Search Results (422)

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

Background: Vaccine hesitancy (VH) represents a growing concern among healthcare professionals and students, potentially undermining public health efforts. Nursing, pediatric nursing, and midwifery students are future vaccinators and educators, making it essential to understand their attitudes, knowledge, and confidence toward vaccination. This study aims to assess vaccine-related perceptions and behaviors among these student populations in an Italian university. Methods: A cross-sectional survey was conducted between November 2022 and February 2024 at the University of Rome “Tor Vergata”. A structured, anonymous questionnaire, including the Vaccination Attitudes Examination (VAX) scale, vaccine knowledge items, and sources of information, was administered to students in nursing (n = 205), pediatric nursing (n = 46), and midwifery (n = 21). Statistical analyses included descriptive statistics, ANOVA, post hoc tests, and Mann–Whitney U tests. Results: Among the 272 participants, 20.6% reported refusing at least one recommended vaccine, and 18.4% delayed vaccination for non-medical reasons. Vaccine knowledge and confidence increased significantly with academic progression (p < 0.001). Midwifery students showed both the highest concern for long-term vaccine effects and the greatest confidence in vaccine safety. Institutional and scientific sources were the most trusted, though traditional and non-institutional media also influenced perceptions, particularly among midwifery students. Conclusions: Despite high COVID-19 vaccine uptake, VH persists among health professional students. Discipline-specific patterns highlight the need for early, targeted educational strategies to enhance vaccine literacy and reduce hesitancy. Tailored training may empower future professionals to become informed and credible advocates for vaccination. Full article

Background: Insomnia and excessive sleepiness are significant health problems with a complex etiology, increasingly affecting young people, especially students. This study aimed to assess the prevalence of sleep disturbances and patterns of psychoactive drug use among female Polish students. We also explored the potential impact of the COVID-19 pandemic on sleep behaviors. We hypothesized that sleep disorders are common in this group, that medical students are more likely to experience insomnia and excessive sleepiness, and that the pandemic has exacerbated both sleep disturbances and substance use. Methods: This cross-sectional study utilized a custom survey designed using standardized questionnaires—the Athens Insomnia Scale and Epworth Sleepiness Scale—that was distributed online using the Computer-Assisted Web Interviewing method. A total of 11,988 responses were collected from 31 January 2016 to 1 January 2021. Inclusion criteria were being female, having a college student status, and giving informed consent. Results: Among the 11,988 participants, alcohol use declined after the pandemic began (p = 0.001), while sedative use increased (p < 0.001). Insomnia (AIS) was associated with study year, university profile, and field of study (p < 0.001), with the highest rates in first-year and non-medical students. It was more common among users of sedatives, psychostimulants, and multiple substances. No significant change in insomnia was found before and after the pandemic. Excessive sleepiness (ESS) peaked in first-year and medical students. It decreased during the pandemic (p < 0.001) and was linked to the use of alcohol, psychostimulants, cannabinoids, and multiple substances. Conclusions: These findings highlight that female students are particularly vulnerable to sleep disorders. The influence of the COVID-19 pandemic on sleep disturbances remains inconclusive. Given the varied results in the existing literature, further research is needed. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

Background: Non-medical use of prescription stimulants is increasing among college students worldwide. While intended for ADHD treatment, many students use these substances to improve their concentration and academic performance. Despite global research, little is known about the psychological and attitudinal factors influencing such use in the Israeli academic context. Objectives: We wished to examine the relationship between self-efficacy, attitudes toward stimulant use, and actual use among Israeli college students, aiming to uncover the mechanisms behind non-medical stimulant consumption. Methods: A cross-sectional online survey was conducted among 598 students from two Israeli academic institutions. The participants completed validated questionnaires assessing their demographic characteristics, stimulant use patterns, self-efficacy, and attitudes. Results: A total of 22% of students reported using stimulants, 17% of them without a prescription. Positive attitudes significantly increased the likelihood of use (Exp(B) = 3.31, p < 0.001), while higher self-efficacy reduced it (Exp(B) = 0.69, p < 0.01). A negative correlation was found between self-efficacy and favorable attitudes (r = −0.17, p < 0.001). The mediation analysis revealed that self-efficacy influences stimulant use entirely through its effect on attitudes toward stimulants. Additionally, stimulant use was significantly more common among Jewish students (25%) compared to non-Jewish students (11%; p < 0.05) and among smokers (36%) compared to non-smokers (20%; p < 0.001). Conclusions: Positive attitudes and low self-efficacy are key risk factors for stimulant misuse. These findings underscore the need for educational interventions aimed at strengthening self-efficacy and promoting healthier coping strategies in academic settings. Full article

Medetomidine, a veterinary α2-adrenergic agonist, has recently emerged as an adulterant in the non-medical opioid supply, yet human exposure has remained poorly characterized. We conducted a pragmatic retrospective cohort analysis utilizing chart review and liquid chromatography–tandem mass spectrometry (LC-MS/MS) toxicology testing on available urine samples from patients presenting to two hospitals in Philadelphia, PA, who fit two clinical phenotypes, intoxication or withdrawal. Samples also underwent glucuronidase pre-treatment to assess impact on the yield of medetomidine and xylazine metabolite detection. Testing identified universal exposure to medetomidine (58/58 samples) via the 3-hydroxy-medetomidine (3-OH-M) metabolite, post glucuronidase treatment and variable xylazine exposure (40/58 samples). Importantly, 32% of medetomidine exposures would have been missed without enzymatic pre-treatment. Patients exhibited two distinct clinical phenotypes: intoxication, characterized primarily by sedation; bradycardia; and often hypotension, and withdrawal, presenting with life-threatening tachycardia; hypertension and often encephalopathy. Notably, clinical phenotype correlated with urinary concentrations of 3-OH-M but not xylazine. These findings underscore the critical need for heightened clinical awareness and need for contemporaneous toxicologic screening mechanisms for medetomidine exposure, emphasizing its distinct clinical presentations and the potential public health implications posed by its widespread adulteration in illicit opioids. Full article

Background: Oral isotretinoin is an effective treatment for refractory and moderate acne unresponsive to conventional therapies, considered the most effective option for such cases. Objective: This study aimed to evaluate the knowledge, concerns, and experiences of acne patients undergoing isotretinoin treatment in Qassim, Saudi Arabia, with a focus on commonly reported adverse effects. Methods: A cross-sectional study was conducted from December 2023 to February 2024 using a self-administered questionnaire. This study targeted male and female acne vulgaris patients from the Qassim region attending the outpatient dermatology clinic at King Saud Hospital (KSH). Results: A total of 131 acne patients participated. Of these, 97.7% had heard of isotretinoin, and 92.4% were aware of its side effects. The most common sources of information were colleagues, friends, or family (37.4%), followed by previous use (26%) and healthcare professionals (24%). The most frequently reported side effect was dryness (51.9%), followed by liver function changes (24.4%) and fetal abnormalities (13%). There was a significant association between educational level and knowledge of isotretinoin’s side effects (p = 0.003) and awareness of specific side effects (p < 0.001). Conclusion: Most acne patients had sufficient knowledge of isotretinoin and its adverse effects, with dryness being the most commonly reported side effect. The primary sources of information were non-medical, highlighting the need for health education to ensure informed and safe isotretinoin use. Full article

The COVID-19 pandemic sparked changes globally, as leaders scrambled to protect wellbeing and safety. With many U.S. students sent away from their campuses, undergraduate students still grappled with the time-old question: “what will I do after college,” except during an unprecedented time in history rife with heightened career uncertainty. This qualitative study presents the results of a survey administered as part of a mind–body health project conducted in the wake of the pandemic, speaking directly to undergraduate college students’ health-related career aspirations. Two open-ended survey questions—(1) what is your intended career, and (2) how (if at all) has the COVID-19 pandemic changed your perspective about your future career—were administered with thematic analysis conducted. Qualitative analysis using hybrid data and theory-driven approaches revealed several themes around an increased desire to work within health-related fields, decreased desire to work in healthcare, non-medical to medical career shift, and additional undecidedness. Connecting theory to practice, Super’s Life-Space, Life-Span Career Theory and Krumboltz’s Social Learning Theory of Career Decision-Making guide practical implications and grander discussion around career development during periods of crisis. Full article

Background/Objectives: University students are particularly susceptible to mental health issues, exhibiting a higher prevalence of insomnia and depressive symptoms compared to the general population. These mental problems adversely affect their academic performance and overall well-being. Understanding this issue is essential for developing effective prevention and intervention strategies for the academic community. The present study investigates the complex role of problematic TikTok use and insomnia in relation to depression among university students. Methods: An online cross-sectional survey was conducted between November 2024 and January 2025, involving a sample of 173 university students in Poland. The participants had a mean age of 23 years (M = 23.09, SD = 3.92), with 73.4% being women, and 49% were enrolled in medical and healthcare faculties. The questionnaire comprised a demographic survey, the Patient Health Questionnaire (PHQ-9) for assessing symptoms of depression, the Athens Insomnia Scale (AIS-8) for measuring symptoms of insomnia, and the modified Bergen Facebook Addiction Scale (BFAS) for evaluating problematic TikTok use (PTTU). The hypotheses were verified using Student’s t-test, Pearson’s correlation, and general linear model (GLM) mediation analysis. Results: The study found no significant gender (women vs. men) and faculty (medical vs. non-medical) differences in the level of symptoms of depression, insomnia, or problematic TikTok use. Insomnia, depression, and PTTU were positively inter-related. Insomnia completely mediates the relationship between PTTU and depression in university students. However, these results must be treated with caution due to the uneven gender distribution and cross-sectional nature of these studies, which limits causal relationships. Conclusions: Excessive engagement with TikTok has been associated with an increase in insomnia symptoms, which subsequently exacerbates depression symptoms among university students. Prevention and intervention strategies should prioritize reducing TikTok usage while simultaneously enhancing sleep hygiene and mental health within the academic population, irrespective of gender and university faculty affiliation. Full article

Aim: The purpose of this study is to identify the factors affecting the empathy that emergency physicians develop toward patients. Material and Method: A total of 200 physicians working in the emergency department were included in the study. The Basic Empathy Scale (BES) consists of 20 items, which are divided into two factors: cognitive and affective empathy. The study data were obtained from the surveys. Results: All empathy scores were statistically significantly higher in women than in men (p values: 0.006, 0.008, and 0.001, respectively). The affective and basic empathy scores of single individuals are higher than those of married individuals (p values: 0.032 and 0.034, respectively). The affective and basic empathy scores of individuals without children are higher than those of individuals with children (p values: 0.023 and 0.014, respectively). Individuals in medical schools show higher cognitive empathy scores compared to non-medical studying (p: 0.004). Individuals who completed special courses (communication, stress management, and empathy) have higher empathy scores compared to those who did not participate (p values: 0.002, 0.021, and 0.001, respectively). All empathy scores are similar regardless of the individual’s experience levels, satisfaction with the work environment, the patient group the individuals has more emotional ties with, or the individual’s ability to understand patients in the environment in which they work. The basic empathy scores of individuals working ≤40 h and ≥60 h are similar but less than the basic empathy scores of individuals working 41–60 h. Conclusions: Training during or after medical school and better working hours will help to improve the empathy of emergency physicians. Female, single, childless physicians have an advantage regarding empathy in the ED. For married physicians having children, more flexible working environments can increase empathy levels. Full article

Background/Objectives: The INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) network introduces an innovative model of psychogeriatric care, combining tertiary mental healthcare with primary care for older adults in low-resource settings in Greece via telemedicine. This study explores viewpoints of healthcare professionals on care delivery within the frames of old-age mental telehealth services in low-resource settings. Methods: All healthcare professionals, including 13 medical and 11 non-medical professionals from diverse healthcare units in urban, rural, and insular areas, participated in a semi-structured survey. Thematic analysis identified key insights. Results: Most participants (N = 19) highlighted the high usability of the INTRINSIC services and their high satisfaction for being members of the network (N = 17) was attributed to the collaborative delivery of integrated, specialized healthcare services in primary healthcare (N = 17). Further identified advantages of the services included the positive impact on timely care delivery (N = 6), cost effectiveness, and alleviation of hospital strain. Healthcare professionals valued the holistic approach of the INTRINSIC services to psychogeriatric care (N = 8) and their role in the improvement of it in communities in low-resource settings (N = 13). However, challenges were also reported, including the low openness and reluctance of service users (N = 7), difficulties in using the INTRINSIC digital platform (N = 5), and increased workload (N = 5). Conclusions: Despite these issues, the INTRINSIC services embody an innovative telehealth model for delivering high-quality, tertiary, mental, and cognitive healthcare services to older adults in underserved areas. Full article

Background: Effective prevention of SIDS/SUID requires a multidimensional approach. It is essential to provide targeted support for marginalized families, improve access to healthcare services, and implement policies aimed at reducing social and economic inequalities. The parallel effective way to reduce the risk of sudden unexpected infant death is through increased awareness of proper infant care. Despite the guidelines available in many countries, the risk of infant death from non-medical causes is still reported. The aim of the study was to assess awareness regarding an infant’s sleep environment and safe sleep practices among Polish caregivers. Methods: The survey was conducted among 451 mothers of infants under 18 months of age. The survey questionnaire was prepared, which consisted of single- and multiple-choice questions with closed and open answers assessing safe sleep practices. Results: Analysis of the survey responses showed that most mothers in the sample (88.9%) were aware that the supine position is the safest. According to the survey, 74.5% of respondents believed that infants should not sleep in the same bed as parents or siblings. In addition, 78.3% of those women stated that infants should sleep separately in their own bed. Despite this knowledge, almost 37.76% of female respondents still put their infants to sleep in their parents’ bed. As many as 98.4% of respondents knew that any items should not be placed in an infant’s crib. Despite this knowledge, a third of respondents still placed additional items in their baby’s crib. In the study 90.7% of women believed that breastfeeding should begin within the first hour after birth. Conclusions: Knowledge of safe sleep recommendations, including sleep environment, sleep position, and spatial organization, does not always translate into proper caregiving practices. Understanding caregivers’ motivations and how they perceive medical information is critical to effective prevention of infant sleep safety. Full article

Objective: This observational cross-sectional study aimed to comprehensively evaluate sensory–cognitive performance in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), with a focus on auditory processing, visual–perceptual abilities, visual–motor integration, and oculomotor function. The study further examined how hyperactivity, age, and gender may influence these domains. Methods: A total of 70 non-medicated children with clinically diagnosed ADHD (mean age = $9.1\pm 2.4$ years; 67.1% male), all with normal visual acuity, were assessed using four standardized instruments: the Test of Auditory Processing Skills, Third Edition (TAPS-3), the Test of Visual Perceptual Skills, Fourth Edition (TVPS-4), the Beery–Buktenica Developmental Test of Visual–Motor Integration, Sixth Edition (VMI-6), and the Developmental Eye Movement (DEM) Test. Statistical analyses included one sample and independent samples t-tests, one-way ANOVA, and Pearson correlation coefficients. Results: Participants demonstrated significantly above-average performance in auditory processing (TAPS-3: $\mu =108.4$, $std=7.8$), average visual–perceptual abilities (TVPS-4: $\mu =100.9$, $std=7.2$), slightly below-average visual–motor integration (VMI-6: $\mu =97.1$, $std=9.0$), and marked deficits in oculomotor efficiency (DEM ratio: $\mu =87.3$, $std=18.1$). Statistically significant differences were observed across these domains (t-values ranging from 2.9 to 7.2, $p<0.01$). Children with hyperactive-impulsive presentations exhibited lower horizontal DEM scores ($\mu =73.4$, $std=12.3$) compared to inattentive counterparts ($\mu =82.9$, $std=16.2$; $p=0.009$). Age and sex influenced specific subtest scores, with boys and children aged 8–9 years achieving higher outcomes in word memory ($p=0.042$) and visual discrimination ($p=0.034$), respectively. Moderate correlations were identified between auditory and visual–perceptual skills ($r=0.32$, $p=0.007$), and between visual–perceptual and oculomotor performance ($r=0.25$, $p=0.035$). Conclusions: The findings from this sample reveal a distinct sensory–cognitive profile in children with ADHD, characterized by relatively preserved auditory processing and pronounced oculomotor deficits. These results underscore the value of a multimodal assessment protocol that includes oculomotor and visual efficiency evaluations. The conclusions pertain specifically to the cohort studied and should not be generalized to all populations with ADHD without further validation. Full article

Background: Antibiotic resistance (AR) is a global public health crisis, largely driven by the misuse and overuse of antibiotics. This study aimed to assess the level of knowledge, attitude, and practice (KAP) toward AR among non-medical university students in Riyadh, Saudi Arabia and identify factors that influence antibiotic use. Methods: A cross-sectional survey was conducted with 672 students from both public and private universities in Riyadh. Data were collected using a self-administered questionnaire covering sociodemographic characteristics and KAP regarding antibiotics. Results: The findings indicated that 59.1% of students had sufficient knowledge of antibiotics, while 60% had positive attitudes, and 60.6% exhibited responsible practices. However, 40.9% of students demonstrated insufficient knowledge, and factors such as age, gender, and field of study significantly impacted KAP outcomes. Females had 65.8% higher odds of demonstrating a positive attitude toward AR prevention, compared to males, and 52% higher odds of adopting appropriate practices than males. The primary source of information on antibiotics was healthcare professionals, particularly doctors. Conclusions: These findings underscore the need for targeted educational interventions to enhance awareness and promote the responsible use of antibiotics among university students, helping to mitigate the threat of antibiotic resistance. Full article

Background: Alcohol and drugs are the most common causes of acute intoxications in children. The aim of our study was to determine changes in hospitalizations for acute intoxications, especially acute alcohol intoxications (AAIs), among children aged 0–18 at the Department of Pediatrics, University Hospital of Split from 2016 to 2021 and to compare them to results of the previous studies conducted in the same department. Methods: We collected data from hospital medical records from 1 January 2016 to 31 December 2021. According to the cause of intoxication, children were divided into two groups, those with AAIs and those with non-alcohol intoxications (non-AAIs), and four age groups, 0–5, 6–9, 10–13, and 14–18 years. We used SPSS 25 for statistical analyses with a p value < 0.05 as statistically significant. Results: There were 218 children hospitalized for acute intoxications at the Department of Pediatrics, University Hospital of Split, 71 for AAIs and 147 due to intoxications with other substances. Medicaments were the most common cause of acute intoxications (41.29%), followed by alcohol (32.57%). Among children hospitalized for drugs intoxications, there were 18.89% suicide attempts, and 88.23% of them were girls. Non-AAIs were most common among 0–5- and 14–18-year-olds. AAIs were most common among boys who were 14–18 years old. The average blood alcohol concentration was 2.15‰, and 8.45% children tested positive for drugs. A significant decrease in AAIs among all hospitalizations was detected in the observed period, especially during COVID-19, predicting a further annual decrease of 21.26%. Conclusions: Although hospitalizations for AAIs among children are decreasing, increasing intoxications with non-medical drugs and medicaments, especially those intentional as suicidal attempts, indicate that intensive work on the mental health of young people and children is necessary. Full article