Search Results (257)

Background/Objectives: Mild Cognitive Impairment (MCI), a condition between normal aging and dementia, is characterized by cognitive changes that do not significantly affect instrumental activities of daily living. The Memory Support System (MSS), an evidence-based behavioral intervention developed by the Mayo Clinic, has been shown to aid those living with MCI and their support partners in coping with cognitive challenges. However, the MSS has not been offered clinically within the Canadian context. Therefore, we conducted a study assessing the feasibility of the MSS from the perspectives of individuals living with MCI and their support partners. Methods: Participants from an institutional registry of research participants, patients, and support partners at a memory clinic, as well as members of a local Dementia Society, were approached to complete an online or paper version of a survey assessing feasibility dimensions. Responses were compared between and within groups for differences in mean scores and associations between linked binary choice response questions. Results: A total of 77 responses were received; 39 surveys were completed by participants with MCI, and 38 by support partners. Respondents found the MSS to be acceptable and practical. On average, participants thought it would be more difficult to train in using the MSS than support partners. Both groups expressed interest in the intervention. On average, participants with MCI and support partners preferred virtual MSS training to in-person and indicated more interest in participating in training over six weeks as compared to two weeks. Conclusions: Flexibility in duration and format when offering the MSS are important considerations when offering the intervention as part of a clinical program. Future research should evaluate cost-effectiveness (e.g., financial, staff resources, etc.) of the MSS approach if it were to be institutionalized in the Ontario healthcare system. Full article

Objectives: Diabetes Mellitus involves demanding challenges that interfere with family functioning and routines. In turn, family and social context impacts individual glycemic control. This study aims to identify this recursive interplay, the mutual influences of family systems and diabetes management. Design: Data was collected through a cross-sectional design comparing patients, aged 22–55, with and without metabolic control. Methods: Participants filled out a set of self-report measures of sociodemographic, clinical and family systems assessment. Patients (91) were also invited to describe their perception about disease management interference regarding family functioning. We first examined the extent to which family variables grouped dataset to determine if there were similarities and dissimilarities that fit with our initial diabetic groups’ classification. Results: Cluster analysis results identify a two-cluster solution validating initial classification of two groups of patients: 49 with metabolic control (MC) and 42 without metabolic control (NoMC). Independent sample tests suggested statistically significant differences between groups in family subscales- family difficulties and family communication (p < 0.05). Binary logistic regression shed light on predictors of explained variance to no metabolic control, in four models: Sociodemographic, Clinical data, SCORE-15/Congruence Scale and Eating Behavior. Furthermore, groups differ on family support, level and sources of family conflict caused by diabetes management issues. Considering only patients who co-habit with a partner for more than one year (N = 44), NoMC patients score lower on marital functioning in all categories (p < 0.05). Discussion: Family-Chronic illness interaction plays a significant role in a patient’s adherence to treatment. This study highlights the Standards of Medical Care for Diabetes, considering caregivers and family members on diabetes care. Full article

With the accelerating globalization and rapid development of science and technology, scientific collaboration has become a key driver of knowledge production, yet its patterns vary significantly across disciplines. This study aims to explore the disciplinary differences in scholars’ scientific collaboration patterns and their underlying mechanisms. Data were collected from the China National Knowledge Infrastructure (CNKI) database, covering papers from four disciplines: mathematics, mechanical engineering, philosophy, and sociology. Using social network analysis, we examined core network metrics (degree centrality, neighbor connectivity, clustering coefficient) in collaboration networks, analyzed collaboration patterns across scholars of different academic ages, and compared the academic age distribution of collaborators and network characteristics across career stages. Key findings include the following. (1) Mechanical engineering exhibits the highest and most stable clustering coefficient (mean 0.62) across all academic ages, reflecting tight team collaboration, with degree centrality increasing fastest with academic age (3.2 times higher for senior vs. beginner scholars), driven by its reliance on experimental resources and skill division. (2) Philosophy shows high degree centrality in early career stages (mean 0.38 for beginners) but a sharp decline in clustering coefficient in senior stages (from 0.42 to 0.17), indicating broad early collaboration but loose later ties due to individualized knowledge production. (3) Mathematics scholars prefer collaborating with high-centrality peers (higher neighbor connectivity, mean 0.51), while sociology shows more inclusive collaboration with dispersed partner centrality. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

Cervical cancer remains one of the main causes of female mortality, especially in middle- and low-income countries, despite efforts towards the implementation of global vaccination against human papillomavirus (HPV). The aim of this study was to review and compare the most recently published international guidelines providing recommendations on cervical cancer screening strategies among average and high-risk women. Thus, a comparative review of guidelines by the US Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the American Society of Clinical Oncology (ASCO), the World Health Organization (WHO), the Canadian Task Force on Preventive Health Care (CTFPHC), the Cancer Council Australia (CCA), and the European Guidelines (EG) was conducted. There is an overall agreement regarding the suggestions made for women younger than 21 and those older than 65, with all guidelines stating against routine screening, with the exceptions of CTFPHC and CCA that expand the age group to up to 70 and 75 years, respectively. Continuation of screening in older women is also suggested in those with a history of a precancerous lesion and those with inadequate screening. Most guidelines recommend routine screening at 30–65 years, while the WHO advises that screening should be prioritized at 30–49 years. HPV DNA testing is the method of choice recommended by most guidelines, followed by cytology as an alternative, except for CTFPHC, which refers to cytology only, with self-sampling being an acceptable method by most medical societies. Agreements exist regarding recommendations for specific groups, such as women with a history of total hysterectomy for benign reasons, women with a complete vaccination against HPV, individuals from the lesbian, gay, bisexual, transgender, and queer communities and women with multiple sexual partners or early initiation of sexual activity. On the other hand, the age group of 21–29 is addressed differently by the reviewed guidelines, while differentiations also occur in the screening strategies in cases of abnormal screening results, in women with immunodeficiency, those with in utero exposure to diethylstilbestrole and pregnant women. The development of consistent practice protocols for the most appropriate cervical cancer screening programs seems to be of major importance to reduce mortality rates and safely guide everyday clinical practice. Full article

The acceptance of myths about intimate partner violence against women by university students can lead to inappropriate and biased professional interventions due to their gender blindness. The aim of this study is to analyze the acceptance of myths about IPVAW among college students, considering differences by gender and degree course. To do this, we conducted a survey with 1531 first-year college students (55.8% women; mean age 18.89 years) and found that a third of the students did not reject the IPVAW myths and a third of them normalized violence. We also found a higher level of acceptance of violence minimization myths in men than in women, especially in Social Sciences and Engineering. The study reveals the need to educate future professionals about IPVAW myths, with an emphasis on minimization and normalization of violence. It also provides useful information for designing awareness programs. Full article

Introduction: Testicular cancer (TC) is diagnosed at a young age and carries a remarkably high cure rate. Hence, there is a sizeable population living in the survivorship phase. Many studies have highlighted the plight of TC survivors as a result of the late side-effects of the different therapeutic modalities used for the treatment of TC. This is the first study in Ireland to highlight the impact of TC on socio-economic health, sexual health, and fertility in survivors. Method: We performed a questionnaire-based survey, which was fully anonymised to encourage participation. Questionnaires were designed to measure the self-reported impact on social, sexual, and economic health on a five-point Likert scale (ranging from no effect to very significant effect), whereas any effect on fertility was investigated with questions regarding biological children before and after cancer with or without medical assistance. Results: A total of 83 TC survivors participated in the study. Almost half of our respondents revealed some effect on their performance at work and personal finances. Around one-third suffered an impact on career choice, job security, and their relationship with their partner. Regarding sexual health, the worst repercussions were noted on sex drive and body image perception, where close to half of the respondents reported at least some deterioration. Ejaculation and erectile function were affected in 30% of the participants. Of all participants, 17% reported issues with fertility, and the same proportion reported seeking medical help to conceive after diagnosis or treatment of TC. Conclusions: In conclusion, some TC survivors experience significant impact on their socio-economic and sexual health. Full article

Background: Fosfomycin is used as a combination partner for the treatment of severe non-urinary tract infections. Individualized dosing of fosfomycin based on therapeutic drug monitoring (TDM) has the potential to reduce drug-related adverse events (AEs). Methods: This retrospective study used routine data from patients receiving intravenous fosfomycin therapy. Plasma concentrations of fosfomycin were categorized into three different ranges: <64 mg/L, 64–128 mg/L, and >128 mg/L. Subsequently, the influence of acute kidney injury (AKI) on reaching the specific plasma concentration ranges and the occurrence of AEs was analyzed. Results: The study included 143 patients (median age 73 years, 66.4% male) with fosfomycin plasma measurements. Beta-lactam antibiotics were most frequently used in combination (62.2%), followed by tetracyclines (12.2%), cotrimoxazole (8.1%), and other agents (17.5%). Fosfomycin concentrations were >128 mg/L in 45% (36/80) of patients with normal renal function, 70.4% (38/54) of patients with AKI stages I to III, and 77.8% (7/9) of patients with renal replacement therapy. AEs occurred in 54% (77/143), mainly hypernatremia (42.6%), hypokalemia (39.9%), and gastrointestinal symptoms (19.6%), with the median fosfomycin plasma concentration being significantly higher in patients with AEs (158 mg/L vs. 131 mg/L, p = 0.01). Multivariate logistic regression analysis revealed that patients aged ≥70 years (OR 3.70, 95% CI 1.24–11.5; p = 0.02) and patients with fosfomycin plasma concentrations > 128 mg/L (OR 3.30, 95% CI 1.09–10.4; p = 0.04) had a higher risk of AEs. Conclusions: There was a significant association between high plasma exposure and the occurrence of AEs. In particular, the impact of acute renal insufficiency on fosfomycin plasma concentrations should be considered. Individualized fosfomycin dosing based on TDM and the intensive monitoring of renal function contribute to reducing drug-related side effects. Full article

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article

This study explores how ideological, relational, and sociodemographic factors predict women’s perceptions of severity and self-responsibility across different types of intimate partner violence (IPV). Using an intra-subject design, 257 women completed the measures of interest, 191 experiencing IPV and 66 non-victims, according to their responses to WHO instruments. Participants were recruited via dissemination of the study through WhatsApp, Instagram, Facebook and institutional email. The results indicated that the primary predictors of perceived severity were ambivalent sexism in physical violence; favorable attitudes toward IPV (all forms of violence); feminist identity (physical violence and controlling behaviors); dependency (psychological violence); commitment (physical sexual, and controlling behaviors); education level (physical violence); and age (sexual violence). For attributed self-responsibility, ambivalent sexism and favorable attitudes toward IPV were predictors for controlling behaviors. Commitment and dependency, being a victim and age-influenced psychological violence, whereas being a victim predicted sexual violence. In addition, physical violence is perceived as the most severe and controlling behavior, eliciting greater levels of attributed self-responsibility than other forms of IPV. These results highlight the main predictors of cognitive distortions (perceived severity of violence and attributed self-responsibility), offering insight into the processes that victims in IPV situations undergo. Full article

Three diaryliodonium dicyanoargentates(I), [MesIAr][Ag(CN)₂] (Ar = Ph 1, Mes 2, 4-MeC₆H₄ 3; Mes = 2,4,6-Me₃C₆H₂), were prepared by anion metathesis. The X-ray structural analyses for these crystals revealed C–I^III∙∙∙N≡C halogen bonds (abbreviated as XB) between I atoms of diaryliodonium cations and N atoms of cyano groups, which provide different supramolecular organization. The noncovalent nature of these interactions was studied by density functional theory (DFT) calculations and topological analysis of the electron density distribution in the framework of the quantum theory of atoms in molecules (QTAIM) at the PBE-D3/jorge-DZP-DKH level of theory both in gas phase and crystal models. The philicities of partners in these contacts were confirmed by electron localization function (ELF) projections, electron density/electrostatic potential (ED/ESP) profiles, and Hirshfeld surfaces analysis. An analysis of the available crystallographic data from the literature allows us to find other examples of σ-hole interactions including the dicyanoargentate(I) anion, and the C–X∙∙∙N≡C (X = Br, I, Te) bonding were also confirmed theoretically. Full article

Adolescents’ health risk behavior may have a longstanding impact on their later adult life and health. The aim of this cross-sectional study is to report on health risk behaviors and sexual attitudes in a sample of Mongolian adolescents (N = 312) in light of their levels of social support and well-being. Measurements were derived from the Health Behavior in School-aged Children (HBSC), including substance use and sexual behavior, whereas social support from parents and peers was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). Student well-being was evaluated using the WHO Well-Being Questionnaire (WBI-5). The frequency of current smokers was 13.1% (boys: 18.9%, girls: 10.2%; χ² = 4.61, Phi = −0.12, p = 0.032). The prevalence rate of current alcohol consumption was 11.2% (boys: 14.2%, girls: 9.7%; χ² = 1.38, Phi = −0.07, p > 0.05), similar to the nationwide results. The percentage of students who have ever had sexual intercourse was 6.4 (12.4% of boys and 3.4% of girls, χ² = 9.33, Phi = 0.17, p = 0.006), similar to Central Asian countries included in the HBSC survey. Boys were more likely to associate sexual activity with self-esteem, intimacy with a partner, and positive perceptions among peers. Conversely, girls expressed greater concern about the negative consequences of sexual activity, such as STDs and pregnancy. Social support from the family played a protective role in frequencies of smoking and drinking. However, levels of the social support subscales did not differ by the students’ relationship status or previous sexual intercourse. These results suggest that there is a need for a complex prevention program to avoid increases in Mongolian adolescents’ smoking and drinking and promote their healthy sexual attitudes and behavior. Full article

Several studies conducted worldwide have reported on the effectiveness of consistent condom use with lubricants in preventing HIV transmission and acquisition; however, men who have sex with men (MSM) in Ghana continue to be disproportionately affected by the HIV burden. They are stigmatized, discriminated against, and criminalized, leading to social isolation, reduced access to health care, and inadequate targeted interventions. The dissemination of HIV prevention tools such as condoms and lubricants is also mainly focused on the general population, and this approach overlooks the specific needs and vulnerabilities of MSM. This study aimed to determine the prevalence and associated factors of consistent condom use with lubricants among MSM in Ghana. We analyzed cross-sectional data from the Ghana Men’s Study II dataset involving 4095 MSM aged 18 years and above. De-identified data were imported into STATA (College Station, TX, USA, software version 17) for data analysis. Descriptive analysis was performed to describe relevant characteristics of the study population. Multivariable logistic regression analysis was performed for significant variables in bivariate analysis to determine the associated factors of consistent condom use with lubricants. All the statistical analyses were performed at a 95% confidence interval, with significant differences at p < 0.05. The prevalence of consistent condom use with lubricants during penetrative anal sex was highest with male partners (44.9%), followed by female partners (40.0%), and all sexual partners (38.9%), respectively. In multivariable logistic regression analysis, having a senior high school education (AOR: 1.76; 95% CI: 0.88–3.12, p = 0.039), tertiary education or higher (AOR: 2.24; 95% CI: 0.86–3.23, p = 0.041), being an insertive sex partner (AOR: 1.26; 95% CI: 1.02–1.56, p = 0.029), being a sex worker (AOR: 1.41; 95% CI: 1.00–1.98, p = 0.048), buying sex from other males (AOR: 1.32; 95% CI: 1.03–1.70, p = 0.027), being a light drinker (AOR: 0.54; 95% CI: 0.42–0.68, p < 0.001), being a moderate drinker (AOR: 0.48; 95% CI: 0.30–0.78, p = 0.003), and possessing good HIV knowledge (AOR: 1.79; 95% CI: 1.46–2.20, p < 0.001) had higher odds of consistent condom use with lubricants. Being Islamic (AOR: 0.65; 95% CI: 0.49–0.87, p = 0.004), having a low income (AOR: 0.57; 95% CI: 0.42–0.77, p < 0.001), and easy access (AOR: 0.52; 95% CI: 0.37–0.72, p < 0.001) to condoms were positively associated with consistent condom use. This study found a low prevalence of consistent condom use with lubricants among the MSM population in Ghana. The study also found a range of socio-demographic, behavioral, and structural factors associated with consistent condom use with lubricants. This calls for very specific and unique public health interventions, such as developing a predictive model to identify and mitigate barriers to consistent condom use with lubricants. Full article

Background: Dairy products contain many nutrients that are important for the human body, as they serve to maintain its physiological functions and protect against many diseases. Their consumption by older adults, however, raises certain doubts, including the risks of lactase deficiency, milk protein allergy, etc. Functional dairy products can help maintain or increase the consumption of dairy products among the elderly. This study aimed to evaluate the relationship between older adults’ habitual purchases of dairy products and their taste preferences and frequency of buying functional dairy products, physical activity, and selected socioeconomic characteristics. Materials and methods: This study was conducted between July and October 2024, among 310 people aged 60 and over in Poland. The study collected data on the frequency of buying dairy products (the PF-DP scale), preferences (the P_DP scale), physical activity (the IPAQ questionnaire), and socio-demographic and economic characteristics. The PCA identified three patterns of buying behavior. The relationship between the identified buying behavior patterns and their determinants was verified using the Kruskal–Wallis test and Chi-square. Results: It was found that high intensity of the “conventional dairy products and fats” pattern correlated with high taste preferences (Me = 8.0; p < 0.05), living with family regardless of whether with or without a partner (11.8% and 15.8%; p = 0.002), high physical activity (MET = 5975.5; p = 0.004), including movement (MET = 1803.0; p = 0.028), sports and recreational activities (MET = 1908.0, p = 0.017), and frequent purchases of different functional food groups. The financial situation described as “we have an average standard of living” was related to the high intensity of the “dairy fat” pattern (62.3%; p = 0.018) and its moderate intensity to the high activity associated with movement (MET = 1788.0; p = 0.004). More than half of the sample never purchased functional dairy products. A high intensity of the “conventional dairy products and fats” pattern was associated with more frequent purchases of functional products compared to other patterns. Conclusions: The higher physical activity of older people was accompanied by a higher intensity of the “conventional dairy products and fats” pattern and more frequent purchases of functional dairy products. An evaluation of the relationships between the determinants and buying behaviors of older people in the dairy market, especially their causal nature, requires further research. Full article

The prevalence of impaired mental health (MH) has increased in recent decades. The aim of the study was to analyze the prevalence of impaired MH amongst registered Spanish golfers using the GHQ-28 questionnaire. A cross-sectional online survey was carried out in Spain between March and August 2024 using a self-administered questionnaire on 298 adult participants. The participants were mainly men (75.1%) over 60 years of age (50.7%) who were married or with a partner (79.5%), and who were active in the job market (56%). Of the participants, 73.5% reported an improvement in MH levels attributed to the game, and 77.2% recommended golf as a way to improve MH. The prevalence of impaired MH was 6.7% (95% confidence interval [CI]: 4.1–10.2%). Differences in impaired MH were found according to age (<=45 years: 28.6%; 46–60 years: 5.0% and >60 years: 4.0%; p = 0.001), marital status (married or with a partner: 4.6% vs. other: 14.8%; p = 0.009) and time of play (morning: 3.3% vs. other: 10.3%; p = 0.015). The prevalence of impaired MH detected was low and these results indicated that such playing habits and characteristics may have a positive impact on the mental wellbeing of golf players. Full article