Prolonged treatment delay often leads to adverse cancer prognosis. However, the demographic and clinical predictors of higher treatment delay burden in the Philippines have not been thoroughly evaluated.

We conducted a population-based retrospective cohort study on patients diagnosed with common cancers who received cancer treatment, to quantify the burden of prolonged treatment delay in the Philippines among this population. We analyzed 20,654 patients with common cancers from the Department of Health-Rizal Cancer Registry. The Poisson regression model with robust variance was used to identify demographic and clinical predictors of prolonged treatment delay. In addition, we examined the associations among those receiving different initial treatment types, including surgery, radiotherapy, and chemotherapy.

We found 35.1 % of the studied cancer patients experienced initial treatment delay of more than 30 days, as well as 25.2 % and 20.0 % experiencing treatment delays exceeding 60 and 90 days, respectively. We found higher risk of prolonged treatment delay of more than 90 days in those with 0-19 years of age at diagnosis, male gender, cancer treatment at non-private hospitals, diagnoses during the 1990s, more advanced cancer stages, and non-surgical initial treatments. For patients with surgery as the initial treatment, younger age at cancer diagnosis was not significantly associated with increased burden of prolonged treatment delay, unlike for those initially treated with radiotherapy or chemotherapy.

By identifying the characteristics of treated cancer patients with higher risk of protracted treatment delay, our findings will inform the national cancer control program to especially target those patients for treatment delay reduction.

To improve mental health care for autistic adults, a better understanding of their real-world intervention use is required. The aim of this study is to investigate individual differences in the intervention trajectories of autistic adults, by examining longitudinal patterns of therapy, counseling, and medication use. Self-reported intervention use of 445 autistic adults (18-87 years) across at least five consecutive measurements (2015-2021) was collected to identify clusters using sequence analysis and hierarchical clustering. Sensitivity analyses and cross-method validation (group-based multivariate trajectory modeling) were used to verify the obtained clusters. Four out of five obtained clusters had sufficient internal consistency and were replicated. These four clusters had distinct intervention trajectories (least intervention, mostly counseling, mostly medication, mixed use) and differed on several demographic variables. Most notably, the "mixed cluster" contained relatively more females and individuals with self-reported co-occurring psychiatric conditions. Many autistic adults used interventions, although they varied in type and duration of intervention use. This reflects the clinical complexity of tailoring intervention approaches and highlights that accessible and multidisciplinary care is essential to adequately support autistic adults. An important next step is to investigate whether available interventions sufficiently support autistic females and those with co-occurring psychiatric conditions.Lay abstractMany autistic adults experience co-occurring mental health problems, which have a negative effect on their well-being and result in increased use of mental health services. To improve mental healthcare for autistic adults, a better understanding is needed of what type of support they use in real life. Clinical guidelines recommend three kinds of mental health interventions: therapy, counseling, and medication. We investigated the use of these types of interventions in a sample of 445 autistic adults (aged 18-87 years) across a 5-to-7-year period. We found evidence for four different patterns of intervention use, or so-called subgroups: (1) least intervention use, (2) mostly counseling, (3) mostly medication, and (4) mixed intervention use. The group with mixed intervention use consisted of relatively more females and individuals with co-occurring psychiatric conditions, especially compared to the subgroup with the least intervention use. It appeared that many, but not all, autistic individuals used mental health services for an extended period. However, there was considerable variability in the type, combination, and duration of intervention use. This means that determining the optimal support for autistic adults is often a complex task, which requires collaboration of clinical experts and autistic individuals themselves, to make informed decisions.

This retrospective study investigated the relationship among psychiatric consultation history, method of suicide, and the background information of individuals who died by suicide, based on postmortem information obtained from the Osaka Prefectural Medical Examiner's Office.

We analyzed the data of 343 cases of suicide that occurred in Osaka City in 2017, focusing on factors associated with a history of psychiatric consultations. The Cochran-Armitage trend test was used to evaluate whether there was a significant linear trend in the distribution of case counts across 10-year age groups. Univariate and multivariate logistic regression analyses were used to identify the factors associated with a history of psychiatric consultations prior to death.

The results revealed that female sex, history of suicide attempts, and choosing jumping as the suicide method compared to choosing hanging were the significant factors associated with a history of psychiatric consultations prior to death. Factors associated with not having a history of psychiatric consultations prior to death were being employed (compared to being unemployed), being a student (compared to being unemployed), and being older (compared to being younger). The Cochran-Armitage trend test revealed no significant linear trend in the distribution of case counts.

The study highlights the need for targeted mental health interventions for specific demographic groups, as well as further research on the impact of mental health conditions and age-related factors on suicide methods. These results may contribute to a deeper understanding of the risk factors for suicide and help in improving suicide prevention strategies.

An understanding of future healthcare needs of patients with chronic rhinosinusitis (CRS) is essential for patients and providers to make informed treatment decisions. Data on the predictors of long-term CRS-related healthcare utilization are limited. While there is evidence of sex differences in CRS, it is unknown whether the factors associated with long-term healthcare needs differ by sex.

The objectives of this study were to evaluate associations between CRS symptoms and CRS-related healthcare utilization and how these associations differ by sex.

We conducted a prospective study of 7,847 subjects, utilizing questionnaire and electronic health record data to assess CRS-related healthcare utilization. Individuals who met CRS symptom criteria were categorized into one of four symptom profiles in 2014: obstruction and discharge; pain or pressure without smell loss; smell loss without pain or pressure; and pain or pressure and smell loss. Healthcare utilization (2014-2019) was classified into one of six categories based on CRS-related clinical encounters and diagnostic imaging: minimal overall utilization, no CRS-related utilization; one-year of CRS-related utilization; repeated CRS-related utilization; episodic CRS-related utilization; and discontinued utilization. We evaluated associations between symptom profiles and utilization categories using multinomial logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), assessing effect modification by sex using cross-product terms.

Of the 7,847 subjects, 62.7% were women and 37.3% were men. Among women, there was no association between CRS symptoms in 2014 and repeated CRS-related healthcare utilization (versus discontinued CRS-related utilization), whereas men with CRS symptoms had nearly twice the odds (OR 1.81 CI: 1.02, 3.20) of repeated utilization. Women who had CRS with pain and pressure, had higher odds of discontinued CRS-related utilization. This was not observed for other symptom profiles.

Healthcare utilization patterns for CRS varied by symptoms and sex. Women with facial pain/pressure were uniquely at risk for discontinuation of CRS-related care, providing further evidence of sex differences among individuals reporting sinonasal symptoms.

The current study aimed to identify non-dismissive language and synthesize practice recommendations for medical providers to use when discussing potential psychological etiologies of chronic pain.

Community-recruited emerging adults (18- to 25-year-olds; N = 138; 68 % female) participated in the current study as part of a larger online survey. Participants were randomly assigned to read either a "dismissive" (i.e., attributed pain to primarily psychological etiologies) or "biopsychosocial" (i.e., provided a more nuanced explanation of the complex interplay between psychological and physiological etiologies of pain) vignette describing hypothetical patient-provider interactions regarding -chronic daily headache complaints.

Participants who read the biopsychosocial vignette and male participants reported significantly more positive reactions (e.g., more satisfaction, higher likelihood of continued care). Qualitative results showed that participants who read the dismissive vignette were more likely to feel their time had been wasted and obligated to explain their pain further.

Hypothetical provider explanations of psychological etiologies of chronic daily headache pain were received more positively when contextualized within a biopsychosocial framework.

This article presents practice recommendations for how medical providers should introduce potential psychological etiologies of a patient's headache pain experience in a non-dismissive manner to decrease the likelihood of provider-generated pain dismissal experiences.

Background/Objectives: COVID-19, caused by the SARS-CoV-2 virus, emerged in late 2019 and rapidly became a global pandemic, affecting over 200 countries. The pandemic has had profound impacts on global health, the economy, and mental health, leading to increased anxiety and more cases of posttraumatic stress disorder in the general population. This study aimed to evaluate the factors influencing the long-term psychological effects, both positive and negative, seen in the late stages of the COVID-19 pandemic in Poland (starting in the second half of 2021). It combined specific COVID-19 anxiety factors with a broader general mental health assessment to identify significant associations. Methods: Data were collected from 416 participants through paper-based and online questionnaires, with 235 valid responses gathered in total. This study utilized the Coronavirus Anxiety Scale; General Health Questionnaire (GHQ-28); and, to study Positive Trauma Effects (PTEs) and Negative Trauma Effects (NTEs), the Changes in Outlook Questionnaire. Data analysis was performed using the R language and a Generalized Additive Model analysis was also performed. Results: The study found generally low levels of COVID-19 anxiety and mental distress among participants. Significant predictors of NTEs included COVID-19 anxiety and general mental health status, which explained 47% of the variance. PTEs were significantly associated with gender, with women experiencing higher PTE levels relative to men. Conclusions: The findings indicate that combining specific ailment anxiety measurements with general mental health assessments enhances our ability to predict Negative Trauma Effects. Addressing mental health symptomatology and well-being during mass health crises is crucial to mitigate long-lasting psychological damage.

Borderline Personality Disorder (BPD) affects 1-2 % of the population and poses significant health challenges. Individuals with BPD face a reduced life expectancy of 14-27 years, primarily due to suicide and cardiovascular-related issues. This scoping review aimed to provide an overview of the existing literature on physical activity (PA) in BPD management, focusing on research characteristics and exploring underlying rationales.

The PubMed, CINAHL, Embase, PsycINFO, Scopus, PEDro and Cochrane databases were searched for both unpublished and published studies from 1980 to February 2025. The search followed the PRISMA-ScR guidelines and the Population, Concept, and Context framework.

Twenty-one studies met the inclusion criteria, including seven RCTs (four ongoing), five non-randomized controlled trials, two non-controlled intervention studies, one single-case experimental study, and six case studies. The studies included 229 participants, primarily female, and covered six PA modalities: structured exercise, yoga, dance movement therapy, outdoor PA's, sports, and body awareness and psychomotor therapies. Analysis identified seven categories of rationales for incorporating PA: improving patient care, fostering emotional regulation, promoting mental health, regulating maladaptive behaviors, enhancing social skills, protecting physical health, and reclaiming embodiment, with fostering emotional regulation as the most prominent.

This review highlights the promising but fragmented research on PA interventions for BPD, with a primary emphasis on psychological aspects. Notable gaps include limited attention to somatic comorbidities and the lack of consistent outcome measures. Future research should prioritize the development of multidisciplinary interventions to address both psychological and physical factors.

Veterinary communication plays a key role in client satisfaction, patient outcomes and clinician wellbeing. Communication assessment tools can help to facilitate improvement strategies.

Over a 5-month period, pet owners attending a small animal hospital were asked to complete a survey assessing their understanding of commonly used veterinary terms and phrases, either online or in paper format. Scores were used to identify areas requiring improvement and investigate the effect of demographic characteristics on owner understanding.

A total of 378 completed questionnaires was received. Over 97% of owners rated the quality of veterinary communication as good or moderate to good. However, approximately one-fifth believed that communication could be improved. While veterinary terms and phrases were broadly understood, none was correctly interpreted by all respondents, and common misconceptions were identified. Respondents with prior medical knowledge scored higher.

The survey methodology allows for misinterpretation of questions, response bias and non-compliance with the requirement that respondents do not receive help in completing the survey from external sources.

While pet owners generally perceived veterinary communication to be good, some commonly used terms and phrases were frequently misinterpreted. Vets should therefore be encouraged to use lay terms when communicating with clients and to take time to confirm that their intended message has been fully understood.

This study examines the roles of optimism and self-efficacy in influencing health behaviors among Polish health sciences students, with a focus on gender differences. A cross-sectional design was used with a sample of 318 students. The General Self-Efficacy Scale (GSES), the Life Orientation Test-Revised (LOT-R), and the Health Behavior Inventory (HBI) were used to assess self-efficacy, optimism, and health behaviors' (HB) intensity, respectively. The variation in the HB was significant concerning the level of dispositional optimism (F(2, 312) = 4.22, p = 0.016, η2p = 0.03). LOT-R results turned out to be a statistically significant condition for higher frequency of positive mental attitude (PMA) behaviors and preventive actions (PAs). Gender differences were observed: higher scores of PMA and PhA were more frequent among men, whilst women were characterized with higher PA. The effect of gender and both GSES and LOT-R for the HBI results was statistically significant in two subscales (with LOT-R for PhA and with GSES for PA). These findings enhance the understanding of psychological determinants of health behaviors and suggest practical implications for educational and public health strategies. Gender turned out to be a significant determinant of some relationships between health behaviors and the examined dispositions in Polish health sciences students.

Acne vulgaris (AV) is one of the most common skin disorders, particularly affecting young people and adolescents, who are also widespread users of social media.

The objectives of this study are to understand why patients seek information about their acne from social media, their perspectives on dermatologists and social media influencers, and how social media sharing affects their views on dermatologists.

This cross-sectional study included 100 AV patients aged 18-45 who visited the dermatology outpatient clinic of Ankara Training and Research Hospital. Patients were asked to complete a 30-item survey titled "Examination of Acne Patients' Trust Levels in Social Media Influencers and Dermatologists". The survey was structured to collect data on patients' social media usage patterns, their sources of information regarding acne (including both dermatologists and social media), and the levels of trust they place in these sources. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and Chi-square tests were used for analysis, with p<0.05 considered significant.

Most participants (95%) used social media for information. Eighty-one percent of the participants had a high level of trust in their dermatologist, and 97% of participants said that they would trust the dermatologist if the information from the dermatologists and social media influencers were contradictory, and 67% sought acne information from social media influencers. Instagram was the most preferred platform for this purpose (63%). The most common reason for consulting social media was to get information about cosmetic products (36%).

This study found that patients trust dermatologists more than influencers. This makes it important for dermatologists to make informative social media posts on acne. Dermatologists should also reach out to social media influencers and encourage them to share posts by consulting with experts on the topic.

Losing a loved one to suicide is an extremely stressful event that is associated with mental health issues. However, little is known about the health care utilization of those bereaved by suicide. Identifying distinct trajectories of mental health care utilization can help reveal gaps in service provision, barriers to access, and opportunities for targeted interventions.

To uncover distinct patterns of mental health care utilization in association with suicide bereavement and explore sociodemographic factors and subsequent suicide risk associated with these patterns.

We analyzed Norwegian population-wide registry data on mental health care utilization at three different levels among 14 781 adults bereaved by suicide from 2010 to 2019 using group-based multi-trajectory modeling to identify groups with distinct mental health care utilization trajectories. Socio-demographic differences between trajectory groups were analyzed in multinomial logistic regression models and the associated risk of suicide was obtained with cox proportional hazards regression models.

We identified four distinct trajectories of mental health care utilization. Two distinct groups of individuals bereaved by suicide either rarely contacted mental health care providers ("Low") or only consulted with general practitioners only ("GP only"). In the latter group, the utilization rate increased post-bereavement. One group of bereaved ("Acute increase") increased their mental health care utilization significantly after the loss, while another group ("High") consistently had a high utilization rate. These groups differed with respect to kinship to the deceased and sociodemographic factors. Individuals in the "GP only" and "High" group had significantly higher risk of suicide when compared to those in the "Low" group.

Individuals bereaved by suicide exhibited diverse patterns of mental health care utilization, reflecting a broad spectrum of needs and responses to loss.

Relapsing polychondritis (RP) is a rare, heterogeneous, multisystem disease lacking standard treatment guidelines. This study describes clinical manifestations in association with approaches to treatment.

Adults with physician-diagnosed RP were recruited into a multicenter observational cohort study. Clinical manifestations, organ damage, and medication history were recorded at the baseline study visit. Treatments received for RP at any time point before the initial visit were categorized into three groups: group 1 was treated with glucocorticoids (GCs) or no drugs, group 2 was treated with nonbiologic immunosuppressive (IS) drugs excluding JAK inhibitors (JAKis) with or without GCs, and group 3 was treated with JAKis or biologic IS drugs with or without nonbiologic IS drugs or GCs.

Included in the study were 195 patients with RP who were predominantly female (167, 86%) and White (174, 89%), with a mean age of 49 ± 13years. All patients had ear, nose, or airway involvement, and 163 (83%) had musculoskeletal manifestations of RP. All patients had at least three clinical manifestations with median of 11 (range 3-19). GC treatment was given to 186 (95%) patients. Organ damage was seen in 80 (41%) patients. Treatment groups 1, 2, and 3 had 37 (19%), 55 (28%), and 103 (53%) patients, respectively. Patients in group 3 were more likely to have organ damage, arthritis, and subglottic stenosis.

Patients with RP have a high burden of clinical manifestations with resultant damage. Physicians typically treat RP with GCs, and the use of other immunosuppressive medications is variable. Absence of a consensus approach to treatment underscores the need for clinical trials and treatment guidelines for RP.

The aim of our study was to determine whether the application of machine learning could predict PASC by using diagnoses from primary care and prescribed medication 1 year prior to PASC diagnosis.

This population-based case-control study included subjects aged 18-65 years from Sweden. Stochastic gradient boosting was used to develop a predictive model using diagnoses received in primary care, hospitalization due to acute COVID- 19, and prescribed medication. The variables with normalized relative influence (NRI) ≥ 1% showed were considered predictive. Odds ratios of marginal effects (ORME) were calculated.

The study included 47,568 PASC cases and controls. More females (n = 5113) than males (n = 2815) were diagnosed with PASC. Key predictive factors identified in both sexes included prior hospitalization due to acute COVID- 19 (NRI 16.1%, ORME 18.8 for females; NRI 41.7%, ORME 31.6 for males), malaise and fatigue (NRI 14.5%, ORME 4.6 for females; NRI 11.5%, ORME 7.9 for males), and post-viral and related fatigue syndromes (NRI 10.1%, ORME 21.1 for females; NRI 6.4%, ORME 28.4 for males).

Machine learning can predict PASC based on previous diagnoses and medications. Use of this AI method could support diagnostics of PASC in primary care and provide insight into PASC etiology.

This study aims to analyze global trends in smoking-attributable peptic ulcer disease (PUD) disability-adjusted life years (DALYs) from 1990 to 2021 and project future trends to 2046.

Data were obtained from the Global Burden of Disease Study 2021. We calculated age-standardized DALYs rates (ASDR) and estimated annual percentage changes (EAPC) for smoking-attributable PUD DALYs. Bayesian Age-Period-Cohort models were used to project future trends.

From 1990 to 2021, global smoking-attributable PUD DALYs decreased significantly, with the age-standardized rate declining from 35.4 to 9.4 per 100,000 (EAPC: -4.45%). High-income regions showed faster declines, while some low- and middle-income countries experienced slower progress or even increases. Gender disparities were observed, with males consistently showing higher ASDR. Projections suggest a continued global decline in smoking-attributable PUD DALYs to 2046, with persistent regional disparities. By 2046, the global ASDR is expected to decrease to approximately 3.2 per 100,000, with higher rates persisting in certain regions such as Kiribati (44.6 per 100,000) and Cambodia (45.1 per 100,000).

While global smoking-attributable PUD DALYs have significantly decreased and are projected to continue declining, substantial regional and gender disparities persist. These findings underscore the need for targeted tobacco control interventions, particularly in high-risk regions and among vulnerable populations, to further reduce the global burden of smoking-attributable PUD.

Understanding patient's healthcare seeking behavior (BHS) and identifying the determinants influencing BHS can optimize the allocation of medical resources and enhance the efficacy of healthcare systems. The purpose of this study is to identify the influencing factors of patients' BHS and to assess the extent and variation in their impact on BHS.

Drawing upon the Anderson Behavioral Model of Health Service Utilization, we summarized the factors influencing patients' BHS into three categories, and examined empirical journal articles published from 2010 to 2023 using meta-analysis. In addition, the Bayesian analysis of variance was introduced to explore the influence of moderators.

A total of 39 empirical journal articles were finally identified for meta-analysis. Ten out of the thirteen factors have a significant and positive influence on BHS, with the exception of trust in medical institutions (z = 0.176, p = 0.077), health record (z = 1.942, p = 0.052), and medical expenses (z = 0.1846, p = 0.065). The results of moderating effect analysis indicate that there is a significant difference in the impact of age (p < 0.001), education level (p < 0.05), family income (p < 0.001), medical insurance (p < 0.001), illness severity (p < 0.01), and healthcare service reputation (p < 0.001) on BHS.

There is a positive and significant influence of the antecedent variables (self-rated health, distance to medical facilities, illness severity, age, family income, education level, marital status, medical insurance, awareness of hierarchical healthcare, health record, and healthcare service reputation) on BHS. Furthermore, the influences of family income, medical insurance, and illness severity on BHS in developed areas are stronger than that in underdeveloped areas, while the influences of age, education level, and healthcare service reputation on BHS in underdeveloped areas are stronger than that in developed areas.

Multimorbidity is a major public health concern. According to previous studies, multimorbidity has been shown to be associated with health-related quality of life (HRQoL). However, existing data concerning high income countries are mainly based on cross-sectional studies. Consequently, longitudinal investigations have been called for. There exist several definitions of multimorbidity in previous population studies, and usually definition is based on self-reported symptoms or diseases or included only few diagnoses. This study aimed to examine how the number of doctor-diagnosed chronic diseases influences HRQoL over time in a population-based setting.

At 31 and 46 years, participants (n = 3573) of the Northern Finland Birth Cohort 1966 answered 15-Dimensional HRQoL questionnaire (15D). Mean 15D-Scores (varies between 0 and 1) were counted according to the number of 43 chosen chronic diseases. These diseases were found and the definition of multimorbidity was measured by a method using both self-reported doctor-diagnosed and register-based chronic diseases.

In both genders, the mean difference of 15D-Scores increased monotonously in line with the increasing number of new emerging diseases diagnosed for 15 years of follow-up from the age of 31-46 years (p < .05). Furthermore, the more diseases the patient had at the age of 31, the more mean 15D-Scores decreased when having more new emerging diseases at the age of 46.

In general, HRQoL decreased during 15-year follow-up for everyone. Furthermore, decrease in the quality of life is significantly associated with multimorbidity in this longitudinal setting.

Due to the high prevalence of low back pain which impacts the lives of those affected, several studies have explored findings associated with the lumbar spine (which is the affected anatomy) using magnetic resonance imaging (MRI). This provides a better understanding of the pathology in the study setting and adds to the literature on the subject, which is useful during intervention and has implications for policymaking. However, there is a paucity of literature in the Ghanaian context. This study therefore explored the patterns of MRI findings in Ghanaian patients with low back pain.

A one-year retrospective cross-sectional design with a purposive sampling method was used to retrieve data from 59 MRI lumbar spine radiologist reports with a clinical history of low back pain. Data was analysed descriptively and inferentially. Inferentially, the Fisher's exact or chi-square (X2) test was utilised to ascertain associations between variables where appropriate. Phi coefficient and Cramer's V were used to assess the strength of significant associations. Statistical significance was deduced at p < 0.05.

Among the reports identified, 57.6% (n = 34) were associated with females and 32.4% (n = 25) were associated with males. The mean age across reports was 44.7 ± 16.1 years. Disc degeneration (93.2%, n = 55) and lumbar spondylolysis (76.3%, n = 45) were the two main findings identified as the most prevalent across reports. The lordotic curvatures of patients with low back pain were predominantly normal (74.6% n = 44). Disc degeneration was strongly associated with L4/L5 (V = 0.644, p = 0.001).

The prevalent finding identified was disc degeneration frequently located at L4/L5. Several other abnormal findings were identified. Age was significantly associated with lumbar spondylosis. Disc degeneration and lumbar spondylosis were more frequent between ages 30 and 70 years.

Not applicable.

Post-acute sequelae of COVID-19 (PASC), or Long COVID, involves persistent symptoms following acute infection, posing a global health challenge. While a growing number of studies have investigated potential predictors and risk factors, uncertainties remain regarding their consistency and clinical applicability. This study investigates PASC prevalence, comorbidities, demographics and viral variants using Dutch primary care electronic healthcare records (EHR).

A retrospective cohort study used EHR data from 59 general practices in the Northern Netherlands, including 19,638 SARS-CoV-2 PCR-positive patients from January 1, 2020, to December 31, 2021. PASC was identified via World Health Organization and CDC guidelines, a Dutch Word2Vec model, and clinical assessments. Relative risk (RR) calculations analysed comorbidities, demographics and viral variants.

PASC prevalence was 5.8% (95% CI: 5.4-6.1%). Comorbidities significantly increasing PASC risk included lung disease (RR: 1.95), cardiovascular disease (RR: 1.73), diabetes (RR: 1.82), kidney disease (RR: 1.98) and mental illness (RR: 1.29). Females and individuals aged ≥45 had increased risk. Multivariate regression revealed higher odds of prolonged PASC for ages 45-59 (adjusted odds ratios [AOR]: 3.02), 60-74 (AOR: 3.25) and 75+ (AOR: 2.44). Combined mental illness and lung disease further increased risk (AOR: 2.55).

Chronic conditions, multimorbidity and demographics significantly influence PASC onset and duration. Targeted interventions may mitigate its long-term impact.

Poisoning represents a major global public health burden with significant regional variations in epidemiology and management. The Saudi Toxicology Consultation Service (TCS) provides nationwide remote consultation through a public hotline, enabling systematic data collection and analysis of poisoning patterns. However, contemporary data on poisoning epidemiology and telehealth services in Saudi Arabia is lacking.

This study aimed to analyze national TCS data originating from public calls, in order to systematically characterize community-based poisoning epidemiology and clinical profiles. Specific goals included determining sociodemographic, seasonal, and geographic distributions, identifying common agent categories and their associated clinical profiles, and analyzing management decisions across different toxic exposure categories.

We conducted a retrospective analysis of all public calls to the national TCS hotline between January 1 and December 31, 2023. Data collected included poisoning cases demographics, geographic location, agent category, symptoms, and management decisions. Descriptive statistics characterized the study population. Chi-square tests assessed associations between variables with significance set at p < 0.001.

Among 39,142 consultations analyzed, children aged 1-<3 years had the highest consultation rate (157.59 per 10,000). Females showed higher utilization than males (15.41 vs. 10.10 per 10,000). The Central region demonstrated the highest consultation rate (19.13 per 10,000). Medications were the most common agent category (49.37%), followed by household products (26.32%) and health supplements (22.99%). Most cases were asymptomatic (97.19%) and managed through home observation (74.53%). However, bites/stings and substance abuse cases more frequently required hospital referrals (70.56% and 61.97% respectively) despite being predominantly asymptomatic.

This first comprehensive analysis of the epidemiology of national toxicology consultations data reveals children 1-<3 years old as the highest risk group for poisonings in Saudi Arabia, with medications as the predominant exposure. The large proportion of cases safely managed by the TCS demonstrates the feasibility and healthcare value of expanding remote toxicology services to improve efficiency and reduce costs. Data-driven insights could inform preventative initiatives, clinical guidance development, and strategic policies to curb poisoning incidence by targeting highest-risk demographics.

This study aimed to build a predictive model to identify frailty in the French national health data system (SNDS) so as to create a new tool to monitor and anticipate the disability burden associated with population ageing. We developed the model using the 2012 wave of the French Health, Healthcare, and Insurance Survey (ESPS) linked to the SNDS (n = 2,829). This survey used Fried's frailty phenotype as the gold standard. We compared two statistical approaches - logistic regressions (stepwise and LASSO selection) and random forest - to predict frailty probability based on different SNDS healthcare claims. We indirectly validated the model by comparing (1) the predicted frailty prevalence in the overall French population in the SNDS with the expected prevalence and (2) the predictive ability of the model for 6-year mortality with that of Fried's frailty phenotype. Logistic regression with LASSO selection was retained as the best method to predict frailty. After stratification for age, we obtained three models for individuals aged 55-64, 65-74, and ≥ 75 years (AUC = 0.61, 0.76, and 0.80 respectively). Applying these models to the SNDS, frailty prevalence was comparable to expected prevalence in all sex and age groups: overall prevalence = 12.9% (95%CI: 12.9-12.9) in the SNDS versus 12.0% (95%CI: 10.8-13.2) in the ESPS. Predicted frailty probabilities in the SNDS showed a similar strong association with 6-year mortality (HRfrail_probability=2.6, 95%CI: 1.9-3.5) compared with Fried's phenotype (HRfrail_phenotype=2.9, 95%CI: 2.1-3.8). Our predictive models are thus useful for estimating frailty probability in the SNDS.

Patient navigation (PN) is a critical intervention in the United States to overcome barriers to cancer care, including logistical, financial, and informational barriers, ensuring patients receive timely and coordinated care. However, there are few studies assessing effectiveness of PN in low- and middle-income countries (LMICs). Here, we aim to begin to fill this gap by assessing the effectiveness of the Kenyatta National Hospital (KNH) patient navigation program (PNP) in improving patient-reported outcomes (PROs).

We used repeated cross-sectional survey design by collecting data from randomly selected 1,126 adults with cancer in three surveys conducted in 2018, 2019, and 2022. The study also drew on qualitative data collected from patients with cancer, caregivers, and program team members as part of an external outcome evaluation.

Logistic regression showed that a higher number of navigation encounters was associated with increased likelihood of improving patients' understanding of their diagnosis, duration of treatment, and satisfaction with information received about needed clinical services. Compared with the 2018 survey, participants of the 2019 (odds ratio [OR], 12.00, 8.00-17.99) and 2022 (OR, 17.18, 10.88-27.14) surveys had markedly higher odds of receiving help finding their way around the facility. Moreover, compared with the 2018 survey, participants of the 2019 survey had lower odds of delaying the start or continuation of their treatment (OR, 0.50, 0.32-0.78).

This study contributes to a limited pool of studies to assess PROs of PNPs specifically for cancer treatment in LMICs, making an important contribution to the existing body of knowledge in global cancer patient support. This study provides evidence that PNPs can function effectively and complementarily in LMICs.

Sex and gender may influence the epidemiology, pathogenesis, and prognosis of cancer. This narrative review describes sex and gender differences in the epidemiology and pathogenesis of cancer, and how such differences may impact the pharmacodynamics and pharmacokinetics of cancer treatment. For most types of cancer unrelated to reproductive function, incidence is higher in males than in females, except for gallbladder and thyroid cancers, which are much more common in women. Cancer mortality is higher in men than women; women account for a larger proportion of survivors. These differences may be related to biological differences in pathogenesis or differences in behaviors relating to cancer risk or detection. The pharmacokinetics and pharmacodynamics of cancer therapies also differ between sexes due to differences in body composition, physiology, and receptor expression. Overall, sex and gender are essential variables to be considered in research and clinical practice, influencing diagnosis, subtyping (biomarkers), prognostication, treatment, and dosage.

To investigate the key factors that influence patients' preferences for telerehabilitation consultations in comparison to traditional in-person physiotherapy consultations and explore how these factors vary across different patient demographic characteristics.

A binary discrete choice experiment was conducted with 152 participants who had participated in physiotherapy. The primary outcome measures were the attributes related to telerehabilitation and in-person consultations, including appointment duration, cost, distance, purpose, therapist, time of day, and wait time. Participants' preferences were assessed based on their choices in the binary choice experiment.

The study did not identify any attributes of consultations that clearly influenced patients' preference for telerehabilitation versus in-person physiotherapy. There was a trend towards preferring telerehabilitation with decreased appointment wait times and lower monetary costs. Patient demographics revealed that individuals with a single chronic health condition were clearly less inclined towards telerehabilitation (OR = 0.5, 95% CI 0.27-0.93), as were those located in outer regional locations (OR = 0.34, 95% CI 0.12-0.99). Additionally, respondents preferring a short 5 km travel distance showed markedly lower preference for telerehabilitation (βTelerehab×Distance_5km = -0.94, 95% CI -4.34 to -0.51, p < 0.001).

To enable broader access to physiotherapy via telerehabilitation, clinicians, and policymakers should prioritize offering timely and cost-effective sessions. The results of this study can then inform the development of telerehabilitation offerings that are better matched to patient preferences.

Although the overall colorectal cancer (CRC) incidence has been steadily declining in the United States, a dramatic increase in the number of CRC cases among individuals younger than 50 years of age (early-onset CRC) has been observed. CRC is the second and first leading cause of cancer death in the United States and among Hispanic men and women living in Puerto Rico (PRH), respectively. We report CRC incidence rates from 2000 to 2021 among PRH and compare them to data in the Surveillance, Epidemiology, and End Results Program (SEER).

Data on colorectal adenocarcinomas diagnosed between January 1, 2000, and December 31, 2021, were obtained from the Puerto Rico Central Cancer Registry and SEER17, including race and ethnicity. Age-standardized incidence rates were calculated using the direct method. The Joinpoint Regression Program calculated temporal trends on CRC incidence rates based on age-adjusted Average Annual Percent Change (AAPC) estimates.

A total of 729,479 incident cases of CRC were analyzed. US Hispanics had the highest percentage of early-onset CRC (EOCRC) cases (17.0%) among the racial and ethnic groups studied. PRH had the highest age-standardized EOCRC incidence rate (12.18 per 100,000 persons) and the highest increase in EOCRC incidence temporal trends (AAPC = 2.68; 95% CI: 1.83 to 3.51).

A significantly higher increase in EOCRC incidence was observed among Hispanic populations. Future studies should disaggregate Hispanic subpopulations by considering the country of ancestral origin, which will help identify specific risk factors and exposures and aid in developing tailored prevention and risk stratification strategies to reduce EOCRC incidence.

Due to the reduction in immunity caused by auto-splenectomy and the consequent opsonic antibody shortage, patients with SCD are more susceptible to encapsulated organism infections, especially asymptomatic urinary tract infection (ASM-UTI). This study investigated the prevalence of ASM-UTI and compared urine and hematology parameters among SCD patients in Ghana to their healthy counterparts.

In this study, 104 SCD participants (cases) and 80 non-SCD (HbAA) controls were recruited. Participants' information was thoroughly documented using a well-structured questionnaire and patient case records. To achieve the study's aims, a mid-stream urine in a cleaned dry aseptic urine capped container and venous blood were collected for laboratory analysis.

The prevalence of ASM-UTI among SCD participants and non-SCD (HbAA) individuals were 22 (21.2%) and 18 (22.5%) respectively. Among the 22 (21.2%) SCD individuals with ASM-UTI, 64% were HbSS and 36% were HbSC. S. aureus 15 (8.2%) accounted for the majority of the organisms isolated with the larger proportion 9(60.0%) isolated from the SCD patients. There was a statistical difference between SCD with ASM-UTI, without ASM-UTI, and non-SCD (HbAA) with respect to urine appearance (p = 0.047), proteinuria (p = 0.024), leukocyte (p < 0.0001). Significantly high total WBC (p < 0.0001), low platelets (p < 0.0001), and low hemoglobin (p < 0.0001) in SCD with ASM-UTI compared to non-SCD (HbAA) with ASM-UTI were also observed. Major risk factors associated with ASM-UTI includes a cloudy urine appearance, a positive (+1 and +2) urine leukocytes and positive (+1) urine bilirubin compared to having a clear urine appearance, negative leukocyte, and a negative bilirubin.

This study has shown ASM-UTI to be common in adult SCD participants with higher rate in females. It has also showed that ASM-UTI can exist alongside other clinical states such as anemia, microalbuminuria, hematuria and proteinuria which are characteristics of kidney disease which can trigger crises in SCD participants.

Serologic testing is a useful adjunct for the diagnosis of Lyme disease, a major public health problem in certain US regions. We aimed to determine whether Lyme disease serologic testing and results differed by sex and age group.

We identified 2 cohorts of individuals across all ages who underwent serologic testing for Lyme disease at a national reference laboratory in 2019 (cohort 1) and 2022 (cohort 2). If an individual had multiple tests in the same year, we included only the first test. We excluded individuals who had been tested in the previous 5 years.

Cohorts 1 and 2 consisted of 578 052 and 550 674 people, respectively. Fewer males than females were tested in cohort 1 (42.7% vs 57.3%) and cohort 2 (42.3% vs 57.7%), although similar numbers were tested for both sexes among nonadults. More males than females had a positive test result in cohort 1 (53.9% more males) and cohort 2 (52.9% more males). The odds ratio of receiving a positive test result among males versus females was 2.09 (95% CI, 2.01-2.17) in cohort 1 and 2.12 (95% CI, 2.05-2.19) in cohort 2. Among people with positive test results, females (except children) were more likely than males to have positive immunoglobulin M and negative immunoglobulin G results, which can serve as a marker of early infection (odds ratio = 1.43 [95% CI, 1.31-1.55] in cohort 1 and 1.38 [95% CI, 1.29-1.47] in cohort 2).

Further studies are needed to understand whether the observed differences in Lyme disease testing and positivity result from sex- and age-associated disparities in social behavior, health care seeking, clinical practice, or other factors.

Subarachnoid hemorrhage (SAH) is a critical condition that has far-reaching implications for public health systems globally due to its severe consequences and long-term disabilities. This study aims to provide a comprehensive analysis of SAH trends from 1990 to 2021 and project future trends up to 2041, aiding in better understanding and management of its global burden.

We utilized data from the GBD (Global Burden of Disease) 2021 database, using joinpoint regression, frontier, and decomposition analyses to assess changes in SAH burden. Bayesian Age-Period-Cohort modeling was implemented to predict future trends. Our study included populations from 204 countries and territories.

From 1990 to 2021, SAH incidence decreased by -1.03% for men and -1.16% for women, while mortality rates declined by -2.56% for men and -2.69% for women. Middle sociodemographic index locations and East Asia experienced substantial declines, particularly among women. However, countries like the Philippines and Turkmenistan showed increasing trends. Population aging and growth significantly contributed to these trends, while epidemiological changes led to reductions in SAH burden. The prediction model forecasts continued decreases in SAH mortality and disability-adjusted life years over the next 20 years, although incidence rates may slightly increase.

The global burden of SAH has significantly diminished from 1990 to 2021, with considerable variations across regions, sexes, and countries. Ongoing and future research should prioritize high-risk populations and develop innovative interventions to further decrease SAH incidence and enhance outcomes.

This study aims to investigate changes in employment status among disease-free working-age cancer survivors (CSs) with late effects from diagnosis to their first meeting in the Late Effects Clinic (LEC) and investigate associated patient-reported outcomes of reduced employment status.

Retrospective analysis of a cohort of CSs followed in a LEC at a single institution from January, 2022, to March, 2023. Working-age CSs with no current evidence of active cancer were included in this study. CSs completed a baseline questionnaire (EORTC QLQ-SURV100) before their initial consultation. Reduced employment status was defined as transition from being in paid work at diagnosis to working fewer hours or not at all at the first visit. Multivariate linear regression analysis was used.

A total of 119 CSs with diverse cancer types with a mean age of 51 years (range 26 to 70) were included in this study. Eighty percent were female. Of 93 CSs in paid work at diagnosis, 66 (71%) have reduced employment status. Reduced employment status was associated with lower role functioning score (β = -12.3, p = 0.046), higher loss of income score (β = 35.1, p = 0.001), and lower Global health status score (β = - 8.3, p = 0.05).

This study shows that the majority of CSs seen in the LEC have reduced employment status. This is associated with impaired quality of life.

Identifying and treating late effects early in cancer survivorship are important to secure CSs' labour market attachment and, thus, their financial and social well-being.

Diabetes, hypertension, and hyperlipidemia frequently co-occur in older adults, significantly increasing their risk for cardiovascular disease, a leading cause of mortality in the United States. Managing these conditions often requires concomitant triple therapy, which includes antihypertensives, oral antidiabetics, and statins. Although medication adherence is critical for reducing cardiovascular risk, adherence to complex regimens is often suboptimal in older populations, further complicating disease management. Medicare's STAR metrics assess adherence to these medications as a measure of care quality. Traditional methods, like the proportion of days covered (PDC), provide single adherence estimates, but fail to capture the dynamic nature of adherence over time. Group-based trajectory modeling (GBTM) offers a more comprehensive approach, graphically depicting patterns of adherence behavior. This study seeks to understand longitudinal patterns and predictors of adherence of concurrent triple therapy among elderly patients under Managed Care using GBTM.

To evaluate adherence patterns to concurrent triple therapy (antidiabetic, antihypertensive, and lipid-lowering medications) among older patients using GBTM and identify predictors associated with each adherence trajectory.

Patients on concurrent triple therapy were identified using a Texas Medicare Advantage dataset from July 2016 to December 2016. Patients included had an overlap of 30 days of triple therapy, a second prescription of each component of triple therapy within the identification period, and a 12-month follow-up after the triple therapy. Monthly adherence was measured using PDC during follow-up. Patients were defined as adherent if they had at least 80% (24 out of the 30 days) covered for all 3 medications. The monthly PDC was incorporated into a logistic GBTM to provide distinct patterns of adherence. Two to five adherence groups were estimated using the second-order polynomial function of time. Predictors of adherence were identified using multinomial logistic regression, guided by the Anderson Behavioral Model.

Of the 7,847 patients included, the following 4 distinct adherence trajectories were identified: adherent (42.5%), gaps in adherence (28.9%), gradual decline (13.4%), and rapid decline (15.3%). Female patients had higher odds of being in the gaps in adherence or rapid decline groups compared with males. Low-income subsidy recipients were less likely to experience rapid decline. Prior hospitalizations increased the likelihood of rapid decline in adherence.

This study identified heterogeneous adherence patterns among older adults on triple therapy for cardiovascular disease risk factors. Targeted interventions tailored to specific adherence trajectories are needed to improve medication adherence and health outcomes in this high-risk population.

Respiratory pathogens pose significant public health challenges globally, particularly in densely populated urban areas. This study aimed to analyze the epidemiological trends of multiple respiratory pathogens in Guangzhou, China, from 2013 to 2023, and investigate associated serological profiles to inform clinical management and public health interventions.

We conducted a retrospective analysis of 96,927 cases with suspected respiratory infections (SRIs) (defined by fever >37.5 ℃, cough, dyspnea, and/or chest pain) at The First Affiliated Hospital of Guangzhou Medical University. Clinical data were extracted from electronic medical records, and immunofluorescence assays were used to detect immunoglobulin M (IgM) antibodies against nine respiratory pathogens.

Of the cases analyzed, 18.01% (17,454/96,927) tested serologically positive for at least one respiratory pathogen. Mycoplasma pneumoniae (MP) was the predominant pathogen (76.51% of serologically positive cases), followed by parainfluenza viruses (PIVS) (9.75%). The highest serologically positive rate was observed in the 5-14 age group (36.01%). Females exhibited a significantly higher overall serologically positive rate (21.30%) compared to males (15.97%, P<0.001). Serological analysis revealed profiles in confirmed infections, with significantly lower coagulation-related parameters (P<0.001) and some elevated inflammatory markers compared to suspected cases.

This comprehensive study provides crucial insights into the changing landscape of respiratory pathogen infections in Guangzhou over an 11-year period. The predominance of MP, particularly among school-age children and females, highlights the need for targeted interventions. The unexpected coagulation profiles in confirmed infections suggest complex pathophysiological mechanisms that warrant further investigation. These findings have important implications for clinical management, diagnostic approaches, and public health strategies in urban settings.

To comprehensively evaluate the global, regional, and national burden of infective endocarditis (IE) from 2010 to 2021, and to project future trends.

This study utilized data from the Global Burden of Disease (GBD) Study 2021. Statistical methods, including joinpoint regression and the auto-regressive integrated moving average (ARIMA) model, were employed to analyze the prevalence, mortality, and disability-adjusted life years (DALYs) of IE, stratified by gender, age, and socio-demographic index (SDI).

From 2010 to 2021, the global prevalence of IE increased by 40.1%, with a total of 421,667 cases reported in 2021. The age-standardized prevalence rate (ASPR) rose from 4.7 per 100,000 to 5.3 per 100,000. Although the number of deaths increased by 23.01% and DALYs rose by 13.26%, both the age-standardized death rate (ASDR) and the age-standardized DALYs rate exhibited slight declines. Significant regional disparities in ASPR were observed, with an overall increase correlated with higher SDI levels. Joinpoint regression analysis revealed that the average annual percentage change (AAPC) in ASPR, ASDR, and age-standardized DALYs rate during this period was 0.8 (0.6, 1.0), -1.1 (-1.7, -0.5), and -1.3 (-1.9, -0.7), respectively. Notably, predictions from the ARIMA model indicate that the ASPR for men is expected to continue rising over the next five years, while a decline is anticipated for women; however, both genders are projected to experience a decrease in ASDR.

Over the past decade, the ASPR of IE has been on a gradual increase, while the ASDR and the age-standardized DALY rate have slightly decreased. It is indicated that some progress has been achieved in the global disease management and treatment effectiveness of IE. Based on the increasing prevalence rate and the relatively high mortality rate, the burden of IE globally will still remain a major public health challenge in the future.

Patient enrolment in primary care refers to the formal process of registering patients with a specific primary care provider, team, or practice. This approach is often expected to enhance continuity and coordination of care. However, limited information exists on the uptake of patient enrolment and its associated characteristics. This review aimed to estimate the uptake of patient enrolment in primary care and examine factors associated with decisions around enrolment.

Eight electronic databases (PubMed, Cochrane Register of Systematic Reviews, Embase, CINAHL, PsycINFO, PAIS, Web of Science, and Scopus) were searched for peer-reviewed articles published from January 2014 to July 2024. Findings from included studies were extracted and synthesised, with uptake estimated through meta-analysis and factors associated with enrolment summarised narratively.

PROSPERO CRD42024597078.

Ten studies across nine publications were included. Of these, eight studies with 27,919,216 participants were included in the meta-analysis. The results showed a pooled patient enrolment uptake rate of 71.4% (95% Confidence Interval [CI]: 13.6-97.5%). There was no significant difference in enrolment rates between population-wide and program-based enrolment (72.4% vs. 73.5%; p = 0.980). Several associated factors were identified in three publications. Women showed higher enrolment rates than men (adjusted odds ratio [aOR] = 1.07, 95% CI: 1.07-1.08), while recently arrived immigrants in a country had lower enrolment rates than the established population (aOR = 0.40, 95% CI: 0.40-0.41). Patients living in small urban/suburban/rural areas had higher enrolment rates than those in large urban/metropolitan regions (aORs: 1.17-2.18). Higher socioeconomic level was associated with increased rates of enrolment. Patients with some specific chronic health conditions, such as those with diagnosed mental illness or substance use disorders, had lower enrolment rates.

The findings reveal that more than two-thirds of patients were enrolled with a primary care provider or practice; enrolment was influenced by demographic, geographic, socioeconomic, and clinical factors. Lower enrolment among men, recent immigrants, individuals living in large urban/metropolitan areas, lower socioeconomic groups, and those with certain health conditions may indicate potential barriers to health service access and opportunities for enrolment. Addressing these disparities is essential to promote equitable access and enhance opportunities for continuity and coordination of primary care.

Low health literacy (HL) is associated with numerous negative health behaviors and outcomes, making it crucial to understand its underlying determinants. While associations between sociodemographic variables and subjective HL have already been demonstrated, data on the association between HL and personality remain limited. This study aims to extend the current knowledge by exploring how personality traits influence HL, beyond the effects of sociodemographic variables on HL. A cross-sectional study was performed with a sample of 238 healthy participants aged 50 to 92 years. Personality was measured using the NEO Five-Factor Inventory and subjective health literacy using the HLS-EU-Q47 questionnaire. Descriptive and correlational analyses as well as a multiple linear regression analysis with the Big Five personality traits, sex, age, and education as predictors of subjective health literacy were performed. The General-HL index was 37.22 (SD 7.98), which corresponds to sufficient or non-limited health literacy. The Big Five personality traits accounted for 32.2% of the variance in health literacy. Of the traits, Conscientiousness emerged as the strongest predictor (β = 0.31, medium effect), followed by Neuroticism (β = -0.21, small effect) and Openness to experience (β = 0.15, small effect). Sex was also a significant predictor of health literacy (β = 0.14, small effect). These results suggest that personality plays a significant role in health literacy, with higher Conscientiousness, lower Neuroticism, and higher Openness to experience, as well as female sex, predicting better health literacy. These findings underscore the importance of considering personality traits in interventions aimed at improving health literacy, with potential implications for both theoretical understanding and practical application in healthcare settings.

Understanding brain health is increasingly important, particularly in light of growing public health challenges related to neurological and psychiatric conditions. These include the rising prevalence of mental health disorders, such as depression and anxiety, as well as neurodegenerative diseases like Alzheimer's and Parkinson's. Lifestyle factors, including stress, poor diet, and insufficient physical activity, also significantly impact cognitive function. Exploring the perceptions and awareness of brain health among young and middle-aged adults is crucial to developing effective educational programs and awareness campaigns tailored to their specific needs. This study aimed to examine the perceptions and awareness of brain health among Cuban youth, focusing on the factors that shape their understanding and attitudes toward brain well-being. A cross-sectional online survey was conducted, with 1,049 participants voluntarily completing the questionnaire. Using "The Global Brain Health Survey," we assessed participants' conceptions of brain health and analyzed associations between demographic variables and brain health knowledge through logistic regression. Our findings revealed that the social environment was viewed as the most significant factor influencing brain health. Other factors, such as profession, genetics, income, and nutrition, were considered important but to a lesser degree. While participants were generally aware of conditions like Alzheimer's disease and depression, there was a notable gap in understanding the cognitive implications of chronic diseases such as hypertension and diabetes, which are prevalent in Cuba. These insights highlight the need for targeted public health initiatives and educational campaigns that promote healthier behaviors and community support, particularly among young adults.

Immigration, as a social determinant of health, encompasses several social and economic transformations. Neglecting to adequately address this issue could potentially worsen pre-existing challenges within health systems and in the management of migration. In the present study, we aim to evaluate the health perceptions, traditional health practices and use of health services of Afghan immigrants. We enrolled 1597 Afghan immigrants over 18 years old in the descriptive cross-sectional research. The mean age of the immigrants was 49.19 ± 1.6 years. The smallest number of points that can be achieved on the health perception scale is 15, while the greatest number is 75. We found that the health perception scale average score is 37.61 ± 7.32. Some factors, such as age 65 and over, female gender, postgraduate education level, good social insurance and economic status, being a public officer, not having any infectious diseases, and having a good Turkish level, have positively affected the health perception levels (p < 0.05). Moreover, we observed that cultural differences, expensive health care, a lack of social insurance, fear and anxiety, lack of language skills, waiting times and traditional health practices were the most common barriers to accessing healthcare services. Considering these issues in the health system, identifying the factors that negatively affect the perception of health and related to the use of health services can help immigrants increase their use of health services and improve their health.

U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers.

A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled.

Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches.

This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

To evaluate hearing preservation (HP) outcomes for patients with small sporadic vestibular schwannomas (VS) who elect to undergo microsurgical resection.

Retrospective study.

Tertiary single-academic institution.

Individuals 18 years or older with small sporadic VS (≤15 mm) who underwent microsurgical resection from 2018 to 2023.

Microsurgical resection via a middle cranial fossa (MCF) or retrosigmoid (RS) approach.

Postoperative HP (word recognition score ≥ 50%) and facial nerve function.

Of the 230 consecutive patients with small sporadic VS who elected to undergo microsurgical resection, hearing was preserved in 61% of patients. When stratified by tumor size, patients with tumors ≤10 mm had a 72% hearing preservation rate. On multivariate analysis, the most important prognostic factors for hearing preservation were the presence of preoperative vertigo (OR, 0.33; 95% CI, 0.17-0.52) and tumor size. Patients with tumors between 0 to 5 mm and 5.1 to 10 mm had 3.62 higher odds (95% CI, 1.39-9.4) and 2.52 higher odds (95% CI, 1.30-4.9) of hearing preservation, respectively, when compared to patients with tumors that were larger than 10 mm. At the time of last follow-up, a House-Brackmann (HB) 1 or 2 was maintained in 95% (n = 218) patients.

Microsurgical resection for patients with small VS is associated with good hearing preservation and excellent facial nerve outcomes. Because larger tumor size portends poorer hearing outcomes, for patients who elect to undergo microsurgical resection for hearing preservation, proactive surgical intervention when tumors are ≤10 mm should be considered to increase the likelihood of hearing preservation.

This article examines variables that predict mental health care enrollment and engagement among refugees. The authors explore a mental health care model designed to identify mental health needs early among refugee arrivals that may interfere with adjustment and overall health outcomes using data from a Midwest refugee resettlement program. Using ecological models of mental distress and theories on help-seeking behaviors, the authors used logistic and count regressions to predict enrollment in mental health care services and utilization rates. Gender, nationality, and presenting problems were significant predictors of enrollment and length of engagement in services. The findings provide guidance to practitioners and resettlement agencies on refugee mental health and opportunities to increasing access and engagement in mental health care.

Background and objectives Hypertension is a major public health concern, contributing significantly to cardiovascular diseases, stroke, and chronic kidney disease. The burden of hypertension is increasing, particularly in low- and middle-income countries, due to lifestyle transitions, urbanization, and dietary changes. Kerala, despite its better health indicators, has a higher prevalence of hypertension compared to the national average, warranting targeted research and interventions. This study aims to determine the prevalence of hypertension among adults in Ernakulam district, Kerala, and to assess its association with sleep quality and other risk factors. Materials and methods A community-based cross-sectional study was conducted among 1,110 adults aged ≥30 years in Ernakulam district, Kerala, from September 2021 to March 2022. Cluster sampling using the probability proportional to size method was employed, selecting 30 clusters with 37 participants each. Data on sociodemographic characteristics, lifestyle factors, comorbidities, and sleep quality were collected using a structured questionnaire. Hypertension was defined per the Eighth Joint National Committee (JNC 8) guidelines based on blood pressure (BP) measurements obtained using a validated digital monitor. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a score of >5 indicating poor sleep quality. Consumption of caffeinated drinks was recorded based on self-reported intake of tea, coffee, soft drinks, or energy drinks, categorized into <2 cups, 2-4 cups, and >4 cups per day. Dyslipidemia, diabetes, and other comorbidities were self-reported based on prior medical diagnoses. Socioeconomic status (SES) was determined using the Kerala Public Distribution System's ration card classification, with above poverty line (APL) and below poverty line (BPL) as categories. Data were analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States), with multivariable logistic regression performed to determine associations between hypertension and risk factors. Statistical significance was set at p < 0.05. Results The mean age of participants was 54.46 ± 14.22 years. The prevalence of hypertension was 49.8% (95% CI: 49.34%-50.25%). Significant risk factors included poor sleep quality (aOR = 2.14, p < 0.001), consumption of caffeinated drinks (aOR = 11.43, p < 0.001), higher SES (aOR = 2.14, p < 0.001), and dyslipidemia (aOR = 12.804, p < 0.001). Conclusion Nearly half of the adult population in Ernakulam district has hypertension. Addressing modifiable risk factors such as poor sleep quality, caffeine consumption, higher SES, and dyslipidemia is crucial in hypertension prevention strategies.