Search Results (279)

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

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

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

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

Brief family support interventions may be an effective and acceptable option when demands on services and pressures on families can often mean intensive, long-term family support interventions are an inefficient and unappealing course of action. The purpose of this scoping review was to better understand the nature of non-medical brief interventions targeted at parents and families experiencing adversity or challenging circumstances that may lead them to seek support from family services. We used a systematic search and selection process to identify publications (papers or webpages) about brief interventions for parents and families within three academic databases and 70 websites. Publications were in scope if the interventions were targeted to parents and families, were non-medical in nature, and were brief (no longer than 10 h duration, or up to four sessions). We identified 78 papers and webpages eligible for inclusion in this scoping review, covering 46 brief interventions. Data were extracted by two researchers and charted in a spreadsheet. Most interventions were delivered in the mental health sector, followed by the education, and then community or family services sector, and most often in a clinical setting. Intervention duration varied, ranging from 45 min to a two-day workshop, and were usually aimed at improving the mental health of children and young people. Interventions were delivered to groups of parents, followed by whole families or individual parents. This review highlights the pressing need for high-quality evaluations of brief interventions for family support, and given the diversity of delivery modes, durations and conceptualisation of ‘brief intervention’ in the field and literature, further synthesis of the evidence through systematic reviews is required. This paper advances understanding and clarity on how brief interventions may be beneficial for families experiencing adversity, yet further evaluation and systematic review for acceptability and efficacy is required. Full article

Background: Tobacco use is responsible for eight million preventable deaths annually, making it a major modifiable risk factor for chronic conditions such as cardiovascular diseases, respiratory illnesses, and over 20 types of cancers. Objective: This study aimed to systematically review the barriers and facilitators of tobacco cessation interventions at both the population and healthcare system levels in the U.S. Understanding these determinants is critical for narrowing health disparities, optimizing resource allocation, and ultimately, enhancing tobacco cessation success rates across all demographic groups. Methods: A comprehensive literature search was conducted across the PubMed, Embase, and Web of Science databases, guided by the population, intervention, comparison, and outcome framework and quality assessment guided by PRISMA guidelines. Data extraction focused on study characteristics, intervention types, barriers, facilitators, and cessation outcomes at both the population and health system levels. The random effects forest plots were graphed to estimate pooled effect sizes for both medical and non-medical interventions. Results: A total of 35 studies met the inclusion criteria from an initial pool of 1555 identified records. Socioeconomic disadvantages, digital inequities, and low motivation constitute primary barriers at the individual level, while systemic factors such as healthcare access limitations, inadequate provider engagement, and lack of financial support further hinder cessation efforts. Financial incentives, culturally tailored interventions, and digital engagement strategies significantly improve tobacco cessation outcomes. Public health implications: as identified by the study, tailored interventions, the expansion of health coverage policies to include intervention, digital solutions, and healthcare resource workforce training will help improve tobacco cessation intervention outcomes. Full article

Background: Premature hair graying (PHG) is one of the most prevalent conditions affecting individuals worldwide. It has been recognized as an important cause of low self-esteem, with a significant physical and social impact. This study investigated the factors associated with PHG by comparing medical students and resident physicians to other non-medical majors at Imam Abdulrahman Bin Faisal University (IAU). Methods: This is a comparative cross-sectional study conducted on resident physicians and students from 10 different colleges of IAU, Eastern Province, Saudi Arabia. This study evaluated the characteristics of PHG and its associated risk factors using an online distributed questionnaire. Results: A total of 2644 students and resident physicians were included in this study, with 45.6% coming from medical colleges. The findings show that the premature graying of hair was higher among obese and overweight individuals and those with a combined deficiency of vitamins B12 and vitamin D. Other factors associated with PHG included a family history of PHG, a lack of exercise, smoking, and allergic rhinitis. Gray hair onset before 25 years old was higher among those with high stress levels (95%) than those with moderate (90%) and or mild (86%) stress levels (p = 0.029). Conclusions: In our study, higher stress levels were related to an earlier age of PHG onset, and there was no difference between medical and non-medical students in PHG. Recommendations for future research include randomized clinical trials and larger cohort studies regarding the characteristics of PHG in the Middle East and those with Arabic ethnicity and assessing the medications that induce possible hair repigmentation. Full article

Aims/Background: Medical education is largely clinical and biomedical with little emphasis being put upon the social determinants of health (SDH) and patient-centredness. A programme entitled “Walking a Day in My Shoes” was devised as a pilot cohort study with the view of evaluating the impact of a clinical shadowing experience upon the empathy, SDH awareness, and patient-centredness of medical students. Methods: A prospective cohort study, involving 28 final-year London-area medical students, employing a three-phase teaching programme comprising preparation, observation, and reflection was carried out. Students’ confidence in the management of non-medical barriers, SDH awareness, and empathy before and after shadowing were measured using pre- and post-shadowing questionnaires. Qualitative analysis of patient feedback and journals also occurred. Results: Statistically significant improvements were observed in students’ empathy (mean score increase from 6.8 to 8.9, p < 0.001), understanding of SDH (advanced comprehension rose from 35% to 93%), confidence in addressing non-clinical barriers (from 39% to 86%), and awareness of logistical challenges (from 31% to 81%). Qualitative analysis highlighted key themes, including systemic barriers (transportation, polypharmacy, and social isolation) and students’ increased awareness of the emotional toll of chronic illness. Patients expressed high satisfaction, with 97% agreeing that the programme improved students’ understanding of chronic disease management. These findings suggest the programme’s practicality and scalability in medical education. Conclusions: This pilot cohort study demonstrated the significant enhancement of the students’ empathy, perception of SDH, and patient-centredness preparation through immersive shadowing. The findings support the use of experiential learning programmes as curricular interventions. Full article

Introduction: Social workers play a critical role in healthcare settings by addressing both medical and nonmedical needs. Trained in human behavior and social environments, they are best suited to screen for social determinants of health (SDOH) and connect patients with resources paving the way for optimal health and well-being. Methods: This narrative review synthesizes the existing literature on SDOH screening practices within healthcare settings, emphasizing the role of social workers. A systematic search was conducted across multiple databases. A total of 26 studies met the inclusion criteria and were analyzed using a qualitative narrative synthesis approach. Results: This review reveals variability in SDOH screening domains, tools, and implementation strategies across healthcare settings. Facilitators and barriers to implementation were identified, including workflow integration, interprofessional collaboration, and contextual readiness. Social workers emerged as key professionals in addressing health-related social risks, leveraging their expertise in patient engagement, assessment, and system navigation. We further introduced the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to suggest the effective integration of SDOH screenings, emphasizing innovation, recipient engagement, contextual readiness, and facilitation. Conclusion: The effective integration of SDOH screenings requires structured workflows, interdisciplinary collaboration, and policy support. The review provides practice models of workflows for SDOH screenings and implications within two different healthcare settings: hospitals and outpatient clinics, offering insights into best practices and areas for future research. Strengthening the role of social workers in SDOH screenings can improve patient outcomes and promote health equity. Full article