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Aims: This article discusses the situation of the social medicine specialty in Skåne, southern Sweden with the aim of understanding the long-term trends of this medical specialty in Skåne and its relation to research in social medicine., Results: In the 1950s to 1980s, there was a balance between clinical and preventive practice, and research. This balance was maintained in the 1980s to early 2000s as the medical specialty and the research moved 'upstream' in the chain of causality to psychosocial, socio-economic and contextual determinants of health. The increasingly 'upstream' character of the specialty and particularly its new position in the regional organisation since 2010 may have made it more vulnerable to general executive-level reorganisations., Conclusions: The specialty should maintain its 'upstream' focus but regain its proximal scope in prevention, epidemiology and health equity. It should regain its place in the health-care system organisation or alternatively become a state-based instead of regional specialty.

Despite solid scientific evidence, the concepts of treatment as prevention (TASP) and Undetectable = Untransmittable (U = U) remain unfamiliar and underutilized for some healthcare providers. We conducted a self-completion survey to evaluate the knowledge of TASP/U = U in different medical specialties. Wilcoxon Rank-Sum, Chi-square and Fisher's exact tests were used for group comparisons and a logistic regression model was used to assess factors independently associated with U = U-non-supportive attitudes. 197 physicians were included; 74% agreed/strongly agreed that people living with HIV (PLHIV) under regular treatment with undetectable viral do not transmit HIV sexually. However, only 66% agree/strongly agree that PLHIV should be informed about that. The knowledge about these concepts was poorer among gynecologists, urologists and internal medicine specialists when compared to infectious diseases specialists after adjustment for age, race/skin color, gender, and sexual orientation. Our study found that knowledge of crucial concepts of HIV prevention may be lacking for some medical specialties. This highlights the need of improvement in medical education.

The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual description of prevention aimed at functioning on the basis of the ICF model. Starting from the ICF-based conceptual descriptions of rehabilitation as a health strategy, a conceptual description of functioning prevention has been developed. Prevention aiming at functioning is the health strategy that applies approaches to avoid or reduce risks of impairing bodily functions and structures, activity limitations and participation restrictions; to strengthen the resources of the person; to optimize capacity and performance; to prevent impairments of bodily functions and structures; to prevent activity limitations and participation restrictions; to reduce contextual risk factors and barriers, including personal and environmental factors; to promote and strengthen contextual facilitators, with the goal of enabling people with impairments and people at risk of disability; and to maintain or improve the level of functioning in interactions with the environment. The proposed concept widens the scope of prevention to all aspects of functioning, including contextual factors.

The article presents the results of the study of factors effecting on professional deformation of stomatologists and its relationship with their personal characteristics, labor experience and medical specialization. the information is compiled with purpose of elaborating comprehensive recommendations on diagnostics of phases of development of syndrome of emotional burnout in this category of medical specialists at the initial stages of its occurrence and proposing measures of its adjustment including social and personal prevention.

Background: A public health student service was set up by the French government in 2018 with the aim of increasing awareness of primary health promotion among the 47,000 students of medicine and other health professions. It is an annual program involving community-based actions on nutrition, physical activity, addiction or sexuality. Our objective was to evaluate its implementation at local level and the different experiences of the stakeholders., Methods: A quasi-experimental study using process evaluation was performed in a Faculty of Medicine in Paris. Quantitative and qualitative data were collected from medical students who carried out preventive health actions, in the institutions in which the actions took place and from a subsample of beneficiaries., Results: One hundred and eight actions were carried out by 341 students in 23 educational or social institutions, mostly high schools (n = 12, 52%). Two thirds of the students did not feel sufficiently prepared to deliver preventive health interventions (65.7%, 224/341); however the beneficiaries found that the interventions were good (278/280, 99,2%). Nineteen (83%) of the host institutions agreed to welcome health service students again, of which 9 required some modifications. For students, the reporting of a satisfactory health service experience was associated with the reporting of skills or knowledge acquisition (p < 0.01). Delivering actions in high schools and to a medium-sized number of beneficiaries per week was associated with students' satisfaction. No effect of gender or theme of prevention was observed. For 248/341 (72.7%) students, the public health service program prompts them to address prevention issues in the future., Conclusion: The public health service undertaken by medical students through the program is a feasible and acceptable means of delivering preventive actions. Reinforcement of training and closer interaction with the host institutions would improve results.

Suicide is among the most important causes of mortality in medicine as it is the most common cause of death due to illness from the teenage years into middle age. Yet our approach to mental health research aimed at suicide prevention has often diverged from accepted practices in other areas of medicine. This includes the exclusion of those at highest risk of suicide from clinical trials and the recent emphasis on prediction. In this Viewpoint, we propose that comparing our approach to that of other medical specialties would help us to avoid strategic errors and discuss the implications for the field of suicide prevention.

Academic research trends involving public health education may reflect a certain degree of talent construction status. This study systematically reviews the data for published literature on graduate public health education, aiming to provide evidence for the optimization of public health postgraduate training mechanisms in China. Keyword cooccurrence analysis was performed based on high-frequency keywords. From 1992 to 2008, the annual number of publications in this field was relatively low in China, averaging fewer than 5 articles. The number of publications showed a steep increase after 2009. The publications were mostly from single research institutions, including comprehensive universities and military medical universities, concentrated in Beijing and Shanghai. The high-frequency keywords were public health and preventive medicine, postgraduate training, professional degree, MPH, curriculum, and teaching reform. Hotspots consisted of practical teaching research, training, educational reform and comparative education research. Research on public health postgraduate education has not reached scale and has insufficient support. Moreover, many problems in graduate public health education still cannot be solved by existing studies: authentic and practical learning, a unified approach to cultivate graduate students, organizational change of graduate public health education, and international cooperation and public health education.

This study examines the quality of entry translation in Dorland's Medical Dictionary (DMD) containing mistranslation and maltranslation. This embedded-case study used DMD human-based and website mistranslation leading to maltranslation. The purposively selected data were 111 tropical medicine related the entries and its definition inserted in the "Kamus Kedokteran Dorland Edisi 31" and the website translated by Google Translate. The translation techniques and assessment of the quality were processed in a Focus Group Discussion. The rational how a mistranslation raised maltranslation was based on the basic medical science when a doctor examined, diagnosed, treated, promoted and prevented diseases for the benefit of patients. Findings show that 111 entries made up of 158 human-based translated sentences are composed of 2816 units of translation, and the 162 Google Translate sentences for 3054 units. There are 18 translation techniques in human-based translation, 16 in Google Translation, 80 mistranslations leading to 57 maltranslations causing incorrect diagnosis, mistreatments, and misdirection of health promotion and prevention of disease. Of 40 tokens, maltranslation occurs 32 times and human-based translation 25 times, implying low quality of the translation that requires improvement of the definition, word entries, and sentences in the website.

In pandemic crises such as the COVID-19 pandemic, individuals' behavior has a strong impact on epidemiological processes. Compliance with prevention guidelines, such as social distancing, is critical to avoid further spreading an infectious disease or to slow down its spread. However, some individuals also or instead engage in panic behavior, such as hoarding. We investigate how education prepares individuals to respond adequately by modelling the path from seeking information about COVID-19 to eventual behavior. Based on a sample of N = 1182 adult Americans, gathered at the pandemic's onset (March 2020), we conclude that science knowledge helps individuals convert information into coronavirus knowledge. This knowledge then helps individuals avoid panic behavior. Individuals lacking coronavirus knowledge and science knowledge still comply with prevention guidelines when they have a general trust in medicine. Individuals lacking knowledge still follow prevention guidelines when they trust in medicine. Facilitating science knowledge and trust in science through education and targeted public health messaging are likely to be of fundamental importance for bringing crises such as the COVID-19 pandemic under control.

Society has shifted issues of subjective and social reality of the population into the medical field, with the obsession with perfect health becoming a predominant pathogenic factor in the increase in the number of diseases and patients, while the level of health in the population is improving. The power of medicine has made the idea of «medicalising» various aspects of life that can be perceived as medical problems as attractive even when it is not the case. Living entails times of unhappiness and anguish but, should we treat these episodes? We are in the health culture of «everything, here and now». In this article, the ethical implications of unnecessary interventions are analysed, along with the different alternatives that the professionals involved may perform to redirect this situation. It is reflected if we want a world where we all risk wearing labels for this or that disease., (Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.)

Context: Athletic trainers must develop the knowledge and skills to recognize signs and symptoms of dermatologic conditions in the physically active population. Objective: To present an overview of an educational technique aimed at promoting the development of skills related to dermatological care that meets clinical practice needs and accreditation requirements for athletic training programs at all levels. Background: Curricular content standards in athletic training education require learners to obtain the skills necessary to perform an evaluation, formulate a diagnosis, and establish a plan of care relevant to the integumentary system, including dermatological conditions. Cognitive Learning Theory uses specific sequencing of content and learning sessions to promote student engagement in the learning process. Description: Within an evaluation course for nonorthopaedic conditions, a 3-class session learning module was developed to target instruction, application, and assessment of dermatological conditions. This article describes the development, overview of content, delivery methods, outcomes to date, and connection to the instructional standards in athletic training. Clinical Advantage(s): Integrating evaluation of dermatological conditions into athletic training curricula enhances clinical decision-making skills and direct application of these skills to clinical practice. Conclusion(s): Athletic trainers should be able to effectively identify, manage, and potentially refer patients with dermatological conditions. Educating future athletic trainers to be able to prevent the spread of infection, decrease disease transmission, and enhance their ability to recognize and manage dermatological conditions is vital to their development toward independent clinical practice.

Purpose: Health-related issues are widely covered in news agencies by medical and health journalists. The quantity, format and quality of their coverage influence the general public as well as policymakers and professions. Current studies and observations suggest that news agencies are more dominated by medical topics (disease, symptoms, epidemiology, treatment and medicines) than general public health issues (risk prevention, health protection, education and promotion). This study explores the causes of the current situation in Iran and generates solutions for supporting health-promoting media that may also prove beneficial for other countries. Design/methodology/approach: A qualitative study was conducted to explore the coverage of health-related topics in selected news agencies. Stakeholders, including health journalists, health professionals and public relations staff at the Iranian Ministry of Health and Medical Education were interviewed. Data were collected until data saturation was reached. The transcripts of all the 17 interviews conducted were analyzed using conventional content analysis. Findings: Four groups of causes were identified, including individual factors, organizational factors, socioeconomic factors and the different nature of medicine and public health. The participants proposed several solutions that were classified into three categories, including the empowerment of stakeholders through capacity development, organizational change and mutual communication and culture change. Originality/value: Creating health-promoting media is a complex but urgent task, and providing a comprehensive and deep understanding of the dynamic interdependencies of the multiple factors at play in it and developing and implementing the most effective interventions for it requires a systematic approach.

The search for new methods for treating duct-destructive pancreatitis is a relevant problem. Endogenous intoxication and oxidative stress that accompany acute pancreatitis often progress even after surgery, which forces one to search for additional possibilities of preventing these severe consequences. This research studied the effect of small doses of direct electric current and intravenous ozone therapy in combination with therapeutic omental pancreatic bursoscopy in the treatment and prevention of the infection of necrotic foci of the pancreas. The rate of postoperative complications in patients with infected pancreatic necrosis and the causes of death of patients with infected pancreatic necrosis were studied.

The Latinx population in the United States is disproportionately affected by HIV. Our community-based participatory research partnership developed, implemented and evaluated a Spanish-language peer navigation intervention designed to increase HIV testing and condom use among social networks of immigrant Spanish-speaking Latinx gay, bisexual and other men who have sex with men (GBMSM) and transgender women (TW). We randomized 21 social networks of Latinx GBMSM and TW, ages 18-55 years, to the intervention, known as "HOLA," or a waitlist control group. Social network participants (n = 166) completed structured assessments at baseline and 12-month follow-up (24 months after baseline). Follow-up retention was 95%. Individual in-depth interviews with a sample of participants documented their intervention-related experiences, needs, and priorities to inform future research. At follow-up, "HOLA" participants reported increased HIV testing (adjusted odds ratio = 8.3; 95% CI = 3.0-23.0; P < 0.0001). All study participants reported increased condom use; there was no significant difference between HOLA and waitlist control participants. In-depth interviews identified critical intervention elements and impacts and community needs and priorities. The "HOLA" intervention is effective for increasing HIV testing among Latinx GBMSM and TW, an initial step within the HIV prevention and care continua, and may be adaptable to promote pre-exposure prophylaxis uptake.

Cardiovascular diseases are an emerging cause of morbidity and mortality in India. India produces less than 150 cardiologists annually, leading to a gap between the need and availability of trained professionals. A three-year cardiology-training programme is available for post-graduate doctors in the conventional medical education system. The majority of the people living in rural areas, small towns, and district towns in the country do not have any access to cardiac care, because trained cardiologists are mostly concentrated in the metropolitan are or capital cities. To address this issue Indira Gandhi National Open University has designed and developed a two-year, full-time training programme in the area of non-invasive cardiology for medical graduates, named the Post Graduate Diploma in Clinical Cardiology, which is being offered through the open and distance learning mode. The objective of the programme is to train a large number of medical graduates effectively to enable early recognition, management and prevention of common cardiovascular diseases. Learners have been given the opportunity to train in different departments and are posted in various areas in this programme, such as management of common cardiovascular diseases (6 months), ECG and Stress Testing (3 months), Echocardiography (3 months), ICU/CCU management (6 months), Paediatrics Cardiology (3 months), preventive cardiology (3 months). Self-learning materials, 33 video programmes (1260 minutes), and a monthly, live, interactive teleconference (90 minutes), have been incorporated into this programme. Beside these, 50 theory counselling sessions, 25 guest lectures, seminars, journal clubs and case discussions have been provided in every training center. Hands-on skills training is provided to every learner as prescribed in this programme. The 72 credits in the programme are divided into seven theory and six practical courses. Students need to pass in each course independently both in the internal examination and the term end examination. The minimum teacher-student ratio has been maintained strictly in both training and term end practical examinations. The topmost cardiac institutes/hospitals across the country have been identified as training centers, as per the norms of the university. This programme began with 116 students in 16 training centers in 2006. In 2013, 443 students were enrolled in 67 training centres. More than 320 cardiologists are involved as academic counselors in this training programme. A total of 1006 candidates have successfully completed their training and many of them are providing services in small or district towns of the country.

In 2007, the American College of Sports Medicine, with endorsement from the American Medical Association and the Office of the Surgeon General, launched a global initiative to mobilize physicians, healthcare professionals and providers, and educators to promote exercise in their practice or activities to prevent, reduce, manage, or treat diseases that impact health and the quality of life in humans. Emerging from this initiative, termed Exercise Is Medicine, has been an extensively documented position stand by the American College of Sports Medicine that recommended healthy adults perform 150 min of moderate dynamic exercise per week. The purpose of this article is to demonstrate the foundation for this global initiative and its exercise prescription for health and disease prevention has roots that began in antiquity more than two millennia ago. Individuals and concepts to remember are that Susruta of India was the first "recorded" physician to prescribe moderate daily exercise, Hippocrates of Greece was the first "recorded" physician to provide a written exercise prescription for a patient suffering from consumption, and the global influence of Galen from Rome combined with his recommendation on the use of exercise for patients in the management of disease prevailed until the 16th century. Historically intertwined with these concepts was exercise being advocated by select physicians to minimize the health problems associated with obesity, diabetes, and inactivity.

This article reviews the personal and professional processes of developing an interdisciplinary approach to understanding the complex issues of environmental health in their community, political-economic, social science, and scientific contexts. This interdisciplinary approach includes a synthesis of research, policy work, and advocacy. To examine multiple forms of interdisciplinarity, I examine pathways of integrating medical and environmental sociology via three challenges to the boundaries of traditional research: (1) crossing the boundaries of medical and environmental sociology, (2) linking social science and environmental health science, and (3) crossing the boundary of research and advocacy. These boundary crossings are discussed in light of conceptual and theoretical developments of popular epidemiology, contested illnesses, and health social movements. This interdisciplinary work offers a more comprehensive sociological lens for understanding complex problems and a practical ability to join with scientists, activists, and officials to meet public health needs for amelioration and prevention of environmental health threats. (Contains 1 figure.)

Objective: This review examines the evidence for psychosocial influences in asthma and behavioral medicine approaches to its treatment. Method: We conducted a systematic review of the literature on psychosocial influences and the evidence for behavioral interventions in asthma with a focus on research in the past 10 years and clinical trials. Additional attention was directed at promising new developments in the field. Results: Psychosocial factors can influence the pathogenesis and pathophysiology of asthma, either directly through autonomic, endocrine, immunological, and central nervous system mechanisms or indirectly through lifestyle factors, health behaviors, illness cognitions, and disease management, including medication adherence and trigger avoidance. The recent decade has witnessed surging interest in behavioral interventions that target the various pathways of influence. Among these, self-management training, breathing training, and exercise or physical activation programs have proved particularly useful, whereas other essential or promising interventions, such as smoking cessation, dietary programs, perception and biofeedback training, and suggestive or expressive psychotherapy, require further, more rigorous evaluation. Given the high comorbidity with anxiety and mood disorders, further evaluation of illness-specific cognitive behavior therapy is of particular importance. Progress has also been made in devising community-based and culturally tailored intervention programs. Conclusion: In concert with an essential medication treatment, behavioral medicine treatment of asthma is moving closer toward an integrated biopsychosocial approach to disease management. (Contains 1 table and 1 footnote.)

Problem-based learning (PBL) is well suited for courses in the history of medicine, where multiple perspectives exist and information has to be gleaned from different sources. A student, an archivist, and a teacher offer three perspectives about a senior level course where students explored the antecedents and consequences of medical technology. Two active learning strategies were used: (a) PBL to explore the historical basis of procedures used to diagnose, prevent and treat a single disease, tuberculosis, and (b) a concurrent inquiry-based component that permitted individual exploration of other medical technologies and demonstration of learning through diverse options (book reviews, conversations, essays, archival research, oral exams). This course was highly rated by students with an overall rating of 9.5 ± 0.7 (36 students from 2008-2012).

Objective: The author identifies and seeks to remove barriers contributing to physician/medical students' decisions NOT to seek mental health care. Methods: Following a cluster of medical student and physician suicides in one medical community, medical trainees anonymously shared their views regarding seeking mental health treatment in light of the current disclosure requirements for medical licensure. In an effort to identify medical licensure questions that more accurately assess for potential impairment--replacing the stigmatizing global inquiry about past mental health treatment--47 states' medical licensure questions available on the web were examined. Representatives from the state's psychiatric and medical societies joined efforts to formally request the State Medical Board to revise the licensure questions. Results: The State Medical Board unanimously approved the recommended changes. Conclusion: Overcoming stigma within the medical profession regarding seeking psychiatric care is a difficult process requiring ongoing education of our colleagues. Physicians must have the opportunity to seek confidential mental health treatment at their earliest signs of distress in order to maximize their optimal functioning in an effort to prevent impairment.

A medical model has advantages over a legal model in thinking about special education, especially in responding supportively to difference, meeting individual needs, and practicing prevention. The legal conceptual model now dominates thinking about special education, but a medical model promises a brighter future for special education and for children with disabilities.

Notes performance injuries are a concern among musicians. Gives an overview of performing arts medicine, a new field offering benefits to music students and professionals. Comments on the educators' role in preventive strategies. States music educators can make a useful contribution to research by sharing their knowledge. (NL)

Primary care is at the forefront of healthcare delivery. It is the site of disease prevention and health management and serves as the bridge between communities and the health care system As ethnographers of primary care, in this article we discuss what is gained by situating anthropological inquiry within primary care. We articulate how anthropologists can contribute to a better understanding of the issues that emerge in primary care. We provide a review of anthropological work in primary care and offer empirical data from two ethnographic case studies based in the United States, one focused on social risk screening in primary care and the other examining the diagnosis and care of people with dementia in primary care. Through these cases, we demonstrate how research of and within primary care can open important avenues for the study of the multidimensionality of primary care. This multidimensionality is apparent in the ways the medical field addresses the social and structural experiences of patients, scope of practice and disciplinary boundaries, and the intersection of ordinary and extraordinary medicine that emerge in the care of patients in primary care.

Abstract The tumor-suppressing p-53 binding protein is a crucial protein that is involved in the prevention of cancer via its regulatory effect on a number of cellular processes. Recent evidence indicates that it interacts with a number of other proteins involved in cancer in ways that are not fully understood. An understanding of such interactions could provide insights into novel ways p53 further exerts its tumour prevention role via its interactions with diverse proteins. Thus, this study aimed to examine the interactions of the p53 protein with other proteins (peptides and histones) using molecular simulation dynamics. We opted for a total of seven proteins, namely 2LVM, 2MWO, 2MWP, 4CRI, 4 × 34, 5Z78, and 6MYO (control), and had their PBD files retrieved from the protein database. These proteins were then docked against the p-53 protein and the resulting interactions were examined using molecular docking simulations run at 500 ns. The result of the interactions revealed the utilisation of various amino acids in the process. The peptide that interacted with the highest number of amino acids was 5Z78 and these were Lys10, Gly21, Trp24, Pro105, His106, and Arg107, indicating a stronger interaction. The RMSD and RMSF values indicate that the complexes formed were stable, with 4CRI, 6MYO, and 2G3R giving the most stable values (less than 2.5 Å). Other parameters, including the SASA, Rg, and number of hydrogen bonds, all indicated the formation of fairly stable complexes. Our study indicates that overall, the interactions of 53BP1 with p53K370me2, p53K382me2, methylated K810 Rb, p53K381acK382me2, and tudor-interacting repair regulator protein indicated interactions that were not as strong as those with the histone protein. Thus, it could be that P53 may mediate its tumour suppressing effect via interactions with amino acids and histone.

Objectives Job strain in dentistry makes the profession highly susceptible to occupational burnout. People with high sensory processing sensitivity (SPS) perceive workplace as more stressful and more demanding. Emotional intelligence (EI) is both a trait and an ability, which helps individuals adapt to the environment and reduces burnout. This study examines the relationship between SPS and burnout among Polish dentists and whether EI may be a protective factor against burnout in a group of highly sensitive dentists. Material and Methods Polish dentists (N = 201) answered a questionnaire, the short Polish version of the Highly Sensitive Person Scale (HSPS-10), the Trait Emotional Intelligence Questionnaire – Short Form (TEIQue-SF), the Oldenburg Burnout Inventory (OLBI), and the demographic data questionnaire. Results Moderated hierarchical regression analyses showed that SPS can predict burnout factors exhaustion (p < 0.001) and disengagement (p = 0.012). Higher trait SPS was associated with higher burnout factors. Emotional intelligence can predict burnout factors exhaustion (p < 0.001) and disengagement (p < 0.001). Higher trait EI was associated with lower burnout factors. Also it turned out that EI moderates the relationship between SPS and burnout factor exhaustion (p = 0.015). The findings illustrated reverse buffering effect. UNIANOVA analyses showed that EI may have a protective effect on burnout, although this effect decreases for exhaustion and disappears for disengagement in the group of highly sensitive dentists. Conclusions Sensory processing sensitivity can help to identify dentists who are at risk to develop burnout. Training to increase EI levels can be implemented to reduce the risk of burnout among dentists, although it appears to be insufficient among those at higher risk, i.e., the highly sensitive dentists. This shows the importance of searching for other possible factors that could protect highly sensitive dentists from burnout. Int J Occup Med Environ Health. 2024;37(5):524–34

To effectively prevent cervical cancer, a leading cause of global morbidity and mortality among women, widespread adoption of the HPV vaccine has a well-established link to human papillomavirus (HPV) infection. HPV vaccine must be the vaccine’s effectiveness in reducing HPV infections, and subsequent cervical lesions have been extensively demonstrated, marking a pivotal milestone in public health. Important research highlights the vaccine’s safety profile, allaying worries and promoting trust in its application. By targeting HPV strains responsible for a majority of cervical cancer cases, vaccination emerges as a strategic intervention to curb the burden of this malignancy. The strategy is used to search PubMed and Google Scholar, with only free full-text and English language study included. However, addressing existing misconceptions and ensuring equitable vaccine access remains imperative. Informed decision making is pivotal, necessitating comprehensive public health initiatives that educate communities about the vaccine’s benefits. Encouragingly, successful vaccination programs in various regions have demonstrated tangible reductions in HPV prevalence and cervical cancer incidence. This review concludes by emphasizing the urgent need for global collaboration to integrate HPV vaccination into routine immunization schedules, thereby fortifying the collective effort to mitigate cervical cancer’s impact. As a cost-effective, evidence-based strategy, widespread HPV vaccination stands as a linchpin in the ongoing battle against cervical cancer, promising a healthier future for women worldwide.

Vitamin D deficiency is emerging as a very serious public health problem. Numerous epidemiological studies link vitamin D deficiency to the pathophysiological process of several acute and chronic diseases. Sun exposure, vitamin D supplementation, and fortification of foods with vitamin D are the present strategies adopted to tackle this epidemic. While this can be effective, recent evidence suggests the need to consider the multifaceted causation of vitamin D deficiency such as impaired liver function, kidney function, hyperparathyroidism, and endocrine dysfunction. Therapeutic fasting, a popular nutritional approach has shown to have a positive association with vitamin D levels. This perspective attempts to provide an overview of literature discussing fasting and vitamin D, the possible mechanisms behind this association, and discusses the future possibilities of using fasting as a public/clinical tool in mitigating vitamin D deficiency.

To comprehensively improve the level of standardized screening, diagnosis and treatment of hypertension, the Clinical practice guidelines for the management of hypertension in China has been jointly initiated by Chinese Society of Cardiology, Chinese Medical Association, Hypertension Committee of Cross-Straits Medicine Exchange Association, Cardiovascular Disease Prevention and Rehabilitation Committee, and Chinese Association of Rehabilitation Medicine. This guideline addresses several important clinical problems in the field of screening, diagnosis evaluation and treatment of hypertension, fully assesses the latest high-quality clinical research evidences available, and gives clear recommendations. It also advocates the new concepts and perspectives, such as moving forward the diagnosis and treatment of hypertension, promoting the target of blood pressure reduction, simplifying the risk stratification of cardiovascular diseases, and paying attention to the screening of secondary hypertension, which will help promote the prevention and treatment of hypertension in China.

Abstract Background Severe acute pancreatitis (SAP) is a life-threatening condition that can require invasive mechanical ventilation (IMV) to ensure adequate oxygenation and ventilation. However, IMV can cause delirium, a temporary and fluctuating state of consciousness disorder, which negatively impacts patient outcomes. Perphenazine, an antipsychotic drug that blocks dopamine receptors, can alleviate symptoms such as irritability and restlessness that caused by delirium. This retrospective study aimed to identify risk factors associated with delirium in SAP patients after extubation and withdrawal from IMV, and to determine whether prophylactic use of perphenazine could reduce the incidence of delirium. Methods A total of 40 patients with SAP aged 18–75 years who underwent IMV and were successfully extubated offline after treatment were included. Perphenazine was used consistently 2 mg q12 h for 2 days before extubation. The assessment of delirium began after the removal of the endotracheal tube, using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) every 12 h. Patients were divided into delirium (n = 9) and non-delirium (n = 31) groups or perphenazine (n = 22) and non-perphenazine (n = 18) groups. The clinical data of patients upon admission and after extubation between groups were analyzed using SPSS 26 software. Binary logistic regression was used to evaluate the risk factors for delirium. Results Patients with a mean age of 42 years and a male to female ratio of 1.58:1 were enrolled. The incidence of delirium was 22.50%. Univariate analysis (P = 0.025) and binary logistic regression (P = 0.035, 95%CI 0.002–0.762) showed that prophylactic use of perphenazine reduced the incidence of delirium. Fentanyl use was a risk factor for delirium in the univariate analysis (P = 0.039). Patients in the delirium group were hospitalized longer than those in the non-delirium group (P

Abstract Surgical site infection (SSI) continues to be a common complication of surgery. The real benefit of using topical antibiotics for the prevention of SSI in abdominal hernia repair surgery is still unknown. This study aimed to evaluate the usefulness of topical gentamicin in SSI prophylaxis in incisional hernia repair with mesh. A randomized controlled trial was conducted in patients undergoing open incisional hernia repair. Patients were randomly assigned to one of two groups: in the gentamicin group, each layer of the abdominal wall was irrigated with gentamicin solution before wound closure, and in the saline solution group (placebo), each layer of the abdominal wall was irrigated with normal saline solution. The incidence of SSI and other surgical site complications was compared between both groups, and the presence of adverse effects with the use of topical gentamicin. Data from 146 patients were included for analysis: 74 in the gentamicin group and 72 in the saline solution group. SSI was observed in six patients (8.1%) in the gentamicin group and eight patients (11.1%) in the saline solution group, with no significant differences (p = 0.538) between both groups. No statistically significant differences were observed in the presentation of seroma, hematoma, and surgical wound dehiscence between both groups. No adverse effects were reported from topical application of gentamicin. In this clinical trial, the use of topical gentamicin in incisional hernia repair with mesh did not significantly reduce the incidence of SSI. EU Clinical Trials Register: EudraCT 2018-001860-45 (04/07/2019).

Abstract Previous studies identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment at baseline. Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing, who completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke’s Cognitive Examination–Revised, adapted for culturally acceptable use in Aotearoa New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes. The analysis included 783 participants without cognitive impairment at baseline (54.7% female, mean age 62.7 years, 25.0% Māori, the Indigenous people of Aotearoa New Zealand). There was an association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) over two years, while controlling for covariates. The findings emphasise the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.

Abstract With the emergence of new strains of Covid-19, the adoption of preventive behaviors is still considered a requirement to control this disease. Therefore, considering the importance of social cognitive factors in adopting various types of preventive behaviors, the present study was conducted to design and psychometrically measure the social cognitive factors related to Covid-19 preventive behaviors. A cross-sectional study was conducted on 526 people ages 18 and over with multi-stage stratified, cluster and random sampling in Isfahan, Iran in 2022. The questionnaire was validated and formulated in three stages: designing, creating and reducing items. After collecting information and creating a bank of items, qualitative and quantitative methods were used to calculate the tool’s validity. Data analysis was done in SPSS23 software at a significance level of less than 0.05. In the present study, the average age score of the participants was 39.16 ± 11.48. The results related to the construct validity in the exploratory part show that the five factors (Outcome expectations, self-efficacy, social support, self-regulation and barrier self-efficacy) obtained have a specific value higher than one and range from 1.376 to 9.343. Correlation between factors shows that all factors have a relatively high relationship with each other (P

Abstract Effective self-management is essential for patients with heart failure, but many struggle with acquiring the necessary skills. Given the complexity of heart failure management and the importance of patient adherence to prescribed regimens, this study aims to investigate the knowledge, attitudes, and practices (KAP) concerning the prevention of heart failure recurrence among patients. A cross-sectional study was conducted at the Third People’s Hospital of Yancheng City from September 1, 2023, to December 31, 2023, employing a self-administered KAP questionnaire. The study included 421 heart failure patients, of whom 230 (54.6%) were male. Median scores for knowledge, attitudes, and practices were 12.00 [10.00, 13.00] (possible range: 1–18), 20.00 [19.00, 21.00] (possible range: 5–25), and 16.00 [15.00, 17.00] (possible range: 5–22), respectively. Pearson’s correlation analysis indicated a positive correlation between knowledge and attitude scores (r = 0.183, P

According to the epidemiological dictionary definition, environmental factors have a property of influence. However, the exposure doses of risk factors (RF) and their relation to the severity, prevalence of the harmful effect in the exposed population remains unknown. Aim of the study was to find out the exposure to predictors of cardiovascular diseases (CVD) in the group of employees of locomotive crews (ELC) of the Trans-Baikal Railway (TBR). Material and methods. Predictors of acute coronary syndrome, coronary heart disease, cerebral stroke and sudden cardiac death were determined using multivariate statistical analysis during the 2008–2013 study of 22 items of a natural group of initially healthy 7959 male employees of locomotive crews (ELC) of the Trans-Baikal Railway (TBR) aged 18–66 years old. The qualities of predictors as screening tests were assessed by the quality control method of a verifiable diagnostic test (VDT) with binary outcomes. Using this method the exposure doses in the observation group were found out by determining the sensitivity value of CVD predictors. Results. The studied CVDs had overlapping predictors that had different quantitative scores in terms of VDT indicators. Exposure to risk factors at the population level can be measured by the sensitivity index of VDT, which reflects the prevalence (accumulation) of risk factors among those individuals who have the final outcome. Conclusions. Risk factors in different exposures (concentration) form different CVDs. It is necessary to monitor RF in ELC to assess their exposures, predict CVD, and organize therapeutic and preventive measures and medical care.

Background: Coronavirus disease 2019 (COVID-19), caused by Severe acute respiratory syndrome coronavirus 2, has posed a global health crisis since its emergence in late 2019. Objectives: To assess the knowledge, attitudes, and practices related to COVID-19 prevention among medical undergraduates in Enugu Metropolis, Nigeria. Materials and Methods: A descriptive cross-sectional study was conducted, involving undergraduate medical students from the University of Nigeria, Enugu, and Ituku-Ozalla campuses. A total of 450 participants were recruited through convenience sampling, and a structured questionnaire was used for data collection. The questionnaire covered sociodemographic information, COVID-19 knowledge, attitudes, and preventive practices. Data were analyzed using the Social Package for Social Science version 28, with statistical significance set at P < 0.05. Results: The majority of participants demonstrated good knowledge of COVID-19 prevention (89.6%), with significant associations observed between knowledge and the level of study (P = 0.001). A significant relationship was also noted between knowledge and attitude (P = 0.000). In terms of practice, 24.2% of medical students reported good COVID-19 prevention practices. Additionally, a majority of participants (n = 405; 90%) had not been vaccinated against COVID-19, largely influenced by vaccine hesitancy. Conclusion: Efforts should focus on transforming knowledge into positive attitudes and encouraging better COVID-19 preventive practices among medical undergraduates. Addressing vaccine hesitancy through targeted education and awareness campaigns is imperative to mitigate the risks associated with the pandemic and potential future waves.

Abstract Background Cataract surgery requires a high level of dexterity and experience to avoid serious intra- and post-operative complications. Proper surgical training and evaluation during the learning phase are crucial to promote safety in the operating room (OR). This scoping review aims to report cataract surgery training efficacy for patient safety and trainee satisfaction in the OR when using virtual reality simulators (EyeSi [Haag-Streit, Heidelberg, Germany] or HelpMeSee [HelpMeSee foundation, Jersey city, New Jersey, United States]) or supervised surgical training on actual patients programs in residents. Methods An online article search in the PubMed database was performed to identify studies proposing OR performance assessment after virtual-reality simulation (EyeSi or HelpMeSee) or supervised surgical training on actual patients programs. Outcome assessment was primarily based on patient safety (i.e., intra- and post- operative complications, OR performance, operating time) and secondarily based on trainee satisfaction (i.e., subjective assessment). Results We reviewed 18 articles, involving 1515 participants. There were 13 using the EyeSi simulator, with 10 studies conducted in high-income countries (59%). One study used the HelpMeSee simulator and was conducted in India. The four remaining studies reported supervised surgical training on actual patients, mostly conducted in low- middle- income countries. Training programs greatly differed between studies and the level of certainty was considered low. Only four studies were randomized clinical trials. There were 17 studies (94%) proposing patient safety assessments, mainly through intraoperative complication reports (67%). Significant safety improvements were found in 80% of comparative virtual reality simulation studies. All three supervised surgery studies were observational and reported a high amount of cataract surgeries performed by trainees. However, intraoperative complication rates appeared to be higher than in virtual reality simulation studies. Trainee satisfaction was rarely assessed (17%) and did not correlate with training outcomes. Conclusions Patient safety assessment in the OR remains a major concern when evaluating the efficacy of a training program. Virtual reality simulation appears to lead to safer outcomes compared to that of supervised surgical training on actual patients alone, which encourages its use prior to performing real cases. However, actual training programs need to be more consistent, while maintaining a balance between financial, cultural, geographical, and accessibility factors.

Abstract Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health.

Abstract Background Schools are a prime setting for the delivery of universal and targeted mental health interventions. Current school-based mental health interventions may not be developed to fully meet student mental health needs and co-production is needed to understand what young people really want. Despite this, research on school-based mental health interventions does not consistently engage in co-production, involving stakeholders, such as young people and schools, in the decision-making, development, evaluation and/or implementation stages. This highlights that transforming the development of school-based mental health interventions is crucial to meeting all stakeholders’ needs. In this paper, we aim to briefly review an approach to co-production that can be used when conducting research on school-based mental health interventions that centre stakeholder voices to drive meaningful change. We describe a case study to showcase this approach. Main body We highlight recommendations and important elements to consider for each stakeholder when engaging in different levels of co-production, including young people, teachers, and schools. We provide practical examples of how this may look like in practice, theoretical underpinnings, and impact on outcomes. Our case study of co-producing a talk to improve mental health literacy in secondary school students is highlighted to demonstrate how a group of young people, teachers, epidemiologist, psychiatrist, and researchers can work together to develop school-based mental health interventions. Conclusion Co-production can be successfully conducted amongst researchers and stakeholders to develop school-based mental health interventions. Changes made to the talk were guided by synthesis of feedback that aligned with the balanced needs, perspectives, and opinions of all stakeholders. The use of this co-production approach in research on school-based mental health interventions with young people, teachers, and schools has important implications for research, service provision, and stakeholder empowerment.

Abstract Metabolic syndrome increases the risks of cardiovascular diseases, type 2 diabetes, and certain cancers. The early detection of metabolic syndrome is clinically relevant, as it enables timely and targeted interventions. In the current study, we aimed to investigate the association between metabolic syndrome and heart rate measured using wearable devices in a real-world setting and compare this association with that for clinical resting heart rate. Data from 564 middle-aged adults who wore wearable devices for at least 7 days with a minimum daily wear time of 20 h were analyzed. The results showed significantly elevated all-day, sleeping, minimum, and inactive heart rates in men with pre-metabolic or metabolic syndrome compared with those in normal individuals, whereas sleeping heart rate and heart rate dips were significantly increased and decreased, respectively, in women with metabolic syndrome. After adjusting for confounders, every 10-beats-per-minute increment in all-day, sleeping, minimum, and inactive heart rates in men corresponded to odds ratios of 2.80 (95% confidence interval 1.53–5.44), 3.06 (1.57–6.40), 4.21 (1.87–10.47), and 3.09 (1.64–6.29), respectively, for the presence of pre-metabolic or metabolic syndrome. In women, the association was significant only for heart rate dips (odds ratio = 0.49 [95% confidence interval 0.25–0.96] for every 10% increment). Models incorporating inactive or minimum heart rate in men and heart rate dip in women demonstrated better fits, as indicated by lower Akaike information criterion values (170.3 in men and 364.9 in women), compared with models that included clinical resting heart rate (173.4 in men and 369.1 in women). These findings suggest that the heart rate indices obtained from wearable devices may facilitate early identification of metabolic syndrome.

Abstract Background Very few studies to date investigated the prospective association of changes in exposure to the food environment with cardiovascular disease (CVD) risk. We aim to explore if time-varying exposure to the food environment was associated with hospitalization and mortality due to total and specific types of CVD in The Netherlands. Methods In this prospective cohort study, 4,641,435 Dutch adults aged 35 + years who did not change residence in 2002–2018 were identified through registry data. Exposure to the food environment was defined as time-varying Food Environment Healthiness Index (FEHI) scores (range: − 5 to 5) and time-varying kernel density of specific food retailers (e.g., fast food outlets, supermarkets) around the home location between 2004 and 2018. The main outcome measures were hospitalization and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020, based on hospital and death registries. Results In Cox regression models, each unit increase in the FEHI was associated with a lower hospitalization and mortality of CVD (hospitalization hazard ratio (HRh) = 0.90 (0.89 to 0.91), mortality hazard ratio (HRm) = 0.85 (0.82 to 0.89)), CHD (HRh = 0.88 (0.85 to 0.91), HRm = 0.80 (0.75 to 0.86)), stroke (HRh = 0.89 (0.84 to 0.93)), HRm = 0.89 (0.82 to 0.98)), and HF (HRh = 0.90 (0.84–0.96), HRm = 0.84 (0.76 to 0.92)). Increased density of local food shops, fast food outlets, supermarkets, and convenience stores and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke, and HF hospitalization and mortality. Conclusions In this observational longitudinal study, changes in exposure to a healthier food environment over 14 years were associated with a risk reduction in CVD hospitalization and mortality, in particular in urbanized areas and for younger adults and those with higher incomes.

Introduction: Early Childhood Caries (ECC) is a major public health issue that negatively affects children’s physical and mental health. Silver Diamine Fluoride (SDF) is a novel material that has the potential to improve dentin hypersensitivity and enhance enamel remineralisation. This alkaline solution is known to be more resistant to acidic environments than hydroxyapatite. Aim: To measure the pH (Potential of Hydrogen) in saliva at three different intervals after the application of 38% SDF in children with ECC. Materials and Methods: This pre-post single-group quasi-experimental study was conducted in the Department of Paediatric and Preventive Dentistry at Rajarajeswari Dental College and Hospital in Bengaluru, Karnataka, India from September 2021 to February 2022. A total of 15 patients with ECC, aged 3-6 years, were selected for the application of 38% SDF. Saliva samples were collected before the application, immediately after the application, and one hour after the application of 38% SDF. pH analysis was then conducted. The data obtained were subjected to statistical analysis. Repeated measures of Analysis of Variance (ANOVA) and Bonferroni’s post-hoc test were used for multiple comparisons of salivary pH levels at different time intervals. Age and gender-wise comparisons of mean salivary pH levels at different time intervals were conducted using an independent Student’s t-test. Results: Among the 15 participants included in the study, the average age of the subjects was 4.60±1.06 years. Among the study participants, 9 (60.0%) were males and 6 (40.0%) were females. A comparison of mean salivary pH levels at different time intervals showed that the mean salivary pH levels before the SDF application were 6.45±0.22, immediately after the application were 6.95±0.18, and one hour after the application were 7.30±0.27. In the gender-wise comparison, a higher mean pH was recorded in males than in females. Conclusion: The change in mean pH was found to be statistically significant before and after the application of SDF, as well as at the one-hour time interval, showing an increasing trend. This indicates that the changes in salivary pH that occur after applying 38% SDF are clinically significant and can be used as an effective caries control and preventive strategy.

The proportion of young individuals that present with acute myocardial infarction is a major problem that keeps increasing. The specific characteristics of premature coronary artery disease and its differences between young and older individuals need to be elucidated. Although risk factors are similar in different age categories, there is a great difference in their prevalence. The vast majority of young patients are males and there is a higher prevalence of cigarette smoking, family history of premature coronary artery disease, lipid disorders, and illicit drug use, while the prevalence of hypertension and diabetes mellitus is lower. Young individuals with acute coronary syndrome usually present either with ST-segment elevation or non-ST-segment elevation myocardial infarction. It is not unusual for young patients to present with atypical symptoms to the office of primary care physicians, leading occasionally to incorrect or delayed diagnosis. Therefore, prompt and correct diagnosis is necessary to implement the specific management as quickly as possible. A literature research of studies was conducted for the last 10 years, regarding the risk factors and prevention of premature myocardial infarction. As databases, we used PubMed and peer reviewed journals. The aim of this review is to raise awareness among family medicine and primary care physicians, regarding the clinical presentation of young patients with acute myocardial infarction, to provide optimal medical attention.