK5 6HE, United Kingdom.
| | - Titilola Gbaja-Biamila
- College for Public Health and Social Justice, Saint Louis University, St. Louis, United States; Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - David Oladele
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chisom Obiezu-Umeh
- College for Public Health and Social Justice, Saint Louis University, St. Louis, United States
| | - Adesola Zaidat Musa
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Lateef Akeem Blessing
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | | | - Donaldson F Conserve
- Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Ebenezer Adeoti
- College for Public Health and Social Justice, Saint Louis University, St. Louis, United States
| | - Hong Xian
- College for Public Health and Social Justice, Saint Louis University, St. Louis, United States
| | | | - Juliet Iwelunmor
- Washington University School of Medicine in St. Louis, St. Louis, United States
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph Tucker
- London School of Hygiene and Tropical Medicine, London SK5 6HE, United Kingdom; University of North Carolina at Chapel Hill, Chapel Hill, United States
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13
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Townsend G, Robistow L, Butt AL, Pak A. Errors and omissions in GA predictors for cesarean delivery. J Anesth 2025; 39:476-477. [PMID: 39704807 DOI: 10.1007/s00540-024-03448-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 12/12/2024] [Indexed: 12/21/2024]
Affiliation(s)
- Grace Townsend
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Lily Robistow
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Amir L Butt
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, Oklahoma City, OK, WP114073104, USA
| | - Aimee Pak
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, Oklahoma City, OK, WP114073104, USA.
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14
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Dempsey NC, Shokrollahi K, Cappuyns L, Tridente A, Heyland DK. Redefining the concept of the elderly burn patient: Analysis of a multicentre international dataset. Burns 2025; 51:107468. [PMID: 40288004 DOI: 10.1016/j.burns.2025.107468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 01/06/2025] [Accepted: 03/23/2025] [Indexed: 04/29/2025]
Abstract
BACKGROUND The elderly are highly vulnerable to major burn injuries. Typically, 'elderly' is accepted as ≥ 65 years of age. This cut-off is arbitrary, lacks a robust evidence base and is potentially damaging from a clinical-decision-making perspective. The study objective was to utilise a large international dataset of major burns to stratify mortality risk by age and objectively define 'elderly' patients with significantly higher risk of poor outcome. METHODS We performed a sub-analysis of the RE-ENERGIZE clinical trial dataset. RE-ENERGIZE included 1200 patients admitted to 54 burn centres worldwide with 2nd and/or 3rd degree burns, who were expected to require skin grafting. In a first-of-its-kind age stratification study, we stratified major burns patients by five-year age intervals. Logistic regression and Cox proportional hazards analyses were performed with three-month mortality and time-to-discharge-alive (TTDA) as the primary and secondary outcomes. RESULTS Three-month mortality was 15.41 %. Age was associated with three-month mortality upon multivariable logistic regression analysis (p = 0.000, OR=1.06, CI=1.05-1.08), independently of total burn surface area burned (TBSA%), Acute Physiology and Chronic Health Evaluation II (APACHE II) and Charlson Comorbidity Index (CCI). Age 80 + was independently associated with increased mortality and TTDA, when compared to all referent 5-year age groups (p ≤ 0.000-0.043). The Lethal Dose 50 (LD50) for the 80 + group was 20.5 %. CONCLUSIONS We present a new threshold of risk stratification in patients with major burns; Patients ≥ 80 years have a significantly poorer outcome, irrespective of injury severity, resultant critical illness severity, and variables including comorbidities, which has implications for prognostication and management decisions.
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Affiliation(s)
- Nina C Dempsey
- Department of Life Sciences, Manchester Metropolitan University, Chester Street, Manchester, UK
| | - Kayvan Shokrollahi
- Mersey Regional Burns Centre, Whiston Hospital, Mersey & West Lancashire NHS Trust, Merseyside UK; University of Liverpool Faculty of Health and Life Sciences, University of Liverpool, Thompson Yates, Brownlow Hill, Liverpool, UK
| | - Laura Cappuyns
- Mersey Regional Burns Centre, Whiston Hospital, Mersey & West Lancashire NHS Trust, Merseyside UK
| | - Ascanio Tridente
- Intensive Care Unit, Whiston Hospital, Mersey & West Lancashire NHS Trust, Merseyside UK
| | - Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada.
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15
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Long CC, Dugan JE, Jo J, Williams KL, Jonzzon S, Terry DP, Yengo-Kahn AM, Zuckerman SL. Initial Symptom Severity and Recovery of Sport-Related Concussion in Team Versus Individual Sport Athletes. Neurosurgery 2025; 96:1261-1271. [PMID: 39431780 DOI: 10.1227/neu.0000000000003225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 09/01/2024] [Indexed: 10/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Recovery after sport-related concussion is variable, and potential differences between team vs individual sport athletes are not fully understood. In a cohort of athletes with concussions, we sought to compare these groups across (1) symptom severity score, (2) individual symptom cluster scores, and (3) recovery metrics. METHODS A retrospective, cohort study of 13 to 23-year-old athletes treated at a regional sport concussion center between November 2017 and April 2022 was conducted. Athletes were categorized into team vs individual sport athletes, with additional classification of individual sports based on strong vs minimal team elements (ie, the degree of interdependence displayed by athletes). The primary outcomes were symptom severity score, measured by either the Sport Concussion Assessment Tool-5th Edition or the Immediate Post-Concussion Assessment and Cognitive Testing, and physical, cognitive, emotional, and sleep symptom cluster scores. Secondary outcomes were recovery metrics, including time to return-to-learn, symptom resolution, and return-to-play. RESULTS Of the 1051 athletes, 954 (90.8%) were in team sports and 97 (9.2%) in individual sports. In multivariable linear regression, individual sport athletes had higher emotional symptom severity compared with team sport athletes (β = 0.09 [0.01, 0.17], P = .034) when adjusting for sex, attention-deficit/hyperactivity disorder, psychological disorders, time to clinic, on-field evaluation, and Immediate Post-Concussion Assessment and Cognitive Testing vs Sport Concussion Assessment Tool-5 th Edition scale. There were no significant differences in return-to-learn ( P = .104), symptom resolution ( P = .941), or return-to-play ( P = .279) on univariate regressions. CONCLUSION In the current single-center, pilot study of athletes with a sport-related concussion, individual sport athletes exhibited more emotional symptoms than team sport athletes. These preliminary data lend early support that individual sport athletes may be more at risk of emotional symptoms than team sport athletes after a sport-related concussion. Clinicians may use these findings to identify athletes who may be particularly vulnerable to emotional symptoms.
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Affiliation(s)
- Connor C Long
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City , Tennessee , USA
| | - John E Dugan
- College of Medicine, University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jacob Jo
- School of Medicine, Vanderbilt University, Nashville , Tennessee , USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville , Tennessee , USA
| | - Kristen L Williams
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville , Tennessee , USA
| | - Soren Jonzzon
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville , Tennessee , USA
| | - Douglas P Terry
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville , Tennessee , USA
| | - Aaron M Yengo-Kahn
- Division of Pediatric Neurosurgery, University of Utah School of Medicine, Salt Lake City , Utah , USA
| | - Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville , Tennessee , USA
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16
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Vera A, Lanaspa A, Jiménez O, Navarro A, Basurte MT, Beunza M, Ciriza M, Basterra N, Sadaba R, Ruiz-Quevedo V, Álvarez V. Reduced left atrial strain is associated with worse outcomes in coronary embolism. Heart Vessels 2025:10.1007/s00380-025-02561-3. [PMID: 40434417 DOI: 10.1007/s00380-025-02561-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2025] [Accepted: 05/14/2025] [Indexed: 05/29/2025]
Abstract
Coronary embolism (CE) is an uncommon cause of acute myocardial infarction (AMI), representing around 3% of cases. Left atrial strain (LAS) has emerged as a promising tool for assessing atrial function, however its prognosis role in CE remains unsettled. We retrospectively analyzed 100 consecutive patients with CE that was diagnosed based on criteria encompassing clinical, angiographic and diagnostic imaging findings. We evaluated in-hospital and long-term outcomes. Among the 100 patients, 28 experienced adverse in-hospital events. In the univariate analysis, lower estimated glomerular filtration rate, peak troponin I, lower LAS reservoir, atrial fibrillation (AF), right ventricular dysfunction (RVD), mitral regurgitation and reduced left ventricular ejection fraction were associated with in-hospital events. Multivariate analysis confirmed reduced LAS reservoir (OR 0.88, 95%CI 0.81-0.95; p = 0.03), AF (OR 15, 95%CI 1.4-168; p = 0.02), and RVD (OR 18, 95% CI 1.2-275; p = 0.04) as independent predictors of adverse in-hospital outcomes. After a median follow-up of 26 months, 21 patients (23%) experienced adverse long-term events. In the univariate analysis chronic kidney disease, STEMI presentation, RVD and lower LAS reservoir were associated with worse long-term outcomes. In multivariate analysis, reduced LAS reservoir (HR 0.9 (95%CI 0.84-0.98; p = 0.02)) remained a significant predictor of long-term adverse outcomes. On the log-rank test using the discriminatory cutoff value of LASr < 17.5%, LASr was associated with higher risk of long-term outcomes (p < 0.001). Reduced LAS is associated with worse in-hospital and long-term outcomes in patients with CE. These findings highlight the potential role of LAS as a valuable prognostic tool in CE.
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Affiliation(s)
- Alberto Vera
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain.
| | - Arturo Lanaspa
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Octavio Jiménez
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Adela Navarro
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - María Teresa Basurte
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Maite Beunza
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Mercedes Ciriza
- Radiology Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Nuria Basterra
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Rafael Sadaba
- Cardiac Surgery Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Valeriano Ruiz-Quevedo
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
| | - Virginia Álvarez
- Cardiology Department, Hospital Universitario de Navarra, c/Irunlarrea 3 Pamplona, 31008, Pamplona, Navarra, Spain
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17
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Wu PY, Lee SY, Wong LT, Chao WC. Early deep sedation was associated with post-hospital one-year mortality in critically ill surgical patients: a propensity-matched retrospective cohort study. BMC Anesthesiol 2025; 25:268. [PMID: 40420270 PMCID: PMC12105271 DOI: 10.1186/s12871-025-03137-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 05/18/2025] [Indexed: 05/28/2025] Open
Abstract
OBJECTIVE Sedation is a crucial issue in critical care, but the impact of early deep sedation on post-hospital mortality in critically ill surgical patients remains unclear. METHODS We linked the 2015-2020 critical care database at Taichung Veterans General Hospital with the nationwide death registration in Taiwan. Log-rank test was used to estimate survival curves between patients with and without deep sedation, defined by the average Richmond Agitation-Sedation Scale (RASS) level within the first 3 days equal to or lower than - 3. A multivariable Cox proportional hazards regression model was used to determine hazard ratios (HR) and 95% confidence intervals (CI). Furthermore, we used propensity score-matching (PSM) analysis to validate the association. RESULTS A total of 7,135 critically ill surgical patients were enrolled, and 13.7% of them experienced early deep sedation. Independent predictors for post-hospital one-year mortality included old age, male, more comorbidities, high acute physiology and chronic health evaluation (APACHE) II score, and low body mass index. We noted that receiving midazolam (aHR 1.368, 95% CI 1.052-1.780) or propofol (aHR 1.459, 95% CI 1.136-1.874) was associated with increased mortality compared with dexmedetomidine. Early deep sedation was independently associated with post-hospital mortality after adjusting for covariates (aHR 1.216, 95% CI 1.019-1.452), and the association remained robust in the PSM analysis (aHR 1.313, 95% CI 1.054-1.636). CONCLUSION We identified the association between early deep sedation and post-hospital mortality, a modifiable factor, in critically ill surgical patients. Further prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Peng-Yen Wu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Urology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shang-Yi Lee
- Department of Anesthesiology, Taichung Veterans General Hospital Puli Branch, Taichung, Taiwan
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Ting Wong
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Cheng Chao
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
- Department of post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- Big Data Center, National Chung Hsing University, Taichung, Taiwan.
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18
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Alfian SD, Abdulah R, Hak E. Development of a prediction rule for incomplete vaccination among children in Indonesia. BMC Public Health 2025; 25:1915. [PMID: 40413413 DOI: 10.1186/s12889-025-23109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/08/2025] [Indexed: 05/27/2025] Open
Abstract
BACKGROUND Childhood vaccination is a fundamental public health intervention, playing an essential role in improving health outcomes and preventing serious infections. Despite proven benefits of vaccination programs, its coverage in Indonesia remains inadequate over the years. Therefore, this study aims to develop a prediction rule using intrapersonal, interpersonal, organizational, community, and policy-related factors to distinguish between Indonesian children < 2 years at high and low risk of incomplete vaccination. METHODS The prediction rule was developed using cross-sectional data from the 2017 Indonesia Demographic Health Survey. Data on vaccination status was obtained from a vaccination card, which was filled out by health care providers during vaccination. Multivariable logistic regression was applied to develop a prognostic score based on the regression coefficients of associated parental intrapersonal, interpersonal, organizational, community, and policy-related factors. Discrimination of the model was assessed with Receiver Operating Characteristic (ROC) curve. RESULTS The sample population in this study comprised 3,790 respondents, and 2,414 (63·7%) were incompletely vaccinated. Several factors such as a mother at young age, absence of a mobile telephone, limited antenatal care attendance, absence of postnatal checks within two months after birth, had not received tetanus vaccination during pregnancy, and low socio-economic status were independently associated with incomplete vaccination. The area under curve (AUC) of the model was 0·67, which showed moderate discrimination, but was acceptable. Using a cut-off score of > 20 points, only half of the parents with a high probability of incompletely vaccinated children are selected with a sensitivity of 60% and specificity of 64%, and only 41% of parents with incompletely vaccinated children are missed. CONCLUSION This novel, easy-to-use prediction rule could be a useful tool to complement current strategies and further encourage tailored vaccine uptake interventions, particularly to parents with a high chance of incompletely vaccinated children in Indonesia.
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Affiliation(s)
- Sofa D Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Jatinangor, KM 21, Jatinangor, Sumedang, Indonesia.
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia.
- Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl. Raya Jatinangor, KM 21, Jatinangor, Sumedang, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Eelko Hak
- Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
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Abdallah R, Assaf M, Malaeb D, Sakr F, Dabbous M, El-Khatib S, Fekih-Romdhane F, Hallit S, Obeid S. The association between generalized anxiety disorder and disordered eating symptoms among Lebanese adults with the moderating effect of self esteem. Sci Rep 2025; 15:17850. [PMID: 40404748 PMCID: PMC12098691 DOI: 10.1038/s41598-025-02985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 05/19/2025] [Indexed: 05/24/2025] Open
Abstract
Our study aims to assess the moderating effect of self-esteem in the association between generalized anxiety disorder and disordered eating symptoms among a sample of Lebanese adults. The study engaged a cohort of 629 participants, who were recruited in May 2023, utilizing a snowball sampling technique. Data were collected via a questionnaire that included socio-demographic variables and the following scales: the Generalized Anxiety Disorder Scale (GAD-5), the Eating Attitudes Test (EAT-7), and the Single Item Self-Esteem Scale (SISE). Higher GAD-5 scores (Beta = 0.01; p = .004) were significantly associated with higher EAT-7 scores. The interaction generalized anxiety disorder by self-esteem was also significantly associated with EAT-7 scores (Beta = - 0.003; p = .019), indicating that self-esteem moderates the relationship between GAD and disordered eating symptoms. At low (Beta = 0.006; p = .001) and moderate (Beta = 0.003; p = .007) levels of self-esteem, higher GAD-5 scores were significantly associated with higher EAT-7 scores (more severe disordered eating symptoms). In contrast, at high levels of self-esteem, the association was not significant (Beta = 0.001; p = .812), indicating that higher self-esteem may act as a protective factor, reducing the impact of GAD on disordered eating symptoms. While an association between anxiety and disordered eating symptomatology has been reported, this study adds to the body of literature by indicating that the strength of this association may vary with an individual's level of self-esteem, which underscores the importance of integrating self-esteem-building strategies into therapeutic interventions aimed at reducing disordered eating in individuals facing anxiety. Future studies would allow for a more dynamic and nuanced understanding of the causal pathways between anxiety, self-esteem, and eating behaviors.
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Affiliation(s)
- Ralph Abdallah
- Faculty of Arts and Sciences, University of Toronto, Toronto, Canada
| | - Melyssa Assaf
- Department of Biology, Faculty of Arts and Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sami El-Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Sahar Obeid
- Department of Psychology and Education, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Hayati I, Daud S, Ismail IA, Rashid MSM, Ismail Z. Towards safer motherhood: a cross-sectional study of seatbelt practice and its correlates with pregnant front passengers in Samarinda, Indonesia. BMC Pregnancy Childbirth 2025; 25:596. [PMID: 40399832 PMCID: PMC12096799 DOI: 10.1186/s12884-025-07697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 05/06/2025] [Indexed: 05/23/2025] Open
Abstract
BACKGROUND The use of seatbelts in motor vehicles among pregnant women can reduce morbidity and mortality due to road traffic crashes; however, to date, there are no published studies on seatbelt usage among pregnant women in Indonesia. This research aims to promote the safety of pregnant women when using a motor vehicle. Its objective was to investigate the practices of seatbelt usage among pregnant front passengers and the associated factors. METHODS A cross-sectional study was conducted in Samarinda, Indonesia. Pregnant women were asked to complete a self-administered validated and published questionnaire, the SaPeIH-Q, which included sociodemographic information, and an assessment of knowledge, attitudes, and practices related to seatbelt usage among pregnant women. Multiple logistic regression (MLogR) was performed via SPSS version 27 to identify independent factors associated with seatbelt usage. RESULTS Among the 326 pregnant front passengers, only 34.7% used seatbelts, and only 39.3% correctly identified the placement of the three-point seatbelt. The practice of using seatbelts before pregnancy and knowledge of seatbelt usage were significantly associated with using seatbelts during pregnancy (p = 0.001 and 0.004, respectively). CONCLUSION The seatbelt usage rate among pregnant front passengers was low. Pregnant front passengers who used seatbelts before pregnancy were more likely to use them during pregnancy, and pregnant women with good knowledge were more likely to use seatbelts during pregnancy. The rate of seatbelt use during pregnancy may improve with increasing knowledge of seatbelt usage and the use of seatbelts before pregnancy.
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Affiliation(s)
- Ida Hayati
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
- Study Programme of Midwifery, Institute of Technology Health and Science, Wiyata Husada, Samarinda, East Kalimantan, Indonesia
| | - Suzanna Daud
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Sungai Buloh, 47000, Selangor, Malaysia.
- Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Puncak Alam, Selangor, Malaysia.
| | - Ilham Ameera Ismail
- Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Puncak Alam, Selangor, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | | | - Zaliha Ismail
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
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21
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Kohlhase K, Strzelczyk A, Willems LM, Mandelka L, Reitz SC, Czabanka M, Funke M, Grefkes C, Marzi I, Schindler C, Bohmann FO. Predictive factors and prevalence of acute symptomatic seizures among patients with acute traumatic brain injuries. Epilepsy Behav 2025; 170:110487. [PMID: 40398178 DOI: 10.1016/j.yebeh.2025.110487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 04/16/2025] [Accepted: 05/12/2025] [Indexed: 05/23/2025]
Abstract
INTRODUCTION Traumatic brain injuries (TBI) significantly contribute to hospital admissions in Europe. Acute symptomatic seizures (ASz), occurring within seven days post-TBI, increase morbidity and mortality. This study analyzes the frequency, risk factors, and short-term outcomes of ASz in patients with acute TBI. MATERIAL AND METHODS This retrospective study included 212 patients with acute TBI admitted to the University Hospital Frankfurt/Germany between 2018 and 2021. Data were collected on demographics, injury characteristics, clinical course, and outcomes. ASz were defined as clinically or electroencephalographically detected seizures within seven days post-TBI. Logistic regression was used to identify predictors of ASz and non-convulsive status epilepticus (NCSE). RESULTS ASz occurred in 17.9 % (n = 38) of patients, with a mean latency of 2.4 ± 1.9 days post-TBI. Status epilepticus developed in 47.4 % (n = 18) of these patients, predominantly as NCSE (n = 15). Predictors of ASz included older age (OR = 1.034, p = 0.012), higher Glasgow Coma Scale (GCS) at 24 h (OR = 1.133, p = 0.021), severe TBI (OR = 5.085, p = 0.018), and pneumonia (OR = 5.828, p = 0.007). For NCSE, significant predictors were older age (OR = 1.059, p = 0.021), pneumonia (OR = 6.766, p = 0.012), and urinary tract infection (OR = 7.38, p = 0.012). Patients with ASz had a significantly worse modified Rankin Scale (mRS) score at discharge (OR = 5.01, CI: 1.93-13.0, p < 0.001)). CONCLUSION ASz are a frequent and serious complication of TBI, particularly in severe cases and older patients. Early identification of high-risk patients using predictive factors such as age, GCS, and pneumonia may result in earlier treatment and improved outcomes. The findings highlight the importance of dedicated epilepsy monitoring in acute TBI care.
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Affiliation(s)
- Konstantin Kohlhase
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany.
| | - Adam Strzelczyk
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany; Goethe University Frankfurt, University Hospital, Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Frankfurt, Germany
| | - Laurent M Willems
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany; Goethe University Frankfurt, University Hospital, Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Frankfurt, Germany
| | - Luis Mandelka
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany
| | - Sarah C Reitz
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany; Goethe University Frankfurt, University Hospital, Department of Neurosurgery, Frankfurt, Germany
| | - Marcus Czabanka
- Goethe University Frankfurt, University Hospital, Department of Neurosurgery, Frankfurt, Germany
| | - Moritz Funke
- Goethe University Frankfurt, University Hospital, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt, Germany
| | - Christian Grefkes
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany
| | - Ingo Marzi
- Goethe University Frankfurt, University Hospital, Department of Trauma Surgery, Frankfurt, Germany
| | - Cora Schindler
- Goethe University Frankfurt, University Hospital, Department of Trauma Surgery, Frankfurt, Germany
| | - Ferdinand O Bohmann
- Goethe University Frankfurt, University Hospital, Department of Neurology, Frankfurt, Germany
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22
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Tang R, Liu Q, Li J, Li M, Wang H, Yu Q. Menopausal symptoms and risk factors in Chinese women: a multicenter cross-sectional study. Climacteric 2025:1-7. [PMID: 40391495 DOI: 10.1080/13697137.2025.2500563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 04/23/2025] [Accepted: 04/27/2025] [Indexed: 05/21/2025]
Abstract
OBJECTIVE This study aimed to examine menopausal symptoms and their associated factors among premenopausal, perimenopausal and postmenopausal groups of middle-aged Chinese women. METHODS The nationwide cross-sectional study involved 9740 middle-aged women from 115 medical centers across 27 provinces in China. Logistic regression analyses were performed to explore the associations between menopausal symptom severity and age, menopausal status, body mass index (BMI), smoking, employment status, income, education level, exercise and alcohol use. RESULTS Among the 9740 participants, 17.6% (n = 1711) were premenopausal, 38.3% (n = 3730) were perimenopausal and 44.1% (n = 4299) were postmenopausal. The likelihood of moderate to severe menopausal symptoms was positively associated with age (odds ratio [OR] 1.10; 95% confidence interval [CI] 1.09-1.11; p < 0.001), perimenopause (OR 2.15; 95% CI 1.90-2.45; p < 0.001) and postmenopausal stage (OR 5.96; 95% CI 5.25-6.77; p < 0.001), smoking (OR 1.96; 95% CI 1.39-2.77; p < 0.001) and unemployment (OR 1.47; 95% CI 1.31-1.65; p < 0.001). In contrast, higher income was inversely associated with symptom severity (OR 0.69; 95% CI 0.58-0.82; p < 0.001). BMI demonstrated a positive association with symptom severity in premenopausal women. CONCLUSIONS Age, menopausal status, smoking, unemployment and lower income were associated with more severe menopausal symptoms.
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Affiliation(s)
- Ruiyi Tang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, National Center for Healthcare Quality Management in Gynecological Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qingyuan Liu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, National Center for Healthcare Quality Management in Gynecological Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- School of Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Jie Li
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of The Chinese University of Hong Kong, Longgang District People's Hospital of Shenzhen, Shenzhen, China
| | - Mei Li
- Department of Obstetrics and Gynecology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hongxia Wang
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Nanshan District, Shenzhen, China
| | - Qi Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, National Center for Healthcare Quality Management in Gynecological Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Iradukunda A, Getnet F, Odjidja EN. Tuberculosis mortality and drug resistance among patients under TB treatment before and during COVID-19 in Burundi: a case-control study. BMC Infect Dis 2025; 25:716. [PMID: 40382541 PMCID: PMC12085829 DOI: 10.1186/s12879-025-11093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 05/07/2025] [Indexed: 05/20/2025] Open
Abstract
BACKGROUND The coronavirus SARS-CoV-2 (COVID-19) experience has underscored the consequences of inequalities in health and access to health services across and within countries. Vulnerable population groups have been disproportionately exposed to certain diseases such as tuberculosis (TB) due to service interruptions. The current study aimed to assess TB related mortality and risk of drug resistance during the COVID-19 Pandemic in Burundi. METHODS We conducted an incident case-control study on 362 TB patients, with 181 multidrug resistant TB (MDR-TB) patients and 181 drug susceptible TB (DS-TB) patients. These patients under TB treatment between July 11, 2018, and November 11,2022 (18 months before and 18 months during COVID-19). Baseline and drug susceptibility status data were captured at treatment initiation. Mortality during treatment follow-up TB mortality was compared between categories of drug susceptibility, period (before vs during COVID-19) and regimen phase. A multivariate logistic regression was used to show the predictive risk factors. K-Fold cross-validation was used to evaluate the final model. RESULTS A half of TB patients was under 40 years old, with majority of them being unemployed, malnourished and lacking food support during TB treatment. Most of them lived in precarious conditions with limited access to healthcare services. The overall TB-related mortality was 16.0% (95% CI: 12.5%- 20.3%) with 15.5% (95%CI: 10.7%-21.8%) in MDR-TB patients and 16.6% (95% CI: 11.6%-22.9%) in DS-TB patients. Stratified by the period, TB related mortality was 15.3% (95%CI: 11.7%-20.9%) before the COVID-19 pandemic and 17.1% (95%C 11.5%-24.6%) during the COVID-19 pandemic. More than a half of deaths in TB patients occurred during intensive phase of treatment. The risk of MDR-TB was significantly higher (p < 0.05) among patients undergoing treatment during the pandemic, those with a low education level, living in rural areas, unemployed, using public transportation, or living in overcrowded households (big family size,a small number of rooms). Additionally, patients with history of TB, previous treatment failure, and close contact with MDR-TB patients were more likely to have MDR-TB. The likelihood of MDR-TB further increased with the cumulative presence of these risk factors on the same TB patient. CONCLUSION TB mortality increased during the COVID-19 pandemic, particularly among MDR-TB patients. The odds of MDR-TB encompass a range of socio demographic and clinical factors particularly among economically disadvantaged patients. These findings underscore the need for targeted equity-driven interventions in high-risked populations, especially in the context of emerging outbreaks, in order accelerate TB elimination goals. Additional investigation on TB related mortality should focus on the intensive phase of treatment, which aligns with the 2025 World Health Organization consolidated guidelines on TB diagnosis and control.
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Affiliation(s)
- Arnaud Iradukunda
- Department of Global Health and Population, Takemi Program in International Health, Harvard T.H. Chan School of Public Health, P.O. Box 02144, Boston, MA, USA.
- Department of Medicine, Kamenge Teaching Hospital, University of Burundi, P.0.Box 1020, Bujumbura, Burundi.
| | - Fentabil Getnet
- National Data Management Center for Health, Ethiopian Public Health Institute, P.O. Box 5645, Addis Ababa, Ethiopia
| | - Emmanuel Nene Odjidja
- Department of Medicine, School of Clinical Sciences, Monash University, Wellington Rd, P.O. Box 3168, Clayton, VIC, Australia
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24
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Kudu E, Yakin F, Korgan MB, Altun M. Considerations for accurate interpretation of prognostic scoring in Fournier's Gangrene. Am J Emerg Med 2025:S0735-6757(25)00345-6. [PMID: 40399145 DOI: 10.1016/j.ajem.2025.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2025] [Accepted: 05/16/2025] [Indexed: 05/23/2025] Open
Affiliation(s)
- Emre Kudu
- Department of Emergency Medicine, Marmara University School of Medicine, İstanbul, Türkiye
| | - Furkan Yakin
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Mehmet Birkan Korgan
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Mustafa Altun
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye.
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25
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Tay LX, Ong SC, Ong HM, Teh EE, Ch'ng ASH, Tiong IK, Razali RM, Parumasivam T. Health-Related Quality of Life in Patients With Alzheimer Disease in Malaysia: Evidence from EQ-5D and QOL-AD. Value Health Reg Issues 2025; 48:101122. [PMID: 40381341 DOI: 10.1016/j.vhri.2025.101122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 02/08/2025] [Accepted: 03/02/2025] [Indexed: 05/20/2025]
Abstract
OBJECTIVES There were only a few studies that assessed health-related quality of life (HRQoL) of patients with Alzheimer disease (AD) in Malaysia. This cross-sectional study was to investigate the HRQoL scores of patients with AD in Malaysia using 2 HRQoL instruments and to identify predictors of patients' HRQoL. METHODS Informal caregivers of patients with AD were recruited in 4 tertiary hospitals during outpatient visits. Patients' HRQoL was assessed using proxy-rated generic (EQ-5D-5L and EQ-VAS), and disease-specific (Quality-of-life Alzheimer's Disease [QoL-AD]) assessment instruments were utilized to obtain proxy HRQoL scores of patients with AD from caregivers via structured interviews. The difference between HRQoL scores and other variables was tested using analysis of variance. Pearson correlation test was conducted between the 2 instruments, whereas a multivariable linear regression model was utilized to identify predictors of HRQoL in patients with AD. RESULTS The mean EQ-5D-5L index, EQ-VAS, and QoL-AD score of patients with AD were 0.63 ± 0.30, 61.05 ± 20.48, and 26.69 ± 6.83, respectively, via proxy ratings. In terms of correlation, EQ-5D was weakly correlated with QoL-AD (r = 0.36, P < .01). EQ-5D index and QoL-AD score reduced significantly as AD advanced (P < .05). Besides, cognitive decline, presence of behavioral symptoms, female caregiver gender, and nonmarried status were associated with lower patients' HRQoL in multivariable models with EQ-5D index (P < .05). CONCLUSIONS Low HRQoL of patients with AD requires attention from healthcare providers and stakeholders in optimal resource allocation and decision making. Such health utility values are useful in future economic evaluations in investigating the cost-effectiveness of new interventions or disease-modifying therapies.
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Affiliation(s)
- Lyn Xuan Tay
- Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
| | - Hui Ming Ong
- Department of Psychiatry and Mental Health, Hospital Pulau Pinang, Ministry of Health Malaysia, Pulau Pinang, Malaysia
| | - Ewe Eow Teh
- Department of Psychiatry and Mental Health, Hospital Pulau Pinang, Ministry of Health Malaysia, Pulau Pinang, Malaysia
| | - Alan Swee Hock Ch'ng
- Department of Medicine, Seberang Jaya Hospital, Ministry of Health Malaysia, Seberang Perai, Penang, Malaysia
| | - Ing Khieng Tiong
- Department of Geriatric, Pusat Jantung Sarawak, Ministry of Health Malaysia, Kota Samarahan, Sarawak, Malaysia
| | - Rizah Mazzuin Razali
- Geriatric Unit, Department of Medicine, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Yirdaw G, Mekonen H, Assaye BT, Amare GA, Yenew C. Prevalence of acute diarrhea and its risk factors among under five children in flood affected Dasenech District, Southern Ethiopia: a cross-sectional study. Sci Rep 2025; 15:16980. [PMID: 40374893 PMCID: PMC12081716 DOI: 10.1038/s41598-025-02120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Accepted: 05/12/2025] [Indexed: 05/18/2025] Open
Abstract
Flooding exacerbates health challenges by spreading waterborne diseases like diarrhea through the destruction of sanitation infrastructure and contamination of drinking water sources. However, evidence on the prevalence and contributing factors of diarrheal diseases among under-five children in the Dasenech district is limited. This study aimed to assess the prevalence of acute diarrhea and its determinants among under-five children in flood-affected areas of the South Ethiopia region. A community-based cross-sectional study was conducted from July 1 to July 15, 2024, in flood-affected areas of the Dasenech district, involving 696 under-five children. Five kebeles were purposively selected, followed by the proportional allocation of households, after which a systematic sampling technique was applied to identify study participants. Data were collected using a pretested and structured questionnaire administered by trained interviewers. Multivariable logistic regression analysis was performed to identify factors associated with acute diarrhea, with statistical significance set at p < 0.05 and a 95% confidence interval (CI). The prevalence of acute diarrhea was 31.6% (95% CI: 28.7-34.3%). Significant predictors of acute diarrhea included non-adherence to exclusive breastfeeding (AOR: 2.14, 95% CI: 1.65-3.98), lack of latrines (AOR: 12.08, 95% CI: 9.77-13.13), unsafe disposal of child excreta (AOR: 3.86, 95% CI: 2.38-6.26), home delivery (AOR: 6.02, 95% CI: 5.53-8.82), and a recent history of diarrhea among mothers or caregivers (AOR: 3.14, 95% CI: 1.33-5.66). Acute diarrhea is highly prevalent among under-five children in the Dasenech district. The findings underscore the need for targeted public health measures, such as improving waste management, promoting exclusive breastfeeding, constructing and utilizing latrines, and addressing maternal and caregiver health, to mitigate the burden of diarrheal diseases in this vulnerable population.
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Affiliation(s)
- Getasew Yirdaw
- Department of Environmental Health Science, College of Medicine and Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Habitamu Mekonen
- Department of Human Nutrition, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bayou Tilahun Assaye
- Department of Health Informatics, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Gashaw Azanaw Amare
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Chalachew Yenew
- Department of Environmental Health Sciences, Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Knorr AC, Ammerman BA, Hoff NA, Congelio L, Unger K, Strony R. The decision to help-seek within 24-hours following a suicide attempt: Rate and proximal correlates within an emergency department sample. Psychiatry Res 2025; 350:116541. [PMID: 40403444 DOI: 10.1016/j.psychres.2025.116541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 04/17/2025] [Accepted: 05/12/2025] [Indexed: 05/24/2025]
Abstract
There is a critical need to identify proximal factors associated with help-seeking following a suicide attempt (SA; i.e., attempt to kill oneself). Many individuals receive emergency department care following a SA; however, little is known about factors distinguishing individuals who present to the emergency department voluntarily (i.e., played an active role in presentation through their own action to obtain help or through requesting help) and those who do not (i.e., brought to the emergency department due to no action of their own) following a SA, which could improve suicide prevention efforts. It was hypothesized that using a poisoning SA method and experiencing social support would increase the likelihood of help-seeking following SA. This study utilized electronic health record data for 553 emergency department patients (Mage = 37.94 [SD = 15.67], 53.30 % female, 94.40 % white) presenting within 24-hours after SA during a two and a half year period across six hospitals within a rural healthcare system. Within 24-hours of SA, 34.4 % engaged in help-seeking. The use of a poisoning SA method and a diagnosis of borderline personality disorder increased the likelihood of help-seeking, whereas a diagnosis of bipolar disorder and being in a romantic relationship decreased the likelihood. Results can inform suicide prevention initiatives to promote help-seeking immediately following SA, a critical period that may represent the last opportunity for self-intervention prior to the occurrence of lasting serious injury or death by suicide.
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Affiliation(s)
- Anne C Knorr
- Geisinger Medical Center, Department of Emergency Medicine, Danville, PA, USA.
| | - Brooke A Ammerman
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA.
| | - Nathan A Hoff
- Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
| | - Laura Congelio
- Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
| | - Kassidy Unger
- Bloomsburg University, Department of Psychology, Bloomsburg, PA, USA.
| | - Robert Strony
- Geisinger Medical Center, Department of Emergency Medicine, Danville, PA, USA.
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Kesrewani E, Chammas G, Malaeb D, Sakr F, Dabbous M, El Khatib S, Hallit S, Fekih-Romdhane F, Obeid S. The mediating role of anxiety between child abuse and pain among a sample of Lebanese adults. Sci Rep 2025; 15:16559. [PMID: 40360660 PMCID: PMC12075661 DOI: 10.1038/s41598-025-01689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Accepted: 05/07/2025] [Indexed: 05/15/2025] Open
Abstract
Pain is defined as an unpleasant sensory and emotional experience in response to a noxious stimulus. Nowadays, it is increasingly prevalent among adults and may be influenced by past experiences such as child abuse, trauma or psychiatric conditions like anxiety. Thus, this study aims to evaluate the mediating effect of anxiety between child abuse and pain among a sample of Lebanese adults. This cross-sectional study was conducted between March and April 2024. Participants were selected using a snowball sampling method from various Lebanese governorates, and completed a self-administered online questionnaire via Google Forms. All adults over the age of 18 were eligible to participate. The questionnaire included sociodemographic questions, the short form of McGill pain questionnaire, the generalized anxiety disorder-7 (GAD-7), and the child abuse self report scale (CASRS-12). A total of 507 Lebanese adults completed the questionnaire. The mean age was 26.80 ± 10.29 years and 73.2% were female. The results showed that anxiety partially mediated the association between child abuse and pain. Higher levels of child abuse were significantly associated with greater anxiety, which in turn was significantly associated with increased pain. Child abuse was directly associated with higher pain levels. The study highlights the relationship that child abuse has on pain in adults and its relationship with anxiety. Future research delving into the relationship between child abuse and chronic pain in adulthood is essential to better understand the underlying pathways and support effective prevention and intervention strategies.
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Affiliation(s)
- Elie Kesrewani
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Georgio Chammas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sami El Khatib
- Department of Biomedical Sciences, Lebanese International University, Al Khyara, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology, Mubarak Al-Abdullah, Kuwait
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- Department of Psychology and Education, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
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Podsiadło P, Mendrala K, Gordon L, Pasquier M, Paal P, Hymczak H, Witt-Majchrzak A, Nowak E, Czarnik T, Darocha T. Survival Prediction for Non-Asphyxia-Related Hypothermic Cardiac Arrest Patients After Extracorporeal Rewarming: Development of the HELP Score. ASAIO J 2025:00002480-990000000-00698. [PMID: 40367356 DOI: 10.1097/mat.0000000000002456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2025] Open
Abstract
The aim of this study was to develop a scoring tool to estimate the probability of survival following extracorporeal rewarming in patients suffering hypothermic cardiac arrest. This is a multicenter retrospective study based on registry data. We included adult patients with hypothermic cardiac arrest not associated with asphyxia, with a core temperature of ≤28°C, who underwent extracorporeal rewarming. A multivariable logistic regression model was developed to serve as the predictive tool. Internal validation with bootstrap resampling was performed to adjust model parameters and reduce model optimism. Our study population included 141 patients. The survival rate was 46% (65/141). A total of 88% of the survivors (57/65) had a favorable neurological outcome (Cerebral Performance Category 1-2). The predictive model includes four variables. Outdoor occurrence of hypothermia and a higher hemoglobin level raise survival odds while higher concentrations of potassium and lactate reduce survival odds. The area under the receiver operating characteristic (ROC) curve was 0.812 and p value of the Hosmer-Lemeshow test was 0.8. We developed a prognostic model to estimate the probability of survival in adult patients with non-asphyxia-related hypothermic cardiac arrest. This model may aid in identifying candidates suitable for extracorporeal rewarming, though it should not be used as the sole deciding factor.
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Affiliation(s)
- Paweł Podsiadło
- From the Department of Emergency Medicine, Jan Kochanowski University, Kielce, Poland
| | - Konrad Mendrala
- Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
| | - Les Gordon
- Department of Anaesthesia, University Hospitals of Morecambe Bay Trust, Lancaster, United Kingdom
| | - Mathieu Pasquier
- Emergency Department, Lausanne University Hospital, and University of Lausanne, Lausanne, Switzerland
| | - Peter Paal
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Hubert Hymczak
- Department of Anaesthesiology and Intensive Care, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Anna Witt-Majchrzak
- Department of Cardiac Surgery, Provincial Specialist Hospital, Olsztyn, Poland
| | - Ewelina Nowak
- Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland; and
| | - Tomasz Czarnik
- Department of Anaesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Tomasz Darocha
- Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
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Damtie Aserese A, Merid M, Getie A, Belayhun Y. Assessment of disordered eating attitudes and associated factors among female undergraduates at Arba Minch University, Southern Ethiopia. BMC Public Health 2025; 25:1730. [PMID: 40348968 PMCID: PMC12065356 DOI: 10.1186/s12889-025-22957-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/28/2025] [Indexed: 05/14/2025] Open
Abstract
BACKGROUND Eating disorders significantly impact physical health and have negative psychosocial consequences. The global burden of anorexia nervosa and bulimia nervosa among young females is estimated to account for 1.9 million disability-adjusted life years. Early identification of disordered eating attitudes is critical for preventing the progression to more severe forms of eating disorders; however, there is limited evidence on this issue among university students in Ethiopia. Therefore, this study aimed to assess disordered eating attitudes and their associated factors among female students at Arba Minch University, Arba Minch, Southern Ethiopia, in 2023. METHODS An institution-based cross-sectional study was conducted at Arba Minch University from January 1, 2023, to April 1, 2023. A total of 600 female students participated in the study, selected through simple random sampling. Data were collected using a self-administered questionnaire, entered into Epi-Info version 7, and exported to SPSS version 20 for analysis. Multivariable binary logistic regression was used to identify factors associated with disordered eating attitudes, with variables having p-values <0.05 considered statistically significant. The strength and presence of associations between the outcome variable and independent variables were measured using adjusted odds ratios with 95% confidence intervals. Model fitness was assessed using the Hosmer and Lemeshow goodness-of-fit test. RESULTS The study found that the prevalence of disordered eating attitudes among female students at Arba Minch University was 11.5% (95% CI: 9.0-14.3). Factors significantly associated with disordered eating attitudes included academic department (AOR=2.27, 95% CI: 1.06-4.86) and body mass index (AOR=5.83, 95% CI: 2.34-14.52). CONCLUSION The study indicated a notable prevalence of disordered eating attitudes among female students at Arba Minch University. Body mass index and academic department were found to be significantly associated with these attitudes. The link between disordered eating and body image concerns underscores the need for policies promoting self-confidence and positive body image. More specifically, university health services should implement routine screening using EAT-26, combined with psychological counseling services to support at-risk students.
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Affiliation(s)
- Addisalem Damtie Aserese
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O. Box: 21, Arba Minch, Ethiopia.
| | - Melkamu Merid
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O. Box: 21, Arba Minch, Ethiopia
- Lund University, Lund, Sweden
| | - Asmare Getie
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O. Box: 21, Arba Minch, Ethiopia
| | - Yosef Belayhun
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, P.O. Box: 21, Arba Minch, Ethiopia
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Zarei R, Alidost F, Damghanian M, Bőthe B, Farnam F. Pornography and problematic pornography use: occurrence, patterns, and associated factors in a national gender-based controlled cross-sectional study. J Sex Med 2025; 22:825-838. [PMID: 40067124 DOI: 10.1093/jsxmed/qdaf034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 02/08/2025] [Accepted: 02/25/2025] [Indexed: 05/14/2025]
Abstract
BACKGROUND A study on pornography is vital due to internet accessibility, widespread pornography usage, and a lack of data, especially in non-western countries. AIM This study estimates the occurrence of pornography use (PU), compares demographic, sexual, and psychological factors between users (PUs) and non-users, and identifies associated factors of PU based on gender. It examines problematic pornography use (PPU), comparing usage patterns between PPUs and non-PPUs, and identifies associated factors of PPU. METHODS In 2021, an online cross-sectional nationwide survey was conducted among 1249 Iranians (865 women, 384 men) in all provinces except one, using a convenience sampling method through social media platforms. OUTCOMES Participants were categorized into PUs and non-users based on their pornography use over the past year. PUs were further divided into PPUs and non-PPUs, using the Problematic Pornography Consumption Scale cutoff (>20). The researcher-made questions assessed patterns of pornography use, demographic characteristics, and sexual information; sexual health variables and psychological factors were evaluated by standard scales. RESULTS PU was reported by 30.1% of participants (n = 376), including 27.5% of women and 35.9% of men. Logistic regression identified being male, shorter marriage duration, earlier age at first sex, lower religiosity, poorer sexual communication, masturbation, substance abuse, and depression as associated factors for PU. Among PUs, 13% (n = 49) were PPUs, including 10% of women and 17.1% of men. Linear regression identified the following risk factors for PPU: being male, longer marriage duration, masturbation, sexual distress, and pornography use. Conversely, having more children was a protective factor. Compared to non-PPUs, PPUs reported higher pornography consumption, the primary motivation being masturbation, greater usage among close friends, prioritizing pornography over sex with their spouse, negative effects on their sex life, and increased use during the COVID-19 pandemic. CLINICAL IMPLICATIONS Healthcare providers should address modifiable factors related to PU/PPU through early sex education and support. Objective measurements of PPU should be prioritized over subjective perceptions, as many infrequent users feel moral incongruence. STRENGTHS AND LIMITATIONS The study's applicability may be limited by imbalanced gender participation, recruitment of married individuals, and a small number of PPUs. However, strengths include standardized assessment tools, gender-based data collection, and anonymous sampling to enhance response accuracy in conservative contexts. CONCLUSION Accurate pornography occurrence measurement requires clear definitions, consideration of dropout rates, and consistent time units. Strong correlations with PPU included frequent masturbation, fewer children, lower education for women, poor sexual communication, and frequent PU for men.
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Affiliation(s)
- Rezvan Zarei
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
| | - Farzane Alidost
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
| | - Maryam Damghanian
- Department of Reproductive Health and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
| | - Beáta Bőthe
- Psychology Department, Université de Montréal, Montréal, H3C 3J7, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles (CRIPCAS), Université de Montréal, Montréal, H3T 1J4, Canada
| | - Farnaz Farnam
- Reproductive Health and Midwifery Department, Tehran University of Medical Sciences, Tehran, 1419733171, Iran
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32
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Velgan M, Vajer P, Michels NR, Einasto M, Kalda R. Factors influencing medical students career intentions in Flanders, Estonia, and Hungary: a multivariable analysis. BJGP Open 2025:BJGPO.2024.0087. [PMID: 39528268 DOI: 10.3399/bjgpo.2024.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 08/10/2024] [Accepted: 09/23/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND The career decisions of medical students are pivotal in shaping the future healthcare workforce. In many countries, the number of medical students who choose general practice as their career is insufficient to meet the needs of the healthcare system. AIM To describe the factors influencing medical students' career intentions and their preference for a career in general practice. DESIGN & SETTING A cross-sectional study involving medical students from Flanders (Belgium), Estonia, and Hungary. METHOD An online questionnaire, which was sent to undergraduate medical students, was used to gather data. Multivariable logistic regression was conducted. RESULTS Altogether 1601 medical students participated in this study, which found that 18.5% of the participants were interested in general practice. Factors related to medical students and the curriculum that predicted the interest in general practice were being a woman, being a medical student from Flanders, being a sixth-year medical student, coming from a rural area, and having GP role models. Students preferring general practice named the following factors as important: short and low-intensity training programme; having long-term and close relationship with patients; continuity of care; regular and flexible working hours; and opportunities to achieve work-life balance. CONCLUSION This study adds further evidence of which characteristics and factors can predict medical students' interest in general practice; having GP role models being the most important predictor. Further research into which qualities medical students value in their role models could give us better understanding on how we can support GPs to be better advocates for their specialty and thereby help increase interest in general practice.
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Affiliation(s)
- Marta Velgan
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Peter Vajer
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Nele R Michels
- The Interuniversity Centre of General Practice Education, Leuven, Belgium
| | - Mart Einasto
- School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Ruth Kalda
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Olivieri DJ, Eastment MC, Mugisha N, Menon MP. Correlates of cervical cancer awareness among women aged 30-49 in five sub-Saharan African nations: Evidence from the Demographic and Health Survey (DHS)-2017-2023. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0003344. [PMID: 40333666 PMCID: PMC12057955 DOI: 10.1371/journal.pgph.0003344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/05/2025] [Indexed: 05/09/2025]
Abstract
Cervical cancer is the leading cause of cancer-related mortality in low- and middle-income countries (LMICs). Prior studies associate high cervical cancer awareness with reductions in cervical cancer incidence. In this study, we utilize nationally representative Demographic and Health Surveys Program (DHS) to analyze correlates of cervical cancer awareness to inform global strategies. All DHS surveys between 2017-2023 were queried for questions on cervical cancer awareness. Socio-demographic variables (e.g., age, marital status), socioeconomic variables (e.g., education, wealth, literacy) and variables pertaining to healthcare decision making, distance traveled, intimate partner violence (IPV), and female genital mutilation/circumcision (FGC/M)) were extracted. Sample weights were applied, and logistic regressions were performed. Variables with p < 0.20 were included in multivariate analysis. Data was obtained from 30,214 women aged 30-49 years old living in Benin, Cameroon, Madagascar, Mauritania, and Mozambique, 19,403 of whom were asked questions on cervical cancer awareness. Cervical cancer awareness varied from 53% in Cameroon to 12% in Benin. Literacy, frequency of watching television, mobile telephone ownership, visiting a local healthcare facility and hormonal contraceptive use were associated with increased cervical cancer awareness, while lack of healthcare decision making independence was associated with decreased awareness after multivariate adjustment. Women who experienced emotional IPV were associated with increased awareness in Cameroon. Less than 4% of all women were screened for cervical cancer. Given the known association between awareness and screening, targeted efforts to increase awareness among women without communication modalities has the potential to reduce global cervical cancer disparities. Potential strategies include co-locating cervical cancer awareness programs with public health programs and implementing large-scale telecommunication outreach programs to improve awareness.
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Affiliation(s)
- Daniel J. Olivieri
- Department of Medicine, Internal Medicine Residency Program, University of Washington, Seattle, Washington, United States of America
| | - McKenna C. Eastment
- Division of Allergy and Infectious Disease, Department of Medicine, Seattle, Washington, United States of America
| | | | - Manoj P. Menon
- Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
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Villanueva RI, Montero CB, Bulnes-Montánchez ME, Alva LS, Carrillo JS, Zevallos A, Salazar F. Risk factors for adverse reactions to nurse-administered propofol during outpatient endoscopy: a cross-sectional study. BMC Anesthesiol 2025; 25:228. [PMID: 40329160 PMCID: PMC12054303 DOI: 10.1186/s12871-025-03012-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 03/17/2025] [Indexed: 05/08/2025] Open
Abstract
BACKGROUND Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, often requiring sedation for patient comfort. Propofol is a common choice for outpatient sedation due to its rapid onset and predictable recovery time. Although propofol has an established safety profile, adverse drug reactions (ADRs) can still occur. This study investigated the prevalence and risk factors associated with ADRs related to nurse-administered propofol sedation during outpatient endoscopic procedures at a private hospital in Peru. METHOD We conducted a retrospective study. The clinical records of 919 Peruvian patients who underwent endoscopic interventions under propofol sedation were reviewed. This study included patients between the ages of 18 and 69 years who had American Society of Anesthesiologists (ASA) physical status classification scores of I-III and who were hemodynamically stable with an oxygen saturation (SO2) > 90% before the procedure. Sedation was nurse-administered using standardized protocols. ADR data, including severity and causality assessment data, were collected. Data were collected and analyzed by SPSS, Inc., and the statistical significance was calculated at the p < 0.05 level. RESULTS A total of 693 patients were included in the study, 30.9% of whom experienced at least one ADR, predominantly cardiovascular or respiratory events such as hypotension and hypoxia, with causality scores classified as probable or definitive. Among the ADRs, 35.8% (n = 87) were moderately severe, and 64.2% (n = 143) were mildly severe. There were no reports of any serious adverse events. An ASA class III status (p = 0.048, PR adjusted (PRa) = 1.73, 95% CI: 1.01-2.99) and a procedure time of more than 20 min (p < 0.0001, PRa = 2.05, 95% CI: 1.53-2.73) were significant risk factors for ADR occurrence. Patients with ADRs had longer recovery times than did those without ADRs (22 min ± 22.5 vs. 14 min ± 8, respectively; p < 0.001). CONCLUSION In our work, moderate propofol sedation administered by trained nursing staff to outpatients undergoing interventional endoscopic procedures was generally safe but not free from risks. Vital parameters should be monitored regularly during long-term interventions and when patients are classified as ASA III.
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Affiliation(s)
- Renzo Inca Villanueva
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | | | | | - Lary Salazar Alva
- Departamento de Gastroenterología, Clínica Ricardo Palma, Lima, Peru
| | - José Salvador Carrillo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru.
| | - Alejandra Zevallos
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Fernando Salazar
- Departamento de Gastroenterología, Clínica Ricardo Palma, Lima, Peru
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Chen JJ, Mermin SA, Duffy LA, Wong SA, Layfield SD, Rodriguez-Villa F, Gelda SE, Gelwan EM, Eisen J, Ressler KJ, Choi-Kain LW, Yip AG. Characteristics and outcomes of individuals screening positive for borderline personality disorder on an adult inpatient psychiatry unit: a cross-sectional study. BMC Psychiatry 2025; 25:452. [PMID: 40325366 PMCID: PMC12054274 DOI: 10.1186/s12888-025-06928-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 05/02/2025] [Indexed: 05/07/2025] Open
Abstract
BACKGROUND Outpatient psychotherapies are gold standard interventions for borderline personality disorder (BPD); however, in clinical reality, higher rates of psychiatric hospitalization and more severe symptoms, including suicidality and self-harm, occur for those with BPD compared to those with other psychiatric disorders in inpatient units. METHODS This study aims to distinguish the clinical profile and outcomes of patients screening positive for a threshold of BPD traits in the inpatient psychiatric setting using the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), from those who do not. RESULTS Compared to those screening negative on the MSI-BPD (MSI-BPD-), those who screen positive (MSI-BPD +) are younger, more likely to be female, and more likely to report a range of health and psychosocial risk factors such as unstable housing, reduced educational attainment, physical health problems, past trauma, and problematic drug and alcohol use. MSI-BPD + patients report significantly higher severity of anxiety, depression, suicidality, self-harm, and global symptoms on admission than MSI-BPD- patients. In terms of response to inpatient care, they also self-report significantly greater improvements and higher proportions of reliable change on measures of anxiety, depression, and general psychiatric severity. At discharge, MSI-BPD + patients no longer report significantly higher suicidality but do report greater levels of thoughts of self-harm. CONCLUSIONS These findings suggest that patients with self-reported BPD symptoms experience acute symptom relief during short-term inpatient hospitalization, including for suicidality-related symptoms. Our study also demonstrates the feasibility of utilizing the MSI-BPD screening tool within a large adult inpatient psychiatric population to identify individuals likely to have BPD with distinct clinical profiles.
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Affiliation(s)
- Joann J Chen
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sam A Mermin
- Gunderson Personality Disorders Institute, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA
| | - Lucie A Duffy
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Fernando Rodriguez-Villa
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Steven E Gelda
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eliot M Gelwan
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jane Eisen
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lois W Choi-Kain
- Gunderson Personality Disorders Institute, McLean Hospital, 115 Mill St, Belmont, MA, 02478, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Agustin G Yip
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
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Mohammed E, Taye G, Aseffa M, Addissie A, Jemal A. Cervical Cancer Screening Uptake and Sociocultural Barriers among Women in Addis Ababa, Ethiopia: Population-Based Study. Cancer Epidemiol Biomarkers Prev 2025; 34:691-697. [PMID: 40036054 DOI: 10.1158/1055-9965.epi-24-1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Revised: 12/05/2024] [Accepted: 02/28/2025] [Indexed: 03/06/2025] Open
Abstract
BACKGROUND Cervical cancer is the second leading cause of cancer death among women in Addis Ababa and other parts of Ethiopia. Yet, there are limited age-eligible city-wide data on cervical cancer screening prevalence in Addis Ababa to inform public policy. METHODS A population-based cross-sectional study was conducted among 1881 screening eligible women aged 30 to 49 years, who were selected from 63 enumeration areas in Addis Ababa based on multistage sampling and proportional sample size allocation. Logistic regression was used to identify barriers to screening. All statistical tests were two-sided, P < 0.05. RESULTS Overall, 30.8% [95% confidence interval (CI), 28.8%-33.0%] of study participants reported receipt of screening in the past 5 years. Less than half (45.7%) of women reported that they received healthcare provider recommendation for screening, and only 15% of married women reported that they had spousal support for it. In the multivariable adjusted model, the odd of being screened was considerably higher in women with healthcare provider recommendation, with spousal support, and with good cervical cancer screening awareness and knowledge of risk factors for the disease. Factors associated with not seeking screening service included feeling healthy and perception of low risk for cervical cancer. CONCLUSIONS Cervical cancer screening uptake is low in Addis Ababa, and less than half received healthcare provider recommendation. Future studies should identify barriers to provider recommendations. IMPACT The findings underscore the need for a coordinated effort to enhance healthcare provider recommendations for cervical cancer screening and to raise awareness about the benefits of screening in the general population.
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Affiliation(s)
- Ebrahim Mohammed
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Taye
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathewos Aseffa
- Department of Oncology, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmedin Jemal
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
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Karim KMR, Islam MH, Tasnim T, Akter S. Child undernutrition is associated with maternal mental health and other sociodemographic factors in low-income settings in Dhaka, Bangladesh. PLoS One 2025; 20:e0322507. [PMID: 40315185 PMCID: PMC12047756 DOI: 10.1371/journal.pone.0322507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Accepted: 03/22/2025] [Indexed: 05/04/2025] Open
Abstract
BACKGROUND Maternal mental health and other underlying factors might affect a child's nutritional status. This study assesses child undernutrition and its associated characteristics, including maternal mental health, in low-income settings in Dhaka, Bangladesh. METHODS A community-based cross-sectional study was conducted among 397 lactating mothers with children aged 6-23 months from low-income settings in Dhaka. Anthropometric measurements were taken following standard protocols, and Z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated. Maternal depression and anxiety were assessed using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-Item Scale, respectively. The child feeding index was developed based on breastfeeding, dietary diversity, and meal frequency. Multivariate logistic regression models explored the relationship between child undernutrition and maternal mental health and other risk factors. RESULTS In low-income regions of Dhaka, the prevalence was 31.9% for stunting, 14.0% for wasting, and 24.1% for underweight children. Approximately half of the mothers experienced depression (55%) and anxiety (50%). High maternal depression levels were associated with increased odds of stunted (AOR = 1.80, 95% CI = 1.10-2.94, p < 0.05) and wasted (AOR = 2.70, 95% CI = 1.38-5.28, p < 0.05) children. Similarly, anxiety was linked to a higher risk of underweight children (AOR = 1.77, 95% CI = 1.04-3.11, p < 0.05). Female children had approximately twice the risk of stunting than boys (AOR = 2.13, 95% CI = 1.32-3.44, p < 0.01). Younger maternal age also doubled the risk of stunting (AOR = 1.97, 95% CI = 1.20-3.22, p < 0.01). Low adherence to a feeding index increased the odds of stunting (AOR = 3.21, 95% CI = 1.99-5.16, p < 0.001) and underweight (AOR = 4.20, 95% CI = 2.50-7.07, p < 0.01). Children born to underweight mothers were almost twice as likely to become underweight (AOR = 2.01, 95% CI = 1.01-4.03, p < 0.05) compared to those born to normal/overweight mothers. CONCLUSION Maternal depression and anxiety adversely affect the nutrition of their children. Sociodemographic factors such as the child's sex, maternal age, maternal health, and child feeding practices significantly contribute to child undernutrition. Policy initiatives should prioritize maternal mental health and address child undernutrition in these settings.
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Affiliation(s)
| | - Md Hafizul Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Tasmia Tasnim
- Department of Nutrition and Food Engineering, Daffodil International University, Daffodil Smart City, Birulia, Savar, Dhaka, Bangladesh
| | - Sumaiya Akter
- Department of Nutrition and Food Engineering, Daffodil International University, Daffodil Smart City, Birulia, Savar, Dhaka, Bangladesh
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Sseguya W, Bahendeka S, Mody N, MacLennan S, Guntupalli AM. Prevalence and correlates of diagnosed and undiagnosed diabetes mellitus among adults in rural Uganda during the COVID-19 pandemic: an evaluation of a community-based screening programme. Int Health 2025:ihaf050. [PMID: 40314932 DOI: 10.1093/inthealth/ihaf050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Revised: 03/24/2025] [Accepted: 04/14/2025] [Indexed: 05/03/2025] Open
Abstract
BACKGROUND One in two people with diabetes in sub-Saharan Africa remains undiagnosed, which has contributed to the region's high rates of diabetes-related morbidity and mortality. While the COVID-19 pandemic likely exacerbated diabetes prevalence, limited data from the region, including Uganda, hampers our understanding of this impact. To address this gap, we analysed the diabetes prevalence and correlates among adults from three rural districts of Uganda using data from a community-based screening programme conducted by community health workers (CHWs) during the pandemic. METHODS We used anonymised data of 2587 records to analyse the prevalence and correlates of diagnosed and undiagnosed diabetes. Prevalence was presented as proportions with 95% CIs. Correlates of diabetes and undiagnosed diabetes prevalence were analysed using logistic regression and presented as ORs. RESULTS The overall prevalence of diabetes was 11.3% (95% CI 10.2 to 12.5%), with a 7.2% (95% CI 6.2 to 8.1%) prevalence for diagnosed diabetes. A high proportion (36.4%) of diabetes cases were undiagnosed. Older age, high body mass index and pre-existing hypertension were associated with high diabetes prevalence. CONCLUSIONS There was a high proportion of undiagnosed diabetes among rural adults during the pandemic. Engaging CHWs in routine diabetes screening and awareness programmes can reduce the burden of undiagnosed diabetes.
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Affiliation(s)
- Wenceslaus Sseguya
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB24 3FX, UK
- Department of Internal Medicine, St Francis Hospital Nsambya, P.O. Box 7146, Kampala, Uganda
| | - Silver Bahendeka
- Department of Internal Medicine, St Francis Hospital Nsambya, P.O. Box 7146, Kampala, Uganda
- Department of Internal Medicine, Mother Kevin Postgraduate Medical School, Uganda Martyrs University, P.O. Box 5498, Kampala, Uganda
| | - Nimesh Mody
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, AB24 3FX, UK
| | - Sara MacLennan
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB24 3FX, UK
| | - Aravinda M Guntupalli
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB24 3FX, UK
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Li K, Feng J, Han L, Wu Y. Association of the 'Life's Essential 8' with FeNO and all-cause mortality: a population-based study in U.S. adults. Acta Cardiol 2025; 80:245-253. [PMID: 40126104 DOI: 10.1080/00015385.2025.2480960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 02/09/2025] [Accepted: 03/10/2025] [Indexed: 03/25/2025]
Abstract
BACKGROUND The 'Life's Essential 8' (LE8), a recent framework introduced by the American Heart Association (AHA), refines and expands the concept of wellness, with a particular emphasis on promoting cardiovascular health. The fractional exhaled nitric oxide (FeNO) score, a non-invasive and easily obtainable biomarker, offers a convenient method for evaluating respiratory conditions such as asthma. While both LE8 and FeNO represent emerging and widely recognised indicators of health, research exploring their interrelationship remains limited. This study aims to examine the associations between LE8, FeNO, and all-cause mortality. METHODS A total of 14,293 eligible participants, aged ≥18 years, were enrolled from the National Health and Nutrition Examination Survey (NHANES) database spanning 2007-2012. This observational cohort study integrated baseline NHANES data with mortality records from the U.S. National Death Index through 2021. To assess the association between LE8 and FeNO, we employed multiple linear regression models, both with and without adjustments for demographic factors and health-related practices. Additionally, these data were utilised to explore the relationships between various health determinants and all-cause mortality. RESULTS In this observational analysis, we found that an increase in the LE8 score was positively associated with elevated FeNO levels, a marker implicated in immune responses to respiratory diseases. Furthermore, higher LE8 scores were inversely associated with survival risk in the population, suggesting a potential protective effect on survival in the studied population. CONCLUSIONS Our findings suggest that primary and tertiary prevention efforts to promote cardiovascular health should be strengthened, especially those targeting unhealthy factors and behaviours to improve cardiorespiratory fitness and reduce survival risk.
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Affiliation(s)
- Kai Li
- Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Jie Feng
- Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Leilei Han
- Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yanqing Wu
- Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
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Pasupat D, Aeumjaturapat S, Snidvongs K, Chusakul S, Seresirikachorn K, Kanjanaumporn J. A Predictive Model for Diagnosis of Acute Invasive Fungal Rhinosinusitis Among High-Risk Patients. Am J Rhinol Allergy 2025; 39:245-252. [PMID: 40007071 DOI: 10.1177/19458924251322949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2025]
Abstract
BackgroundAcute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease mainly affecting immunocompromised patients. Early detection is therefore key to improving patient survival. To date, there are still no standard clinical criteria for AIFR diagnosis.ObjectiveThis study develops a predictive model that utilizes clinical presentation and computed tomography (CT) findings to diagnose AIFR.MethodsA retrospective cohort study was conducted on patients with high risk for AIFR at King Chulalongkorn Memorial Hospital over the past 15 years (2008-2022). We constructed several multivariate logistic regression models for AIFR diagnosis based on different subsets of variables from 3 categories: signs/symptoms, endoscopy, and CT imaging.ResultsThere were 67 AIFR-positive patients and 68 AIFR-negative patients. Combining variables from 3 categories, a 6-variable model (fever, visual loss, mucosal discoloration, crusting, mucosal loss of contrast, retroantral fat stranding) achieved the highest area under the receiver operating characteristic curve of 0.8900 (74.63% sensitivity, 89.71% specificity).ConclusionsWe proposed predictive models for AIFR diagnosis in high-risk patients using clinical variables. The models can be used to guide the decision for further management such as biopsy or surgical intervention.
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Affiliation(s)
- Danunuch Pasupat
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Songklot Aeumjaturapat
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kornkiat Snidvongs
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Supinda Chusakul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kachorn Seresirikachorn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Jesada Kanjanaumporn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Favroul C, Voirin F, Foissey C, Batailler C, Lustig S. A collar is a protective factor against early periprosthetic fracture for cementless stems in total hip arthroplasty : a multivariate analysis in a single-centre cohort of 1,623 total hip arthroplasties. Bone Joint J 2025; 107-B:70-75. [PMID: 40306670 DOI: 10.1302/0301-620x.107b5.bjj-2024-1104.r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
Aims Periprosthetic fractures (PPFs) are a significant complication in total hip arthroplasty (THA), with their incidence varying from 0.1% to 5.2% in registries. The use of a collared femoral stem may reduce the risk of PPF by enhancing the distribution of load and the stability of the implant. The aim of this study was to compare the effect of collared versus collarless stems on the incidence of PPFs in a large cohort of patients. Methods This retrospective study involved all primary THAs performed in a single centre between 1 January 2010 and 31 December 2020. Of the 2,182 THAs performed in 1,767 patients, 559 in 447 patients were excluded for the following reasons: having cemented stems, patients with a femoral neck fracture, dysplasia of the hip, or an oncological indication for surgery. A total of 1,623 THAs in 1,320 patients were included. The data which were collected included the patients' demographics, the surgical approach, the implant characteristics, and the incidence of PPF. Univariate and multivariate analyses were conducted using the Bursac's logistic regression model considering factors such as sex, age, BMI, surgical approach, and the presence of a collar. Results There were nine PPFs within 90 days of surgery: five in the collared stem group (0.4%) and four in the collarless stem group (1.6%). Multivariate analysis revealed that the presence of a collar was the only significant independent predictive factor of a reduced rate of PPFs (p = 0.048). Other factors such as sex, age, BMI, and surgical approach did not show significant correlations. Conclusion The collared stem was a protective factor against early femoral PPF when cementless stems were used in primary THA. These results support the preference for collared versus collarless cementless stems, particularly in patients who are at a high risk of PPF, to enhance the initial stabilty of the stem and reduce complications.
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Affiliation(s)
- Clement Favroul
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France
| | - Florian Voirin
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France
| | - Constant Foissey
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France
| | - Cecile Batailler
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France
- Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, Lyon, France
| | - Sébastien Lustig
- Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, Lyon, France
- Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, Lyon, France
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Pelizza L, Leuci E, Quattrone E, Palmisano D, Paulillo G, Pellegrini C, Pupo S, Pellegrini P, Menchetti M. Compulsory treatment across a 2-year follow-up within an "Early Intervention in Psychosis" program in Italy: Incidence rates and baseline predictors. Schizophr Res 2025; 279:1-12. [PMID: 40157251 DOI: 10.1016/j.schres.2025.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 03/15/2025] [Accepted: 03/19/2025] [Indexed: 04/01/2025]
Abstract
INTRODUCTION Individuals with First Episode Psychosis (FEP) have a higher risk of compulsory admission, but evidence on its prognostic role on outcomes and its baseline predictors is poor. The aims of this investigation were to calculate incidence rate of compulsory admission in FEP individuals treated within an Italian "Early Intervention in Psychosis" (EIP) service across 2 years of follow-up, and to compare clinical and sociodemographic characteristics between FEP patients with and without compulsory admission during the follow-up. METHODS 500 FEP patients were recruited within the "Parma-Early Psychosis" program and completed a socio-demographic chart, the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) scale. For inter-group comparisons, Mann-Whitney and Chi-square tests, Kaplan-Meier survival analysis, Cox and binary logistic regression, and mixed-design ANOVA were performed. RESULTS 30 (6 %) FEP participants were compulsory admitted. At baseline, they were likely to be males and to have a diagnosis of schizophrenia and lower GAF scores. Longitudinally, they had higher risk of service disengagement, new attempted suicide, and functioning impairment, and showed significant group effects in terms of more severe positive symptoms, negative symptoms, uncooperativeness, and GAF scores (0.023 < ƞ2 < 0.100). At baseline, the most robust predictor for compulsory treatment was uncooperativeness (HR = 1.460), while the strongest protective factor was family history of psychosis in first-degree relatives (HR = 5.790). CONCLUSIONS A not negligible part of FEP participants were compulsory admitted across the follow-up. This was longitudinally associated with poor outcomes and worse treatment response. Implementing initiatives to improve the skills of professionals to increase treatment motivation from presentation is crucial to promote positive outcomes.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Bologna (BO), Italy; Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Derna Palmisano
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Clara Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma (PR), Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Bologna (BO), Italy
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Jones CA, Guy P, Xie H, Sayre EC, Zhao K, Lacaille D. Incidence of and Risk of Mortality After Hip Fractures in Rheumatoid Arthritis Relative to the General Population. Arthritis Care Res (Hoboken) 2025; 77:604-613. [PMID: 39542830 PMCID: PMC12038218 DOI: 10.1002/acr.25466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 10/23/2024] [Accepted: 11/05/2024] [Indexed: 11/17/2024]
Abstract
OBJECTIVE Osteoporosis, a known complication of rheumatoid arthritis (RA), increases the risk of hip fracture, which is associated with high morbidity and mortality. Fracture risk estimates in patients with RA treated with contemporary treatment strategies are lacking. The objectives were (1) estimate age-specific and sex-specific incidence rates and compare the risk of hip fractures in RA relative to age-matched and sex-matched general population controls, and (2) compare the risk of all-cause mortality in RA and general population controls after hip fracture. METHODS A longitudinal study of a population-based incident cohort of patients with RA diagnosed between 1997 and 2009, followed until 2014, with age-matched and sex-matched controls from the general population of British Columbia, using administrative health data. Hip fracture outcomes (International Classification of Diseases, Ninth Edition, Clinical Modification [ICD-9-CM] codes 820.0 or 820.2; ICD-10-Canada code S72.0 to S72.2) and mortality at predefined intervals after fracture (in hospital, 90 days, 1-year, 5-year) were identified. Hip fracture incidence rates for RA and controls, and incidence rate ratios (IRRs), were calculated. Cox proportional hazards models compared hip fracture and mortality risk in RA versus controls; logistic regression compared in-hospital mortality risk. RESULTS Overall, 1,314 hip fractures over 360,521 person-years were identified in 37,616 individuals with RA and 2,083 over 732,249 person-years in 75,213 controls, yielding a 28% greater fracture risk in RA (IRR 1.28 [95% confidence interval 1.20-1.37]). Mean age at time of fracture was slightly younger for RA than controls (79.6 ± 10.8 vs 81.6 ± 9.3 years). Postfracture mortality risk at one-year and five-years did not differ between RA and general population controls. Results were similar in a sensitivity analysis including only individuals with RA who received disease-modifying antirheumatic drugs. CONCLUSION People with RA had a greater risk of hip fractures, but no greater risk of mortality post fracture, than the general population. The relative risk of hip fractures observed was not as high as previously reported, likely reflecting better treatment of inflammation and management of osteoporosis and its risk factors.
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Affiliation(s)
- C. Allyson Jones
- University of Alberta, Edmonton, Alberta, and Arthritis Research CanadaVancouverBritish ColumbiaCanada
| | - Pierre Guy
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Hui Xie
- Arthritis Research Canada, Vancouver, and Simon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Eric C. Sayre
- Arthritis Research CanadaVancouverBritish ColumbiaCanada
| | - Kai Zhao
- Arthritis Research Canada, Vancouver, and Simon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Diane Lacaille
- Arthritis Research Canada and University of British ColumbiaVancouverBritish ColumbiaCanada
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Rogers M, Koomey C, Fontenot R. Predictors of NCLEX-RN Failure in Prelicensure Nursing Students. Nurs Educ Perspect 2025; 46:143-148. [PMID: 40013917 DOI: 10.1097/01.nep.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2025]
Abstract
AIM The aim of this study was to identify predictors of NCLEX-RN® failure and guide nursing program support and resources for at-risk students. BACKGROUND Prelicensure nursing programs have adopted stringent admission and progression policies and often delay student testing based on known predictors of NCLEX-RN success. Students also delay scheduling the exam based on their perceived level of test readiness. There is a gap in the literature associated with predictors of NCLEX-RN failure. METHOD A retrospective predictive analysis was conducted on 3,396 graduates for the period 2018 through 2022 using demographic characteristics and academic metrics as variables. RESULTS Students who were men and students with increased lag time to take the NCLEX-RN (>45 days between graduation and initial attempt) were significantly more likely to fail. CONCLUSION Nursing programs using only known predictors of success for admission and progression decisions exclude students who could be successful if given the opportunity.
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Affiliation(s)
- Meagan Rogers
- About the Authors The authors are affiliated with the College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas. Meagan Rogers, PhD, RN, NPD-BC, is associate professor. Cynthia Koomey, PhD, RN, CNE, is clinical assistant professor and associate chair. Rachael Fontenot, BS, is business intelligence analyst. This study was funded by a grant from the Nursing Education Research Initiative at the University of Texas at Arlington. A portion of the literature review and study design was informed by a dissertation by Dr. Rogers. For more information, contact Dr. Koomey at
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Hoben M, Dampf H, Devkota R, Corbett K, Hogan DB, McGrail KM, Maxwell CJ. Facility-Level Variation of Resident Loneliness in Assisted Living and Associated Organizational Context Factors: A Repeated Cross-Sectional Study. Int J Geriatr Psychiatry 2025; 40:e70093. [PMID: 40338173 PMCID: PMC12058444 DOI: 10.1002/gps.70093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Revised: 04/18/2025] [Accepted: 04/25/2025] [Indexed: 05/09/2025]
Abstract
BACKGROUND AND OBJECTIVES Loneliness is common among nursing home residents, and it is also thought to be a problem in assisted living (AL). However, we lack research on loneliness in AL. Our objectives were to assess changes in risk-adjusted prevalence of loneliness in AL, and facility-level variations in loneliness before and during the COVID-19 pandemic, and facility-level factors associated with AL resident loneliness during the pandemic. RESEARCH DESIGN AND METHODS This population-based, repeated cross-sectional study used Resident Assessment Instrument-Home Care (RAI-HC) data (01/2017-12/2021) from Alberta, Canada. On a system-level, we estimated quarterly, risk-adjusted loneliness prevalence, and used segmented regressions to assess whether loneliness changed after the start of the pandemic. For risk adjustment, we used resident-covariates known to be associated with loneliness, but out the health system's or AL home's control (e.g., age or cognitive impairment) to enable fair comparisons over time. Linking AL home surveys, collected in COVID-19 waves 1 (March-June 2020) and 2 (October 2020-February 2021) to RAI-HC records, we used covariate-adjusted general estimating equations (GEE) to assess AL home factors (e.g., staffing shortages, social distancing measures) associated with resident-level loneliness during the pandemic. RESULTS Quarterly samples included 2026-2721 residents. Loneliness [95% confidence interval] fluctuated between 13.6% [11.5%-15.7%], and 16.8% [14.4%-19.2%], with no statistically significant increase during the pandemic. Facility-level median [inter-quartile range] loneliness prevalence varied considerably before (14.9% [8.3%-21.1%) and during the pandemic (13.5% [6.9%-21.3%]). GEEs included 985 residents in 41 facilities (wave 1), and 1134 residents in 42 facilities (wave 2). Facility-factors associated with decreased odds of loneliness included: facilitating caregiver involvement (odds ratio = 0.531 [95% confidence interval: 0.286-0.986]), essential visitor policies (0.672 [0.454-0.994]), and video calls with volunteers or religious/spiritual leaders (0.603 [0.435-0.836]). Facilitating outdoor activities/visits (2.486 [1.561-3.961], and providing hallway-based activities (1.645 [1.183-2.288]) were associated with increased odds of loneliness. DISCUSSION AND IMPLICATIONS Loneliness did not change during COVID-19 in AL on a health system level, but varied considerably between facilities before and during the pandemic. Modifiable facility-level factors explained variations in loneliness within facilities, suggesting important targets for policies and improvement interventions.
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Affiliation(s)
- Matthias Hoben
- School of Health Policy and ManagementFaculty of HealthYork UniversityTorontoCanada
- Faculty of NursingCollege of Health SciencesUniversity of AlbertaEdmontonCanada
| | - Hana Dampf
- Faculty of NursingCollege of Health SciencesUniversity of AlbertaEdmontonCanada
| | - Rashmi Devkota
- Faculty of NursingCollege of Health SciencesUniversity of AlbertaEdmontonCanada
| | - Kyle Corbett
- Faculty of NursingCollege of Health SciencesUniversity of AlbertaEdmontonCanada
| | - David B. Hogan
- Division of Geriatric MedicineDepartment of MedicineCumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Kimberlyn M. McGrail
- Centre for Health Services and Policy ResearchSchool of Population and Public HealthUniversity of British ColumbiaVancouverCanada
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Rushing M, Horiuchi S, Kayle M, Reeves SL, Glaros AK, Paulukonis S. Patterns and Predictors of Hydroxyurea Use Among Californians Living With Sickle Cell Disease. J Pediatr Hematol Oncol 2025; 47:169-176. [PMID: 40261138 DOI: 10.1097/mph.0000000000003027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 03/05/2025] [Indexed: 04/24/2025]
Abstract
Hydroxyurea is the primary disease-modifying therapy for sickle cell disease (SCD), yet adherence is low. Our objective was to identify patterns and predictors of hydroxyurea adherence among Medicaid enrollees with SCD. Children and adults with SCD who received Medicaid benefits between 2009 and 2018 in California were included. Monthly hydroxyurea possession ratios were calculated using filled hydroxyurea prescriptions. Group-based trajectory modeling was applied to identify hydroxyurea possession trajectories and multinomial logistic regression modeling to evaluate predictors of hydroxyurea possession group membership: prior acute care visits due to VOCs, prescriber specialty, and participant sex and age. 713 participants (48% in the 0 to 17 age group, 50% male) had 3 distinct hydroxyurea possession groups: persistently high (n=263, 37%), moderate to low (n=253, 35%), and low to no possession (n=197, 28%). The 18 to 24 and 25+ age groups had greater odds of being in the moderate to low (OR: 2.62, 1.70) and low to no (OR: 3.60, 2.45) than the persistently high possession group compared with the 0 to 17 age group when adjusted for prior VOCs. Children had greater odds of being in the persistently high hydroxyurea possession group compared with young adults and adults, suggesting there are protective factors at this age that promotes better hydroxyurea adherence.
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Affiliation(s)
- Melinda Rushing
- Department of Pediatrics, The Susan B Meister Child Health Evaluation and Research Center
| | - Sophia Horiuchi
- Tracking California Program, Public Health Institute, Oakland, CA
| | | | - Sarah L Reeves
- Department of Pediatrics, The Susan B Meister Child Health Evaluation and Research Center
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | - Alexander K Glaros
- Children's Hospital of Michigan, Central Michigan University, Detroit, MI
| | - Susan Paulukonis
- Tracking California Program, Public Health Institute, Oakland, CA
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Vakili F, Høj SB, Minoyan N, Udhesister S, Laferrière VM, Bruneau J, Larney S. Exploring housing instability through a gender lens among people who inject drugs in Montreal, Canada. Drug Alcohol Rev 2025; 44:1138-1150. [PMID: 40171634 PMCID: PMC12117312 DOI: 10.1111/dar.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Revised: 02/14/2025] [Accepted: 03/17/2025] [Indexed: 04/04/2025]
Abstract
INTRODUCTION Housing instability contributes to harm among people who inject drugs (PWID). We examined determinants of varying levels of housing instability and explored gender differences in housing instability and associated determinants among PWID. METHOD We used baseline data from HEPCO, a community-based cohort of PWID in Montreal, Canada (2011-2022). Housing (past 3 months) was categorised as stable, precarious (i.e., temporary accommodation) or unsheltered. Multinomial logistic regression was used to assess relationships between sociodemographic factors, recent drug use, and housing instability. A multivariable model was constructed using the full sample. Gender differences were explored via stratified and unadjusted analyses given the relatively small number of women. RESULTS A total of 911 PWID (748 men and 163 women) were included. In the multivariable model, not living in a marriage-like relationship, recent incarceration, and not reporting recent heroin use were associated with both precarious housing and being unsheltered, relative to stable housing. Employment, consumption of cocaine, amphetamines, and other opioids were only associated with being unsheltered. In stratified analyses, precarious and unsheltered housing was reported by 14.1% and 23.3% of women and 20.9% and 30.9% of men. Sociodemographic factors and drug use patterns also differed by gender. Although most associations with housing instability were in similar directions for men and women, several estimates differed in magnitude, denoting some signals of gender differences. DISCUSSION AND CONCLUSION Almost half the sample was unsheltered or precariously housed. Studies with larger samples of women should formally examine the relevance of developing gender-specific responses to housing instability.
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Affiliation(s)
- Farzaneh Vakili
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Département de Médecine Familiale et Médecine d'UrgenceUniversité de MontréalMontrealCanada
| | - Stine Bordier Høj
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
| | - Nanor Minoyan
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Department of Social and Preventive MedicineSchool of Public Health, Université de MontréalMontrealCanada
| | - Sasha Udhesister
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Département de Médecine Familiale et Médecine d'UrgenceUniversité de MontréalMontrealCanada
| | - Valérie Martel Laferrière
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Département de Microbiologie, Infectiologie et ImmunologieUniversité de MontréalMontrealCanada
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Département de Médecine Familiale et Médecine d'UrgenceUniversité de MontréalMontrealCanada
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l'Université de MontréalMontréalCanada
- Département de Médecine Familiale et Médecine d'UrgenceUniversité de MontréalMontrealCanada
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48
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Rosa DP, Dubé MO, Beaulieu-Bonneau S, Scott A, Masse-Alarie H, Roy JS. Do Psychological Factors Explain the Persistence of Symptoms in Individuals With Rotator Cuff-related Shoulder Pain? A Prospective Cohort Study. Clin J Pain 2025; 41:e1280. [PMID: 40232880 DOI: 10.1097/ajp.0000000000001280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 02/23/2025] [Indexed: 04/17/2025]
Abstract
OBJECTIVE To determine whether psychosocial factors, such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with rotator cuff-related shoulder pain (RCRSP) following an education program. METHODS One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included 2 meetings with a physiotherapist. After 12 and 24 weeks, participants filled out pain and disability questionnaires and, based on their scores, were classified as having persistent shoulder pain or as recovered. RESULTS A univariable modified Poisson regression showed that higher perceived stress (RR adjusted : 1.02; 95% CI: 1.01-1.04), catastrophizing (RR adjusted : 1.01; 95% CI: 1.01-1.02), symptoms of depression (RR adjusted : 1.03; 95% CI: 1.01-1.06) and anxiety (RR adjusted : 1.03; 95% CI: 1.01-1.06), along with lower resilience (RR adjusted : 0.90; 95% CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. In addition, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RR adjusted : 0.98; 95% CI: 0.97-0.99) and 24 weeks (RR adjusted : 0.99; 95% CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RR adjusted : 0.98; 95% CI: 0.97-0.99). DISCUSSION This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.
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Affiliation(s)
- Dayana Patricia Rosa
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City
| | - Marc-Olivier Dubé
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Simon Beaulieu-Bonneau
- School of Psychology, Faculty of Social Sciences
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City
| | - Alex Scott
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Hugo Masse-Alarie
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City
| | - Jean-Sébastien Roy
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City
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Urban RW, Jennings LA. Exploring the Psychosocial Domain of the Social Determinants of Learning™ Framework: Predictors of Perceived Stress and Resilience in Prenursing Students. Nurse Educ 2025; 50:155-160. [PMID: 39837307 DOI: 10.1097/nne.0000000000001791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2025]
Abstract
BACKGROUND The Social Determinants of Learning™ framework can be used to conceptualize the influence of psychosocial health among students applying to nursing programs. Little is known about variables that may influence psychosocial health in these students. PURPOSE To describe demographic and mental health variables that predict perceived stress and resilience levels in accelerated online prenursing students. METHODS A cross-sectional, survey-based, observational design was utilized. RESULTS Participants were mostly female and from diverse backgrounds. Lower levels of perceived stress were predicted by lower levels of anxiety and higher levels of resilience and self-compassion. Higher levels of resilience were predicted by male gender, higher perceptions of current ability to manage stress, and higher levels of self-compassion. CONCLUSION Incorporating knowledge and skills to support the growth of self-compassion in prerequisite courses taken just prior to nursing program entry may help students to reduce perceived stress and support resilience.
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Affiliation(s)
- Regina W Urban
- Author Affiliations: College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas
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de Terán TD, Boira I, Cerveró A, Casado A, Lopez-de-Eguileta A, Fonseca S, Muñoz P, Nebot C, Nicolini A, Banfi P, Solidoro P, González M. Benefit of continuous positive airway pressure on optic nerve damage in patients with obstructive sleep apnea. Sleep Breath 2025; 29:173. [PMID: 40304843 PMCID: PMC12043755 DOI: 10.1007/s11325-025-03336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Revised: 03/22/2025] [Accepted: 04/18/2025] [Indexed: 05/02/2025]
Abstract
PURPOSE The purpose of our study was to evaluate the effectiveness of CPAP in increasing the thickness of retinal layers. Other aims were to assess retinal and optic nerve damage predictors in OSA and establish predictors of poor response to CPAP treatment in optic nerve damage. METHODS A prospective cohort study with consecutive inclusion of the first 3 patients who attended for treatment each day. All patients underwent a diagnostic polygraph, and patients with moderate-severe OSA treated with CPAP were recruited. Optical Coherence Tomography (OCT) was performed within 3 days of the patient's inclusion and 12 months after the start of CPAP treatment. RESULTS Data from 37 patients with OSA were analysed. After 12 months of CPAP treatment, there was a significant improvement in the thickness of the superotemporal Bruch's membrane opening-minimum rim width (BMO-MRW) (316.54 to 318.23 μm, p-value = 0.08). There was a non-significant improvement in the thickness of nasal, inferonasal and superonasal retinal nerve fibre layers. In a multivariate analysis, HB and Type 2 diabetes mellitus have been associated with an increased odds ratio (OR) of retinal and optical nerve damage (OR = 3.58, p = 0.03 and OR = 4.344, p = 0.042, respectively). CONCLUSION BMO-MRW thickness may assess early damage induced by OSA and the response to CPAP. HB is a predictor of retinal and optic nerve damage in patients with OSA. CPAP treatment has a long-term protective effect on the retina and optic nerve.
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Affiliation(s)
- Teresa Diaz de Terán
- Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
- University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Ignacio Boira
- Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, University Hospital of San Juan Alicante, Alicante, Spain
| | - Andrea Cerveró
- Department of Ophthalmology, 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Alfonso Casado
- Department of Ophthalmology, 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Alicia Lopez-de-Eguileta
- Department of Ophthalmology, 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Soraya Fonseca
- Department of Ophthalmology, 'Marqués de Valdecilla' University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Pedro Muñoz
- Primary Care Management of Cantabria, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain
| | - Claudia Nebot
- Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain
| | | | - Paolo Banfi
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Solidoro
- AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Mónica González
- Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, 'Marqués de Valdecilla' University Hospital, Santander, Spain.
- University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Santander, Spain.
- Department of Pneumology, Sleep and Non-Invasive Ventilation Unit, University Hospital, University of Cantabria, Institute for Research 'Marqués de Valdecilla' (IDIVAL), Av. Valdecilla, 25, Santander, Cantabria, 39008, Spain.
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