Search Results (115)

The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. Full article

Background: Diagnostic delay and error represent pervasive problems in healthcare with grave implications for treatment and prognosis. Though characteristic of human cognition, cognitive biases commonly contribute to delays in the physician decision-making process, particularly in atypical or complex presentations in youth. Methods: We present a case series of three adolescent athletes with varied clinical presentations whose diagnostic conceptualization and treatment were delayed in part due to cognitive biases with consequences for overall health and development, as well as return to sport. Results: The first case depicts how an atypical presentation of celiac disease was attributed to growing pains, illustrating the contribution of anchoring bias and confirmation bias in medical decision making. The second case represents the misattribution of chronic exertional compartment syndrome pain to growing pains and post-exercise soreness, highlighting the influence of ascertainment bias on the initial misdiagnosis. The third case describes how a vertebral mass was misdiagnosed as a left shoulder strain from weightlifting, depicting the contribution of anchoring bias and ascertainment bias in medical decision making. Conclusions: Early recognition of cognitive biases, including confirmation bias, anchoring bias, and ascertainment bias, is crucial for improving medical decision making, particularly in cases of rare or atypical presentations, reducing unnecessary diagnostic delays, and setting more realistic patient expectations. Through discussion of these cases, we highlight concrete steps to manage bias to facilitate timely diagnosis within the primary care and sports medicine setting. Full article

Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial minorities, and those with inadequate insurance coverage, who face significant barriers in accessing comprehensive cancer care. This manuscript explores the multifaceted nature of these disparities, examining the roles of socioeconomic status, race, ethnicity, and insurance status in influencing cancer care access and outcomes. Historical and contemporary data highlight that minority racial status correlates with reduced clinical trial participation and increased cancer-related mortality. Barriers such as insurance coverage, health literacy, and language further hinder access to cancer treatments. Addressing these disparities requires a systemic approach that includes regulatory reforms, policy changes, educational initiatives, and innovative trial and treatment designs. This manuscript emphasizes the need for comprehensive interventions targeting biomedicine, socio-demographics, and social characteristics to mitigate these inequities. By understanding the underlying causes and implementing targeted strategies, we can work towards a more equitable healthcare system. This involves improving access to high-quality care, increasing participation in research, and addressing social determinants of health. This manuscript concludes with policy recommendations and future directions to achieve health equity in cancer care, ensuring optimal outcomes for all patients. Full article

Background/Objectives: Endometriosis, a chronic and debilitating gynecological disorder, exacts a heavy clinical and socioeconomic toll on women’s lives. Despite its prevalence, its timely diagnosis and effective management are hindered by pervasive knowledge gaps among frontline nursing professionals, and these are especially pronounced in under-researched regions such as Al-Jouf, Saudi Arabia. Aim: Guided by the Knowledge–Attitude–Practice model, this study aimed to assess the level of endometriosis-related knowledge among nurses in the Al-Jouf region of Saudi Arabia and to identify the sociodemographic and professional determinants of knowledge levels. Methods: A cross-sectional, descriptive-analytical design was employed between January and July 2024, enrolling 215 nurses from a principal maternity and children’s hospital and two primary healthcare centers in Sakaka. A rigorously validated, bilingual 20-item questionnaire assessing four domains (definition, risk factors, clinical manifestations, and treatment goals) was administered. Data were analyzed using descriptive statistics, multiple linear regression, and binary logistic regression to elucidate predictors of knowledge. Results: A concerning picture emerged: 61% of participants scored below 60% (indicative of low knowledge), with only 6% achieving high scores. Higher educational attainment proved the strongest predictor (β = 0.415, p < 0.001), followed by age (β = 0.232, p < 0.001), years of experience (β = 0.149, p = 0.041), and direct patient care exposure (β = 0.168, p = 0.021). Collectively, these factors explained 37.6% of the variance in knowledge scores, underscoring a critical deficit in endometriosis management preparedness. Conclusions: The stark deficiencies in endometriosis knowledge among nurses in Al-Jouf call for immediate, tailored educational and policy interventions. Strengthening clinical competencies is essential for fostering early diagnosis and improving care outcomes for women burdened by this complex condition. Full article

Weight stigma remains a pervasive issue in contemporary society, impacting individuals’ psychological well-being, social inclusion, and access to opportunities. This study explored the lived experiences of overweight women, focusing on body image, stigma, and engagement with dominant health and beauty norms. Using a qualitative, phenomenological approach, online in-depth interviews were conducted with 14 women aged 25 to 51, primarily residing in southern and eastern Europe (Greece, Cyprus, Albania, Romania, and Bulgaria), with three participants from the United Kingdom. Thematic analysis revealed four key themes: workplace discrimination, pressures during pregnancy and the postpartum period, ambivalence toward body positivity movements, and the emotional toll of stigma, including extreme coping strategies. Participants described being marginalized professionally, scrutinized publicly and within families, and caught between ideals of inclusivity and persistent societal rejection. The findings emphasize the psychological burden of weight-based discrimination and the superficial nature of many body acceptance campaigns. This study calls for structural changes in healthcare, media, and employment practices to support body diversity and dismantle entrenched biases. By centering the voices of overweight women, the research contributes to broader discussions on embodiment, social justice, and intersectionality within the field of body image scholarship. Full article

Background: Misdiagnosis, defined as the incorrect identification of a condition or the failure to identify a condition altogether, can lead to delayed treatment, unnecessary interventions, and avoidable morbidity and mortality. Ehlers–Danlos Syndrome (EDS) is a complex pain disorder that is often misdiagnosed or underdiagnosed due to lack of awareness among healthcare providers and variability in diagnostic criteria. Objectives: This study aimed to determine the misdiagnosis rate of hypermobile EDS (hEDS) with psychiatric disorders by physicians who are not board-certified in psychiatry. Methods: Between January 2010 and December 2018, the medical records of 429 patients who were diagnosed with hEDS were reviewed and analyzed. During the process of taking a history, patients were asked if they had previously been told by physicians who were not board-certified in psychiatry that their symptoms were “in their head”, that they were “making it up” or seeking attention, or that they might suffer from Munchausen syndrome by proxy or a factitious disorder, or if such physicians had diagnosed them with conversion disorder. The Brown University Human Research Protection Program determined that the proposed activity was not research involving human subjects. Results: A retrospective chart review was conducted. Among the 429 patients, 405 patients (94.4%) said yes to at least one of the questions, with only 24 patients (5.6%) not having been misdiagnosed with psychiatric illnesses. A total of 378 patients (88%) were told that they were “making it up”, 326 patients (76%) were told that they were attention-seeking, 286 patients (67%) were diagnosed with conversion disorder, 255 patients (60%) were told that “it was in their head”, and 16 patients (4%) were diagnosed with Munchausen syndrome by proxy or a factitious disorder. Conclusions: Misdiagnosis of Ehlers–Danlos Syndrome is a pervasive issue with profound implications for patients’ physical, mental, and economic well-being. By addressing the underlying causes of misdiagnosis and implementing strategies for improved recognition, the healthcare system can significantly enhance outcomes for individuals who are affected by these complex disorders. Full article

Adolescents living with HIV (ALHIV) (10–19 years) make up approximately 4.2% (320,000) of people living with HIV in South Africa. Adolescence is a developmental period characterized by pervasive biological, social and psychological changes, which challenges adherence and retention in care for ALHIV on antiretroviral therapy (ART). Further, as ALHIV grow “older”, they are expected to transition to the adult HIV treatment programme, where they should assume greater responsibility for managing their chronic condition and healthcare pathway. Whereas it is imperative that ALHIV are transitioned when they are ready, little is known about the challenges and experiences of ALHIV before and during transition. The aim of this paper was to report on the experiences and challenges of transition for ALHIV who received ART at an adolescent-friendly service that is adjunct to a public primary healthcare facility in the Western Cape province of South Africa. Methods: Photovoice methods were employed to explore the transition experiences of ALHIV on ART at a “supportive transition” public health facility in the Cape Town Metro in South Africa. Participants took pictures that depict their experience pre- and during transition to adult care and discussed these in groups with peers. Audio data were digitally recorded and transcribed verbatim and subjected to thematic analysis using Atlas.Ti version 24. Results: The emergent themes described their apprehension to transitioning to adult care; self-management; challenges to adherence; the need for psychosocial support; and how adolescent-friendly services were filling the gap. Conclusions: We illuminate the “I-We-I” configuration, to reflect (the first “I”) individual ALHIV experiences as isolated before being transferred to the supportive facility; how they experience a sense of belonging and family (“we”) in the supportive facility; but face apprehension about transitioning to adult care in the local clinic, where they have to self-manage (final “I”). Full article

Musculoskeletal disorders represent one of the most pervasive health concerns that drive frequent medical consultations and pharmacy encounters. Community pharmacies are well placed to help address this demand as they are accessible settings for healthcare advice and support for patients with musculoskeletal disorders complaining of pain. Heat therapy stands as a valuable component of a multimodal approach to the management of musculoskeletal pain by virtue of multiple effects: pain relief, reduction of muscle spasms and stiffness, and enhanced muscle flexibility and range of motion. However, there is limited guidance on heat therapy use in routine practice, particularly on indications and contraindications, mode of application, and precautions. Such an educational gap has been documented among pharmacists. Therefore, it is paramount that pharmacists gain knowledge about when and how to effectively integrate superficial heat therapy with both pharmacological and physical therapy, to provide patients with a comprehensive, multimodal approach to alleviating musculoskeletal pain. A multidisciplinary panel of experts gathered to develop practical guidance on heat therapy-appropriate application in patients with musculoskeletal pain. In this work, we provide actionable suggestions to build pharmacists’ competency in managing musculoskeletal pain and empower them in effectively using heat therapy as a single therapeutic option or in combination with over-the-counter analgesics. Full article

Background: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health intervention, this vulnerable group is often overlooked in policy and practice. Understanding the factors compromising vaccine equity for these children is critical to reducing zero-dose prevalence and improving health outcomes. Methods: This scoping review examined peer-reviewed, gray literature from 2010 to 2024. Searches were conducted in PubMed, Google Scholar, and relevant organizational reports (WHO, UNICEF). Studies addressing children with disabilities and focusing on immunization barriers, interventions, or lessons learned were selected. English-language publications were screened in title/abstract and full-text stages. Key data extracted included population, barriers, and immunization outcomes. Since this review focused on articles in English, this is a key limitation. Results were synthesized thematically to identify recurring patterns and to guide improved interventions and policies. Results: Twelve articles met the inclusion criteria. Key barriers identified were inadequate healthcare infrastructure, insufficient provider training, limited follow-up services in rural regions, societal stigma, and pervasive misconceptions around both disability and vaccines. Factors such as maternal education, logistical support for caregivers, and using low-sensory, inclusive vaccination settings were consistently linked with better outcomes. Effective strategies included mobile vaccination units, tailored interventions (e.g., distraction or sedation techniques), school-based immunization programs, and robust community engagement to address stigma. Lessons learned underscored the importance of flexible, individualized care plans and empowering families through transparent communication. Conclusions: Children with disabilities continue to experience significant gaps in immunization coverage, driven by intersecting barriers at the individual, health system, and societal levels. Scaling tailored interventions, inclusive policies, strengthened infrastructure, and ongoing research can help ensure these children receive equitable access to life-saving vaccinations. Full article

The exponential growth of connected devices and sensor networks has revolutionized data collection and monitoring across industries, from healthcare to smart cities. However, the true value of these systems lies not merely in gathering data but in transforming it into actionable intelligence. The integration of IoT, cloud computing, edge computing, and AI offers a robust pathway to achieve this transformation, enabling real-time decision-making and predictive insights. This paper explores innovative approaches to combine these technologies, emphasizing their role in enabling real-time decision-making, predictive analytics, and low-latency data processing. This work analyzes several integration approaches among IoT, cloud/edge computing, and AI through examples and applications, highlighting challenges and approaches to seamlessly integrate these techniques to achieve pervasive environmental intelligence. The findings contribute to advancing pervasive environmental intelligence, offering a roadmap for building smarter, more sustainable infrastructure. Full article

In the years following the global emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, researchers have become acutely aware of long-term symptomology associated with this disease, often termed long COVID. Long COVID is associated with pervasive symptoms affecting multiple organ systems. Neurocognitive symptoms are reported by up to 40% of long COVID patients, with resultant effects of loss of daily functioning, employment issues, and enormous economic impact and high healthcare utilization. The literature on effective, safe, and non-invasive interventions for the remediation of the cognitive consequences of long COVID is scarce and poorly described. Of specific interest to this narrative review is the identification of potential interventions for long COVID-associated neurocognitive deficits. Articles were sourced from PubMed, EBSCO, Scopus, and Embase following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles published between the dates of January 2020 and 30 June 2024 were included in the search. Twelve studies were included in the narrative review, including a feasibility study, a pilot study, a case series, a case study, and an observational study, in addition to three randomized clinical trials and four interventional studies. Overall, treatment interventions such as cognitive training, non-invasive brain stimulation therapy, exercise rehabilitation, targeted pharmacological intervention, and other related treatment paradigms show promise in reducing long COVID cognitive issues. This narrative review highlights the need for more rigorous experimental designs and future studies are needed to fully evaluate treatment interventions for persistent cognitive deficits associated with long COVID. Full article

Domestic violence (DV) is a pervasive issue with significant implications for public health, yet it remains under-addressed in healthcare systems. Pharmacists, as accessible healthcare providers, are in a unique position to identify and support individuals affected by DV, but training in this area is often lacking in pharmacy education. This study explores the challenges of and opportunities for integrating DV education into the pharmacy curriculum by interviewing twelve pharmacy educators from Monash University. Using semi-structured interviews, data were analyzed thematically to identify key barriers and facilitators. The findings highlight several benefits of integrating DV education, including pharmacists’ accessibility to patients and their ability to play a vital role in recognizing and responding to DV. However, challenges such as time constraints, lack of confidence, insufficient training, and perceived limitations on pharmacists’ scope of practice were noted. Ethical and legal concerns regarding pharmacists’ roles in DV cases were also identified. This study concludes that integrating DV education into pharmacy curricula is essential; however, it requires significant barriers to be overcome, including the need for specialised training and collaboration with DV experts. This study recommends interdisciplinary workshops and greater faculty support to equip future pharmacists with the necessary skills to address DV effectively. Full article

Adherence to therapy, defined as the extent to which a patient follows prescribed therapeutic recommendations, is a pivotal factor in the effective management of chronic diseases such as diabetes, hypertension, and cardiovascular conditions. This review highlights the profound influence of adherence on clinical outcomes, healthcare costs, and patient quality of life. Despite its critical importance, non-adherence remains a pervasive challenge globally, contributing to suboptimal treatment results, higher rates of complications, increased hospitalizations, and substantial healthcare expenditures. This narrative review examines the multifaceted impact of adherence, focusing on its role in achieving clinical efficacy, mitigating economic burdens, and enhancing patient well-being. The findings reveal that poor adherence exacerbates the risk of disease progression, complications, and higher healthcare costs. Conversely, improved adherence promotes better disease control, fewer complications, and enhanced patient quality of life. Interventions such as patient education, streamlined treatment regimens, and the integration of digital health tools have shown promise in addressing adherence barriers. Furthermore, the role of healthcare professionals is underscored as fundamental, with their continuous support, effective communication, and efforts to build patient trust being essential to fostering better adherence. In conclusion, adherence significantly affects clinical outcomes, healthcare costs, and patient quality of life. Addressing barriers to adherence requires a comprehensive and personalized approach, considering individual patient needs and circumstances. Future research should prioritize the long-term evaluation of emerging technologies and the development of tailored strategies to improve adherence across diverse patient populations. Strengthening adherence is not only crucial for individual patient outcomes, but also for enhancing the sustainability and efficiency of healthcare systems. Full article

The rapid advancement and widespread adoption of artificial intelligence (AI) across diverse industries, including healthcare, finance, manufacturing, and retail, underscore the transformative potential of AI technologies. This necessitates the development of viable AI model marketplaces that facilitate the development, trading, and sharing of AI models across the pervasive industrial domains to harness and streamline their daily activities. These marketplaces act as centralized hubs, enabling stakeholders such as developers, data owners, brokers, and buyers to collaborate and exchange resources seamlessly. However, existing AI marketplaces often fail to address the demands of modern and next-generation application domains. Limitations in pricing models, standardization, and transparency hinder their efficiency, leading to a lack of scalability and user adoption. This paper aims to target researchers, industry professionals, and policymakers involved in AI development and deployment, providing actionable insights for designing robust, secure, and transparent AI marketplaces. By examining the evolving landscape of AI marketplaces, this paper identifies critical gaps in current practices, such as inadequate pricing schemes, insufficient standardization, and fragmented policy enforcement mechanisms. It further explores the AI model life-cycle, highlighting pricing, trading, tracking, security, and compliance challenges. This detailed analysis is intended for an audience with a foundational understanding of AI systems, marketplaces, and their operational ecosystems. The findings aim to inform stakeholders about the pressing need for innovation and customization in AI marketplaces while emphasizing the importance of balancing efficiency, security, and trust. This paper serves as a blueprint for the development of next-generation AI marketplaces that meet the demands of both current and future application domains, ensuring sustainable growth and widespread adoption. Full article

Hospital inpatient care relies on constant monitoring and reliable real-time data. Continuous improvement, adaptability, and state-of-the-art technologies are critical for ongoing efficiency, productivity, and readiness growth. When appropriately used, technologies, such as blockchain and IoT-enabled devices, can change the practice of medicine and ensure that it is performed based on correct assumptions and reliable data. The proposed electronic health record (EHR) can obtain context information from beacons, change the user interface of medical devices according to their location, and provide a more user-friendly interface for medical devices. The data generated, which are associated with the location of the beacons and devices, were stored in Hyperledger Fabric, a permissioned distributed ledger technology. Overall, by prompting and adjusting the user interface to context- and location-specific information while ensuring the immutability and value of the data, this solution targets a decrease in medical errors and an increase in the efficiency in healthcare inpatient care by improving user experience and ease of access to data for health professionals. Moreover, given auditing, accountability, and governance needs, it must ensure when, if, and by whom the data are accessed. Full article