Search Results (683)

The association between COVID-19 vaccination and thromboembolic events has garnered significant research attention, particularly with the advent of vaccines based on adenoviral vectors, including AstraZeneca’s and Johnson & Johnson’s vaccines. This review underscores the uncommon occurrence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and vaccine-induced thrombotic thrombocytopenia (VITT) following COVID-19 vaccination. Although these complications are extremely rare compared to the heightened risk of thrombosis from COVID-19 infection, elements like age, biological sex, type of vaccine and underlying health conditions may contribute to their development. In addition, rare renal complications such as acute kidney injury and thrombotic microangiopathy have been documented, broadening the spectrum of potential vaccine-associated thrombotic manifestations. Current guidelines emphasize early detection, individualized risk assessment, and use of anticoagulation therapy to mitigate risks. Despite these events, the overwhelming majority of evidence supports the continued use of COVID-19 vaccines, given their proven efficacy in reducing severe illness and mortality. In addition, recent comparative data confirm that mRNA-based vaccines are associated with a significantly lower risk of serious thrombotic events compared to adenoviral vector platforms. Ongoing research is essential to further refine preventive and therapeutic strategies, particularly for at-risk populations. Full article

The development of severe SARS-CoV-2 pneumonia is characterized by extensive lung inflammation, which, in turn, leads to respiratory distress and a decline in blood oxygen levels. Hospital admission, along with intensive care or ventilator usage, becomes necessary because this condition leads to serious respiratory problems. This review aims to provide a comprehensive overview of the pathophysiological mechanisms, diagnostic methods, and current therapeutic options for pneumonia caused by the SARS-CoV-2 virus. The pathophysiological process of severe pneumonia due to SARS-CoV-2 infection is characterized by direct lung damage from viral replication, an excessive immune system response, inflammation, impaired gas exchange, and multi-organ failure. The coexistence of various medical conditions leads to substantial lung impairment, resulting in hypoxia and respiratory failure, which can ultimately lead to fatal outcomes. The diagnosis of severe SARS-CoV-2 pneumonia is made through a combination of clinical, radiologic, and laboratory findings. A multifaceted approach integrating antiviral therapy, corticosteroids, oxygen supplementation, ventilatory management, and immunomodulation is imperative to control inflammation and enhance clinical outcomes. Early intervention, meticulous monitoring, and personalized care are paramount for enhancing survival and mitigating complications in critically ill patients with COVID-19 pneumonia. Full article

Background: Spirituality is increasingly seen as a key component of patient-centered care, especially in serious illness or surgery. However, its role among surgical patients in Eastern Europe remains underexplored. Objective: To assess daily spiritual experiences among surgical patients compared to healthy individuals in the Bucovina region (northeastern Romania). Methods: This observational case-control study included 102 participants (51 surgical patients and 51 healthy controls), recruited between March 2023 and April 2024. Participants completed the validated Romanian version of the Daily Spiritual Experiences Scale (DSES). Results: Surgical patients reported significantly higher mean DSES scores (M = 66.27, SD = 16.40) than healthy individuals (M = 55.06, SD = 12.81; p < 0.001). Higher scores were also associated with female gender (p = 0.002), older age, and oncological conditions. Widowed and highly educated participants showed a trend toward higher spirituality, though it was not statistically significant. Conclusions: Surgery may intensify spiritual experiences, possibly as a coping response to perceived risk. Addressing spiritual needs in perioperative care—particularly among women, older adults, and oncology patients—could enhance holistic care and improve patient well-being. Full article

Foodborne diseases are the most common causes of illness worldwide. Bacterial pathogens, including Staphylococcus aureus, are often involved in foodborne disease and pose a serious threat to human health. S. aureus is commonly found in humans and a variety of animal species. Staphylococcal enteric disease, specifically staphylococcal food poisoning (SFP), accounts for numerous gastrointestinal illnesses, through the contamination of food with its enterotoxins, and its major impact on human health imposes a heavy economic burden in society. Commonly, antibiotics and antimicrobials are used to treat SFP. However, a range of complications may arise with these treatments, impeding the control of S. aureus diseases specifically caused by methicillin-resistant S. aureus (MRSA). Natural alternative options to control S. aureus diseases, such as bacteriophages, plant-based antimicrobials, nanoparticle-based or light-based therapeutics, and probiotics, are promising in terms of overcoming these existing problems as they are environmentally friendly, abundant, unlikely to induce resistance in pathogens, cost-effective, and safe for human health. Recent findings have indicated that these alternatives may reduce the colonization and infection of major foodborne pathogens, including MRSA, which is crucial to overcome the spread of antibiotic resistance in S. aureus. This review focuses on the present scenario of S. aureus in foodborne disease, its economic importance and current interventions and, most importantly, the implications of natural antimicrobials, especially probiotics and synbiotics, as alternative antimicrobial means to combat pathogenic microorganisms particularly, S. aureus and MRSA. Full article

Tobacco use disorder remains a leading cause of preventable mortality, with nicotine playing a central role in the development and maintenance of dependence, mainly through its action on α4β2 nicotinic acetylcholine receptors (nAChRs). Smoking cessation treatments must address both physiological withdrawal and the affective disturbances (such as anxiety, irritability, and mood lability) which often facilitate relapses. This review compares two pharmacotherapies used in smoking cessation, varenicline and cytisinicline (cytisine), with particular focus on their impact on emotional regulation, psychological symptoms, and neuropsychiatric safety. Varenicline, a high-affinity partial agonist at α4β2 nAChRs, has demonstrated superior efficacy in maintaining abstinence and is well-supported by robust clinical data, including in psychiatric populations. However, its use may be limited by adverse effects such as nausea and sleep disorders. Cytisinicline, a structurally similar but less potent partial agonist, has recently gained renewed interest due to its lower cost, favorable tolerability profile, and comparable effectiveness in the general population. Although less extensively studied in patients with serious mental illness, preliminary data suggest cytisinicline may offer a better side effect profile, particularly regarding sleep disturbances and emotional reactivity. Both agents appear to ameliorate withdrawal-related affective symptoms without significantly increasing psychiatric risk. Ultimately, pharmacotherapy choice should be guided by individual clinical features, mental health status, treatment tolerability, and resource availability. Further research is needed to establish cytisinicline’s efficacy and safety across diverse clinical contexts, particularly among individuals with severe psychiatric comorbidities. Full article

Self-forgiveness is identified as a contributor to psychological wellbeing and may serve as a mechanism through which religiosity supports mental health. There is a dearth of research on wellbeing and the role of self-forgiveness in the English-speaking Caribbean. This preliminary study explored the relationship between religiosity, self-forgiveness, and wellbeing among persons with serious mental illness (SMI), a population largely overlooked in this context. A convenience sample of 362 out-patients receiving care in Trinidad and Tobago completed self-reported measures of self-forgiveness, the Religious Commitment Inventory, and Havard’s Flourishing Measure. Inferential statistics examined group differences in religiosity and wellbeing, and predictive relationships among key variables. Among persons with SMI, higher religiosity was significantly associated with greater wellbeing (p < 0.0001). Additionally, there was greater wellbeing among those who reported a propensity to self-forgive compared to those who did not (p < 0.0001). Self-forgiveness explained a significant part of the relationship between religiosity and wellbeing. Furthermore, among the non-highly religious, self-forgiveness was also significantly associated with greater wellbeing (p < 0.001). Our findings suggest that self-forgiveness may mediate the link between religiosity and wellbeing, highlighting its potential as a therapeutic coping mechanism for individuals with serious mental illness. This study adds to the growing literature on religious coping in mental health and underscores the need for further research to clarify the mediating role of self-forgiveness. Full article

Background and aims: The Last Aid Course (LAC) has been established to enhance the discussion about dying, death and grief and to raise the public’s awareness of palliative care. The aim of this study was to explore the views and experiences of German Last Aid Course instructors with the LAC as means for Public Palliative Care Education (PPCE), including their opinion about the course content and format and practical aspects of teaching in different settings. Methods: A longitudinal mixed-methods approach was used to explore the views and experiences of the Last Aid Course instructors over a period of five years. Social space orientation was used as the framework for the data analysis. Results: The LAC participants felt empowered after the LACs. Continuing development was a characteristic of the LAC project. The positive effects of the LACs included empowerment and positive interactions between the instructors and participants. In addition, the LACs had a positive impact on all five principles of social space orientation. Conclusions: LACs can contribute to raising public awareness about dying, death, grief and palliative care and empower people to participate in caring for those who are serious ill, dying and grieving. Full article

Background/Objectives: Proper management of food services aimed at preventing malnutrition and weight loss among residents of long-term care facilities is a critical priority. Accordingly, accurate prediction of energy intake requirements is necessary. This study aimed to estimate the energy intake required to prevent weight loss in residents of Japanese long-term care facilities. Methods: Body weight and 12-day dietary intake were measured from residents aged ≥75 years with a body mass index (BMI) < 25.0 kg/m² who were consuming a regular or chopped diet. In the survey, individuals with oral intake were included, while those with swallowing problems, serious illnesses, dietary restrictions, or medications causing appetite loss were excluded. The rate of body-weight loss and the energy intake per kilogram of body weight (kcal/kg BW) during each 6-month period were calculated. The energy intake per kilogram of body weight corresponding to the rate of body-weight loss of 0% was estimated from the regression line between the rate of body-weight loss and energy intake per kilogram of body weight. Results: The data was analyzed for 99 residents (15 men and 84 women, age 89.3 ± 5.0 years, BMI 20.3 ± 2.6 kg/m²). From the regression results in all participants, the energy intake per kilogram of body weight corresponding to the rate of body-weight loss of 0% was 31.4 kcal/kg BW overall and 33.4 kcal/kg BW for those with a BMI < 18.5 kg/m². Conclusions: The calculation of energy intake using a regression line may be able to predict the energy intake required for weight maintenance without using instrumental measurements or estimation equations, especially in the case of underweight individuals. Full article

Introduction: Urinary incontinence (UI) is associated with uncontrolled urine leakage and is treated as a serious disability that prevents the fulfillment of life roles and negatively affects quality of life. Many women do not have knowledge about the nature of UI and treatment options, and the embarrassing nature of the disease makes it difficult to seek specialist care. The aim of this study was to assess quality of life among women with UI and how it affects various areas of their daily functioning. Defining factors that modify the impact of UI on quality of life can provide prognostic information about functional limitations, which will facilitate the rapid implementation of preventive and therapeutic measures. Methods: This study included 158 women with UI. Patients were asked to complete a set of questionnaires, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), Revised Urinary Incontinence Scale (RUIS), King’s Health Questionnaire (KHQ), Acceptance of Illness Scale (AIS), Inventory for Measuring Coping with Stress (Mini-COPY), and Set of Scales for Self-Assessment of the relationship with a partner. Results: Based on the analyses, it was determined that women with MUI experienced a lower quality of life, greater limitations in daily activities, and greater physical limitations compared to women with UUI and SUI. There was a correlation between the severity of UI, the duration of the disease, the level of acceptance of the disease, the education level of the subjects, and quality of life in all areas of functioning. Conclusions: Numerous functional limitations and reduced quality of life have been observed among patients with UI. As part of UI management in clinical practice, it seems reasonable to include measures aimed at identifying patients who are likely to experience more severe consequences of UI so that they can receive targeted care. Full article

Background: Indigenous peoples in Canada endure lasting effects of colonialism including racism, marginalization, and social, political, and geographic inequities resulting in disproportionate rates of disease and inequitable healthcare. Indigenous infants and children in Canada experience a high incidence of birth complications and illnesses, and families are often left to navigate the care of their child with limited resources. Accordingly, improved, culturally responsive and safe healthcare is needed to enhance child outcomes and optimize family well-being. Purpose and Methods: A qualitative study was conducted by our research team including family members of Indigenous children with serious illnesses, a Cultural Advisor, researchers, and pediatric clinicians. In one component of the study, we explored pediatric healthcare providers’ (HCPs) experiences of caring for Indigenous families of children with serious illness. A purposive sample of 19 pediatric healthcare providers took part in semi-structured qualitative interviews or one focus group. The data were analyzed thematically to identify common experiences and priorities for improved supportive healthcare. Findings: Five themes were identified representing insights from pediatric HCPs, with a focus on barriers to effective healthcare at the interpersonal, institutional, and system levels for seriously ill Indigenous children and their families. Ideas for enhancing the social and cultural responsiveness and safety of supportive healthcare were identified. Implications and Conclusions: The findings offer valuable insights and strategies for HCPs to support holistic, comprehensive, and culturally safe and responsive healthcare. Full article

Music therapy in paediatric palliative care offers a unique opportunity for emotional support, legacy creation, and therapeutic connection for children and their families. This paper describes the Heartbeats Intervention, as delivered by a paediatric palliative care music therapist at Sydney Children’s Hospital Australia. This intervention involves recording and creatively integrating the heartbeats of children and family members into personalised musical compositions. Originally inspired by music therapist Brian Schreck’s work, the intervention has evolved to meet diverse therapeutic goals, from soothing children with serious illnesses (including cancer) with recordings of their families’ heartbeats to creating legacy song tracks that support families through bereavement. Despite some logistical and resource challenges, the intervention has been well-received and continues to expand, including the integration of environmental soundscapes and broader community involvement, which allows the intervention to be experienced by a greater number of families. This paper contributes to the limited but growing literature on music therapy in paediatric palliative care, highlighting the Heartbeats Intervention as a flexible and meaningful way to enhance psychosocial support and connection for children and their families. Further research to evaluate its long-term impact and to explore children’s direct experiences of the intervention is needed. Full article

Anorexia Nervosa (AN) is a psychiatric illness with serious medical and physiological implications. Anorexia Nervosa is characterised by significant disruptions in weight, growth and physical health resulting from disordered behaviours such as food restriction, purging and inappropriate exercise. The illness is associated with substantial physical, psychological, social and economic burdens affecting all areas of functioning. Typically emerging in adolescence, AN can have a chronic course and high risk of mortality, with evidence suggesting that approximately 10% of individuals diagnosed with AN will die from medical complications or completed suicide. Whilst inpatient treatment reduces mortality risks through nutritional and weight restoration, outpatient treatment is the preferred level of intervention. In the case of adolescents, family-based treatment (FBT) is the recommended and most researched outpatient model for medically stable adolescents. However, access to FBT is limited, and there are several barriers that exist to receiving care from trained clinicians. This review provides a literature update on studies reporting the real-world access challenges for FBT, with particular attention paid to non-research settings. The review also highlights how digitally delivered treatment, specifically telehealth, has been used to increase access to FBT and examines the preliminary outcomes of telehealth-delivered FBT, which appear comparable to traditional in-person care. Despite these promising findings, provider, intervention and systemic factors have challenged the delivery of traditional in-person and telehealth FBT in real-world settings. Critical areas for future research include the need to understand the impact of potential confounders and what adaptions may be required to increase model feasibility in community settings, where access to specialist services is often limited and access challenges are most felt. Full article

Older adults make up about 12% of the public sector, primary care, and hospital use and represent a large proportion of the users of healthcare services. Older people are also more vulnerable to serious injury from unexpected falls due to tripping, slipping, or illness. This underscores the immediate necessity of stable and cost-effective e-health technologies in maintaining independent living. Artificial intelligence (AI) and machine learning (ML) offer promising solutions for early fall prediction and continuous health monitoring. This paper introduces a novel cooperative AI model that forecasts the risk of future falls in the elderly based on behavioral and health abnormalities. Two AI models’ predictions are combined to produce accurate predictions: The ${AI}_1$ model is based on vital signs using Fuzzy Logic, and the ${AI}_2$ model is based on Activities of Daily Living (ADLs) using a Deep Belief Network (DBN). A meta-model then combines the outputs to generate a total fall risk prediction. The results show 85.71% sensitivity, 100% specificity, and 90.00% prediction accuracy when compared to the Morse Falls Scale (MFS). This emphasizes how deep learning-based cooperative systems can improve well-being for older adults living alone, facilitate more precise fall risk assessment, and improve preventive care. Full article

Ensuring employee safety is a top priority for every enterprise, and it is especially critical in high-risk industries like coal mining. To achieve this goal, it is essential to focus efforts on identifying existing hazards and thoroughly assessing the associated risks. Accurate identification and detailed characterization of occupational hazards play a pivotal role in the occupational risk assessment process, providing the foundation for effective safety strategies. This article presents an analysis of the process of identifying occupational hazards in hard coal mining, based on applicable legal regulations and a review of the relevant literature. The analysis reveals, on the one hand, a diversity of approaches to hazard classification, and on the other, a limited use of the characteristic features of hazards in classification processes. The findings of this review form the basis for proposing a systematic classification of occupational hazards in hard coal mining, taking into account the specific features of hazards in relation to their sources and potential consequences. The proposed classification not only categorizes hazards but also describes the specifics of hazard sources, such as environmental conditions, machinery, chemicals, and human factors, as well as the possible outcomes of these hazards, including physical injury, health impacts, and even fatalities. The aim of this article is to present a proposed classification of occupational hazards in hard coal mining and to provide a detailed characterization of these hazards based on the description of their sources and potential consequences. The proposed approach, grounded in the identification of characteristic features of hazards, facilitates the effective selection of preventive measures that can be implemented to reduce risk and improve workplace safety. Due to the presence of the full spectrum of natural hazards in Polish hard coal mining, the analysis draws on available statistical data, focusing on those hazards that contribute most significantly to fatal accidents and serious injuries. In conclusion, the article emphasizes the importance of a structured and systematic approach to identifying and assessing occupational hazards in the coal mining industry. By drawing on legal and literature-based insights, it aims to contribute to the development of more effective safety practices that protect workers and minimize the occurrence of workplace accidents and illnesses. Full article

Air pollution is one of the most serious environmental threats, with particulate matter PM₁₀ and PM_2.5 representing its most harmful components, significantly affecting public health. These particles are primarily generated by transport, industry, residential heating, and agriculture, and are associated with increased incidence of respiratory and cardiovascular diseases, asthma attacks, and heart attacks, as well as chronic illnesses and premature mortality. The most vulnerable groups include children, the elderly, and individuals with pre-existing health conditions. This study focuses on the analysis of health risks associated with PM₁₀ and PM_2.5 air pollution in the city of Zvolen, which serves as a representative case due to its urban structure, traffic load, and industrial activity. The aim is to assess the current state of air quality, identify the main sources of pollution, and evaluate the health impacts of particulate matter on the local population. The results will be compared with selected Slovak cities—Banská Bystrica and Ružomberok—to understand regional differences in exposure and its health consequences. The results revealed consistently elevated concentrations of particulate matter (PM) across all analyzed cities, frequently exceeding the guideline values recommended by the World Health Organization (WHO), although remaining below the thresholds set by current national legislation. The lowest average concentrations were recorded in the city of Zvolen (PM₁₀: 20 μg/m³; PM_2.5: 15 μg/m³). These lower values may be attributed to the location of the reference monitoring station operated by the Slovak Hydrometeorological Institute (SHMÚ), situated on J. Alexy Street in the southern part of the city—south of Zvolen’s primary industrial emitter, Kronospan. Due to predominantly southerly wind patterns, PM particles are transported northward, potentially leading to higher pollution loads in the northern areas of the city, which are currently not being monitored. We analyzed trends in PM₁₀ and PM_2.5 concentrations and their relationship with hospitalization data for respiratory diseases. The results indicate a clear correlation between the concentration of suspended particulate matter and the number of hospital admissions due to respiratory illnesses. Our findings thus confirm the significant adverse effects of particulate air pollution on population health and highlight the urgent need for systematic monitoring and effective measures to reduce emissions, particularly in urban areas. Full article