Search Results (112)

LGBTQ+ individuals face substance use disparities linked to minority stress. While community belongingness may buffer stress, its role is complex. This study examined divergent associations between belongingness within the LGBTQ+ community and lifetime illicit drug use versus past-year alcohol frequency among LGBTQ+ adults in Kentucky (n = 2953), a region with notably high rates of substance use. Methods: Cross-sectional online survey data were analyzed. We measured LGBTQ+ belongingness, lifetime use of cocaine/crack/heroin/methamphetamine, and past-year alcohol frequency. Logistic and linear regressions controlled for age, education, gender identity, and income. Results: Greater belongingness predicted significantly higher odds of lifetime illicit drug use (OR = 1.24) but lower past-year alcohol consumption frequency (B = −0.094). Transgender and gender expansive identity predicted significantly higher illicit drug use odds and higher alcohol frequency. Conclusions: In this Kentucky sample, LGBTQ+ belongingness showed divergent substance use associations: it was protective against frequent alcohol use but, unexpectedly, was associated with higher odds of lifetime illicit drug use. Findings highlight belongingness’s complex, context-dependent nature and the need for nuanced research and interventions considering substance type and specific vulnerabilities, particularly for TGE individuals. Full article

Background/Objectives: This study aims to compare the safety of tenecteplase versus alteplase for acute ischemic stroke. Methods: This was a multicenter, retrospective cohort study including 11 Memorial Hermann Health System hospitals in Houston from 7 December 2022 to 7 June 2023. Adults presenting with an acute ischemic stroke who received alteplase or tenecteplase were included in this study. The primary outcome was the incidence of hemorrhagic conversion after 24 h of thrombolytic administration. Secondary outcomes included door-to-needle time, incidence of a major or minor bleed, length of hospital stay, incidence of any adverse effect, modified Rankin score at discharge, patient discharge disposition, medication cost, and mortality. Results: A total of 173 patients were reviewed, with 87 patients in the tenecteplase group and 86 patients in the alteplase group. Gender, actual body weight, and use of aspirin or dual antiplatelet therapy within 24 h of thrombolytic administration were statistically disproportionate between both groups. Hemorrhagic conversion occurred in seven patients in the tenecteplase group and eight patients in the alteplase group (p = 0.79). Medication cost was statistically significant between both groups. All other secondary outcomes were similar between tenecteplase and alteplase. Conclusions: In this underpowered study, we did not observe a statistically significant difference in the rate of 24 h hemorrhagic conversion between the tenecteplase and alteplase groups. Further studies with a large sample size are warranted to assess safety outcomes. Full article

Background/Objectives: Weight loss and its subsequent regain pose significant challenges for those dealing with overweight and obesity. This study explores weight loss strategies among adults in Saudi Arabia and evaluates factors linked to weight regain. Methods: This cross-sectional study focused on adults residing in Jazan, located in southwest Saudi Arabia. Data collection was conducted using a self-administered questionnaire that assessed participants’ demographics, medical history, perceptions of body weight, weight loss methods, and the incidence of weight regain. Logistic regression was used to determine whether there were statistically significant differences related to the occurrence of weight regain. Results: A total of 368 participants reported efforts to lose weight over the past 3 years. The average age of these participants was 32.7 years (standard deviation: 11.3), and the gender distribution was almost equal. The majority of the sample (65%) voiced dissatisfaction with their body weight. Some participants employed a combination of weight loss methods, with exercise, reduced food intake, and intermittent fasting being the most frequently mentioned. The findings also indicate that a minority sought professional help, whether from a physician or a nutritionist. Over 90% claimed to have successfully lost weight at least once during their attempts, but more than half (139 individuals) experienced weight regain following their weight loss efforts. Within the univariate logistic regression, higher odds ratios of weight regain were detected among men, older participants, those living in rural areas, individuals with higher levels of education, employed persons or business owners, those with higher monthly incomes, smokers, khat chewers, and those diagnosed with a chronic condition (p values < 0.05). However, the multivariate logistic regression revealed that only residence, monthly income, smoking status, and being diagnosed with a chronic disease remained statistically significant as predictors of weight regain after adjusting for other variables (p values < 0.05). Conclusions: These findings highlight the significance of incorporating weight regain prevention into body weight management for individuals dealing with overweight and obesity. Further research is needed to evaluate specific dietary, physical activity, and psychological factors that may increase the risk of weight regain in certain participants. Full article

This article presents a structured review of literature published between 2015 and 2025 on the experiences of rural LGBTQIA+ youth. Using targeted search terms—including “LGBT*,” “rural,” “country,” “young people,” “sexual and gender minority (SGM),” “small town,” “youth,” and “students”—a research team identified 26 peer-reviewed articles that met inclusion criteria. Through team-based thematic analysis, six core themes emerged: (1) gaps in intersectional analysis, (2) mental health outcomes, (3) culturally responsive services and resources, (4) community climate and context, (5) experiences of victimization, and (6) policy. Across these themes, the review highlights the resilience, agency, and strength of LGBTQIA+ youth navigating rural environments. The literature consistently demonstrates how experiences of victimization are closely linked to mental health outcomes, while access to social support—particularly from affirming adults in systems (such as schools)—can mitigate harm and foster well-being. Implications for social work research, practice, and policy are discussed, with an emphasis on supporting LGBTQIA+ youth in U.S. Southern rural settings. Full article

Introduction/Objectives: Although desmopressin is commonly used to reduce bleeding hazards in patients undergoing kidney biopsies, its effectiveness varies among individuals. This study aims to assess the impact of desmopressin on bleeding risk and hemodynamic stability in patients undergoing kidney biopsies while also identifying potential risk factors influencing these outcomes. Methods: A retrospective study was conducted at King Abdulaziz Medical City to evaluate adult patients who underwent either native or transplant kidney biopsies. The collected data included demographics, comorbidities, demographics, desmopressin usage, vital signs, lab results, and bleeding events. Bleeding was defined as a composite outcome encompassing both minor and major bleeding. Results: Data from 210 patients who received desmopressin during kidney biopsies were analyzed alongside 200 control patients. The distribution of gender and age was comparable between the two groups. However, the types of biopsies differed significantly, with a greater number of native kidney biopsies in the desmopressin group. Desmopressin was associated with a reduced incidence of major bleeding and shorter hospital stays. Longitudinal analyses revealed significant time-dependent changes in mean arterial pressure, hemoglobin, and hematocrit, although no treatment effect was observed. Logistic regression showed no significant impact of desmopressin on composite bleeding, hypotension, or hyponatremia, though comorbidities and transplant biopsies were associated with a reduced risk of hyponatremia. Conclusions: Desmopressin was associated with fewer episodes of major bleeding and shorter hospital stays but had no direct effect on hemodynamic parameters. Nevertheless, further research is necessary to explore its long-term clinical impact. Full article

A growing knowledge base highlights the importance of accounting for a variety of social and structural determinants of health (SDOH) when understanding mental and behavioral health among adolescents and young adults. The objective of the current study is to examine patterns of self-reported SDOH deficits and characterize participant health indicators and social identity across classes. Data is from a cross-sectional national study of young people who were recruited through study advertisements on social media and surveyed online. Data were collected between June 2022 and October 2023. Eligibility included (1) ages 13–22 years, (2) living in the United States, and (3) proficient in English. Health indicators included suicide attempts, suicidal ideation, drug overdose, perceived likelihood of living to age 35, non-suicidal self-injury, recent alcohol use, and depression. Five classes of SDOH deficits were identified: (1) Economic Instability, (2) Low Overall SDOH Deficits, (3) High Social SDOH Deficits (adversity and discrimination), (4) High Economic SDOH Deficits, and (5) High Overall SDOH Deficits. Differences across class by health indicators and marginalized identity were found, with high proportions of gender minority and sexual minority youth in both the High Overall SDOH Deficit group and the High Social SDOH Deficit classes. Black youth were more likely to be part of the High Economic SDOH Deficits class. The findings encourage a public health approach that recognizes that improving the health of today’s young people must be connected to policies that reduce poverty, improve neighborhoods, and increase access to basic goods, services, and healthcare. Full article

This paper examines morphosyntactic agreement in gender and number within the spontaneous spoken discourse of Spanish-speaking adults with Williams syndrome (WS), compared to that of typically developing (TD) speakers. Data were collected through natural speech transcriptions from both WS and TD groups. The analysis was conducted using Netlang 1.0.0—a piece of corpus annotation software—based on Dependency Grammar, to capture agreement patterns among determiners, nouns, and adjectives. The findings reveal that WS speakers’ gender and number agreement patterns are closely aligned with those observed in TD speakers, with only minor variations, such as a slight tendency toward unmarked gender forms among TD participants. Additionally, error rates are low in both groups, suggesting that observed discrepancies might be due to individual variation rather than condition-specific deficits, even though the statistical power of the study is limited. These results contribute to the ongoing debate on language abilities in WS, indicating that individuals with WS produce morphosyntactic agreement similarly to individuals with TD. Further research with larger datasets is recommended to validate these results, as individual variability within the WS group underscores the need for a more nuanced approach to analysis. Full article

The decline in colorectal cancer (CRC) due to screening success in the U.S. is inconsistent across populations and age groups. CHamorus (Chamorros) and Filipinos constitute minorities in the U.S. but comprise over 70% of the population in Guam where steep increases in CRC incidence occur before the age of 50, and only 53.9% of persons have met national screening standards. This preliminary study explored knowledge, cultural beliefs, and age-specific recommendations associated with CRC and screening. Five focus groups segregated by age and gender were conducted with persons aged 40 and above. Data were collected on knowledge, attitudes, beliefs, and screening education recommendations. Focus group participants (n = 25) were predominantly CHamoru (60%), Filipino (32%), and female (56%). The mean age was 55. Participants preferred interventions that integrated storytelling from CRC survivors with emphasis on family education rather than limiting to screening-age adults. Multicoders performed an iterative collaborative analysis for the main themes: knowledge of CRC/screening primarily derives from family experiences; increased outreach is needed for men; use of personal narratives; and screening is motivated by family values and intergenerational consciousness. Findings can inform future studies on age- and culturally-tailored early detection strategies to improve CRC screening participation in Pacific populations. Full article

Background: From 1 January 2024, Poland legally banned the sale of energy drinks (EDs) containing caffeine and taurine to minors under 18. EDs are rich in stimulants, making them particularly popular among adolescents and young adults seeking energy boosts. Their consumption is associated with adverse health effects and engagement in risky behaviors. This descriptive snapshot study explores energy drink consumption, motivations, and risk perception among Polish adults. Methods: A cross-sectional, nationwide survey (N = 1121) was conducted over a three-day period using the computer-assisted web interviewing (CAWI) method. The sample was representative of the adult Polish population in terms of gender, age, and geographical location. Data collection occurred 14 months after the implementation of legal restrictions on ED sales to minors. Results: Among 1121 adults (54.3% female), 15.1% reported weekly ED consumption, 9.7% monthly, 13.3% less than monthly, and 62.0% never. Younger age (p < 0.05), male gender (aOR = 1.63 [1.25–2.13]; p < 0.001), and active occupational status (aOR = 1.63 [1.19–2.24]; p = 0.002) were significantly associated with ED use. Overall, 83.0% of respondents perceived EDs as harmful, and 87.2% supported the sales ban to minors, although only 45.6% considered the ban effective. Additionally, 31.8% had observed minors consuming EDs in the past 30 days. Sociodemographic characteristics were associated with risk perception and support for regulation: women (aOR = 1.50), individuals with higher education (aOR = 1.44), and those with good financial status (aOR = 2.35) were more likely to perceive EDs as harmful and endorse regulatory measures. Conclusions: Educational interventions should prioritize young adults, particularly males, who constitute the primary consumers. There is also a need to enhance enforcement mechanisms to limit minors’ access to energy drinks and curb their marketing and availability, thereby improving public health protection. Full article

Introduction: This study aimed to assess, through health metrics and bibliometric analysis, the global research on attitudes and social stigma of people living with HIV/AIDS and to identify research findings, gaps, and future directions. Methods: A cross-sectional bibliometric study was conducted through a structured search in different databases. Fifteen thousand four hundred and ninety-six documents were found between 1981 and 2024. Results: 83.5% were original articles, and international co-authorship was 30.66%. Since 2000, there has been an increase in research on HIV/AIDS attitudes and social stigma. The United States is the most prolific country worldwide (n = 7837 publications; 50.5%), with the highest number of prolific institutions (n = 4/5), as well as the greatest influence and relevance in research (h-index 170). The most studied topics worldwide are social support and social psychology concerning homosexuality, middle age, and youth in people living with HIV/AIDS. There was no significant correlation between the volume of publications, countries’ income levels, and the most prolific geographic regions with adult HIV prevalence, overall HIV incidence and prevalence, or antiretroviral therapy coverage in people living with HIV (p > 0.05 for all cases). Conclusions: Over the past two decades, research has shifted from human rights, legal rights, and ethics to attitudes toward healthcare, with the recent interest in pre-exposure prophylaxis, gender minorities, and intersectional stigma. The absence of strong correlations between publications volume and global health HIV-related indicators underscores the necessity of translating evidence into actionable strategies to reduce stigma and improve health outcomes. Full article

This study aimed to assess the feasibility and acceptability of the online delivery of a spiritual–mind–body (SMB) wellness intervention previously delivered and validated in person, Awakened Awareness for Adolescents (AA-A), designed for spiritual individuation among emerging-adult undergraduates. Undergraduates aged 18–25 (N = 39) participated in an open trial study. Enrollment, retention, and engagement rates were calculated to assess the feasibility of delivering AA-A online. Thematic analysis on qualitative feedback was conducted to assess acceptability. Clinical and spiritual well-being were assessed before and after AA-A delivery using self-report measures and pre-to-post-intervention changes examined. Results were compared to previous findings from AA-A delivered in person. Interactions between sexual and gender minority (SGM) status and AA-A delivery method on spiritual well-being change scores were explored. Significant improvements were seen in anxiety and post-traumatic stress symptoms and spiritual well-being. Affordances and constraints of the online format were identified across three themes. SGM students showed significantly greater improvements than non-SGM students in depression and anxiety symptoms and spiritual well-being. AA-A is feasible and acceptable in an online format and can support students’ spiritual individuation and mental health in a way that is comparable to its in-person format. Furthermore, the online format may be particularly beneficial for SGM students to actively participate and engage. Full article

Sexual and gender minority (SGM) communities experience an increased risk for sexual victimization. Because these rates are reported in aggregate, little is known about the unique experiences of sexual violence among individuals with differences of sex development/intersex variations (DSD/I). The purpose of this study is to describe the experiences of sexual victimization in adolescents and young adults (AYAs) with DSD/I as part of a larger qualitative study exploring experiences of minority stress, stigma, and resilience. Participants were recruited through multidisciplinary care clinics and DSD/I support groups in the United States and the Netherlands. Data on sexual experiences and sexual health were analyzed thematically, with a specific focus on reports of sexual victimization. Of the 20 participants, 25% reported experiences of sexual violence. Experiences were reported across gender identities and DSD/I diagnoses. Participants described experiences as (a) resulting from DSD/I, (b) exacerbated by DSD/I, or (c) healthcare practices experienced as sexual violence. Medicalization, early loss of (bodily) autonomy, and cisgender heteronormative reproductive societal norms were reported as possible factors associated with sexual victimization experiences. The sexual victimization of individuals with DSD/I appears prevalent and associated with specific risk factors and, therefore, deserves clinical and scientific attention. Full article

Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation, and access to care. This study analyzes hospitalization rates due to vaccine-preventable conditions and identifies factors contributing to an increase in these rates in the southeast United States. This study used data from four different data sources. The data covers four pre-pandemic years (2016 to 2019) and the pandemic period (2020 to 2022). The analysis categorized the numbers and rates of hospitalizations for conditions with an available preventative vaccine across three age groups: pre-school aged children, school-aged children, and adults. Comparisons between school- versus non-school-mandated vaccines and a focus on differences between rural versus urban communities, as well as demographic characteristics (i.e., gender, race, and ethnicity), are included. Chi-squared tests were used to assess differences in this descriptive part of the analysis. Linear multiple regression was used to examine the independent influence of geographic location while accounting for potential longitudinal trends and the dimensions of the SVI, including socioeconomic status, household composition, disability, minority status and language, and household type and transportation. The dataset included data from 22,797,826 inpatient episodes, including 32,358 for which the principal reason for hospitalization was a vaccine-preventable condition, not including COVID-19. The analysis shows a consistent pattern characterized by higher rates of hospitalization for counties classified as rural. The pattern holds for preschool age (p < 0.001), school age (p = 0.004), and adults (p = 0.009). The differences are statistically significant in the white population (p = 0.008); in pre-school children, school-age children, and adults (p < 0.001); in females (p = 0.08 in pre-school, and p = 0.013 in adults); and black adults (p = 0.02). The regression results confirmed the findings of the descriptive analysis, indicating significantly higher rates in rural communities. Finally, the regression analysis also showed significantly higher rates associated with greater social vulnerability. This study highlights gaps in vaccination opportunities. These gaps can be seen geographically and in terms of social vulnerability, affected by factors such as poverty, language barriers, household composition, and access to care. Hospitalizations due to immunizable diseases were found to be higher in rural areas, particularly among adults. Communities with a high SVI show a significant increase in hospitalization rates. Community-engaged vaccination outreach programs and state policies could improve vaccination rates, and therefore, public health in rural areas, reducing hospitalizations, and lowering infectious disease risks in these areas. Full article

This analysis was conducted in the context of the crisis caused by the COVID-19 pandemic, when the uncertainty and demand for food modified consumption patterns. Therefore, this study aimed to analyze variations in the expenditures allocated to pasteurized and powdered milk during and after the pandemic, considering the socioeconomic and demographic factors influencing these choices. A cross-sectional ordinary least squares (OLS) regression model was implemented using data from the National Household Income and Expenditure Survey for 2018, 2020, and 2022. The model evaluated variables such as income, household size, educational level, and gender of the household head, as well as the presence of minors and older adults at the regional level. The findings demonstrated that, in 2020, expenditure on pasteurized milk exhibited an elasticity of 0.888, suggesting heightened sensitivity to income during the pandemic period. In contrast, the elasticity of powdered milk was lower, with a value of 0.013 between 2018 and 2020, and negative values by 2022. Additionally, households headed by women, households with a higher level of education, and households with children spent more on pasteurized milk. These findings confirm the importance of milk as an essential commodity and highlight the substitute role of powdered milk in low-income households. Full article

Background/Objectives: Developing nutrition-oriented and more responsible consumer behaviors is crucial for the well-being of current and future generations. Food choice determinants and concerns of Gen Zs—also referred to as Post-Millennials, or Zoomers—were explored from a sustainable food system perspective to identify factors encouraging young people to be on the front line of this much-needed transformation. Methods: Quantitative data were collected with the use of the CAWI method from 650 adults representing Generation Z living in Polish cities. Statistical analysis identified three consumer segments, and cluster (CL) means were statistically contrasted using a one-way ANOVA with Scheffé tests for post hoc comparisons. Results: The research results indicate that the key considerations of food choice in the studied Gen Z sample are taste, price, and health. External factors, such as social media influencers and consumer trends, play a relatively minor role in decision-making. Gen Zs were more aware of the link between their eating patterns and health than the link between their eating habits and the natural environment. Members of the biggest cluster (CL3), constituting 48.3% of the total sample, declared the highest level of agreement with statements referring to links between diet, environment, and health from the food system perspective. This most allo-centered (community-oriented, altruistic) consumer segment, differing significantly with gender to other CLs was more concerned about climate change and protecting the natural environment and open to changing its dietary habits. Conclusions: Implementing research-based policy measures focusing on Generation Z, especially young women, as potential leaders and drivers of food system change is recommended. Full article