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ObjectivesInformed by a social-ecological framework, this study nested undocumented students' individual mental health needs within micro-level campus factors and the macro-level immigration policy context to examine how these are associated with undocumented Latina/o/x college students' use of on-campus mental health services.MethodA large-scale survey was administered to 1,277 undocumented college students attending 4-year public universities in California. Only Latina/o/x respondents were included in this study (N = 1,181). Fifty percent of students attended a UC system (n = 589). On average, students were 21.84 years old (SE = .15), and most were women (75.3%, n = 890).ResultsGreater level of mental health symptoms and perceived mental health need, and greater use of campus-wide resources and undocumented student services predicted greater likelihood of using on-campus mental health services. Greater perceptions of social exclusion due to the immigration policy context predicted lower use of mental health services.ConclusionsResults indicate that a greater use of resources and an inclusive campus environment, as well as efforts to minimize policy-related feelings of social exclusion, may facilitate undocumented students' professional mental health help-seeking. These findings emphasize the need to take multiple and multi-level ecological factors into account when considering mental health service use, particularly in the case of undocumented immigrants and likely other structurally marginalized groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Athletes face unique mental health stressors, including internal/external pressure, time displacement, and physical injury. In addition, athletes who experience mental illnesses such as depression and anxiety reference the role of social factors—specifically stigma—as barriers to mental health. The present study draws on 37 testimonials from The Players' Tribune in which athletes disclosed mental illness. A theoretical thematic analysis pinpointed themes within the testimonials of athletes who elucidated and refuted myths concerning mental health in sport. Through disclosure, the athletes challenged stigma by protesting myths that discourage help-seeking behavior in sport. The analysis identified six themes in the myths concerning (a) professional success, (b) strength, (c) identity, (d) the sports story treatment of mental health, (e) sport as escape, and (f) isolation. Implications are discussed in relation to changing social norms in sport. [ABSTRACT FROM AUTHOR]

Although numerous editorials claim the COVID-19 pandemic has disproportionately impacted vulnerable populations, particularly those affected by HIV, these claims have received limited empirical evaluation. We analyzed posts to Reddit's r/HIVAIDS from January 3, 2012 through April 30, 2022 to (a) assess changes in the volume of posts during the pandemic and (b) determine the needs of HIV affected communities. There were cumulatively 100% (95%CI: 75-126) more posts than expected since the US declared a pandemic emergency. The most prevalent themes in these posts were for obtaining an HIV + diagnosis (representing 34% (95%CI:29-40) of all posts), seeking HIV treatment (20%; 95%CI:16-25), finding psychosocial support (16%; 95%CI:12-20), and tracking disease progression (8%; 95%CI:5-11). Discussions about PrEP and PEP were the least common, representing less than 6% of all posts each. Social media has increasingly become an important health resource for vulnerable populations seeking information, advice, and support. Public health organizations should recognize how the lay public uses social media and collaborate with social media companies to ensure that the needs of help-seekers on these platforms are met.

Mental health is crucial throughout life and significantly influences overall well-being, yet it is often overlooked and stigmatized. Mental health issues among men are a significant public health concern due to societal norms that discourage emotional vulnerability and seeking help, leading to underreporting and inadequate access to necessary services. While research has explored these connections, a gap exists in understanding how these factors influence the mental health of young men specifically. The study was conducted in the college department of an institution in Malaybalay City, Bukidnon. It utilized an explanatory sequential research design, beginning with quantitative data collection to measure 106 male students' experiences with mental health expression and stigma, followed by qualitative methods to explore the experiences of 5 male students in-depth regarding their mental health expression. This study examines the factors influencing male students' willingness to communicate mental health expression. The study shows a strong positive correlation between adverse experiences and higher-level stigma, underscoring how societal attitudes discourage open communication. Moreover, the qualitative findings reveal that societal norms, personal experiences, and coping mechanisms play a role. Themes like stereotyping, social anxieties, and feelings of isolation emerged, highlighting students' challenges in seeking support. These qualitative insights support the quantitative data, which shows a high prevalence of stigma surrounding mental health. The study emphasizes the need to address these cultural and structural barriers to create a more supportive environment that reduces stigma and encourages help-seeking behavior among male students. [ABSTRACT FROM AUTHOR]

This study aimed to understand the lived experiences of seasoned language instructors in online teaching. The study employed a qualitative research design using a phenomenological approach with 10 participants selected through purposive sampling from higher educational institutions in General Santos City. Results revealed that seasoned language instructors had negative and positive views on challenges in online teaching. They view the challenges as technological hurdles, situations that evoke uncertainty, limit students' participation, and prevalence of dishonesty. Additionally, language education becomes complex. On a positive note, these challenges promote innovative learning and serve as motivating factors that ignite passion for teaching. Coping mechanisms employed by seasoned language instructors encompass seeking help and collaboration, maintaining open-mindedness and introspection, participating in seminar workshops, sustaining a work-life balance, keeping a positive outlook, and seeking divine providence. Furthermore, their insights on improving online teaching accentuate the importance of learning by doing, upgrading technological skills, and pedagogical creativity, seeking peer support, and emphasizing the need for school administrators to be responsive to the evolving demands of online education. Thus, adjusting to online teaching requires passion and commitment to overcome the hurdles. It requires educators to be lifelong learners to be effective in practicing the teaching profession in virtual platforms. [ABSTRACT FROM AUTHOR]

The incidence of postpartum depression (PPD) among Chinese women surpasses the global average, and this disparity is closely associated with the level of social support they receive. Using Sensitive Interaction Systems Theory and Family Communication Patterns Theory as guiding frameworks, we conducted a content analysis of 705 posts gathered from the hashtag #PPD (chanhou yiyu) on Zhihu, a popular Chinese social media platform. Our findings reveal that postpartum women primarily seek social support from their husbands and mothers-in-law through indirect nonverbal and direct verbal communication strategies. They tend to receive more problem-focused support than emotion-focused solace. Moreover, the use of direct verbal communication strategies promotes potential support providers' problem-solving behaviors, while the use of indirect nonverbal strategies elicits their avoidance behaviors. In addition, the conversation-oriented family communication pattern strengthens the positive association between direct verbal communication and support-providing behaviors, whereas the conformity-oriented family communication pattern weakens this relationship. This study contributes to the applicability of the abovementioned theories in the Chinese context and provides insights for future interventions aimed at addressing PPD among women. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Parenting interventions are effective for improving child conduct problems (CPs), but online self‐directed interventions are required to improve reach and impact. Mothers are the main users of such programmes; fathers show low participation rates despite evidence of increased efficacy when they participate.This randomised controlled trial examined the efficacy of Family Man, a brief, self‐directed online parenting intervention for fathers and mothers of children with CPs. The intervention involves several innovative design features to maximise the engagement of fathers. Families (N = 103; 102 mothers, 78 fathers) seeking help with managing their 2‐ to 8‐year‐old child's CPs were randomly assigned to either the Family Man intervention condition (n = 53) or a 4‐week waitlist control group (n = 50). Primary outcomes were frequency and severity of child CPs and secondary outcomes included dysfunctional parenting, parenting efficacy, parenting stress, parental psychological distress, household disorganisation and interparental conflict.Repeated measures ANOVAs/MANOVAs found that at 4‐week post‐assessment, parents in the intervention group reported significantly lower levels of child CPs than waitlist. Significant effects for the intervention group relative to waitlist were also found across all secondary outcomes examined. Intervention effects were maintained at 2‐month follow‐up for the intervention group. Outcomes did not significantly differ for mothers and fathers.Results support the efficacy of this brief, self‐directed online parenting intervention in improving child CPs and a range of parent and family outcomes, both for fathers and mothers. Implications for improving the reach and impact of parenting interventions and increasing father engagement, are discussed. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsDiscussionFilipino men's self-perceived masculinity and their inclination to seek help are influenced by the cultural context, and barriers in their help-seeking behaviour moderate this relationship. It is hypothesised that higher self-perceived masculinity corresponds to a diminished tendency to seek help, shaped by categorisation into social groups based on masculinity.The respondents were 348 Filipino males, aged 21–45 years, who accomplished the online survey. The participants completed the Male Role Norms Inventory-Revised, Barriers to Help Seeking Scale, and General Help-Seeking Questionnaire. A series of moderation analyses utilising JAMOVI was performed to investigate the moderation of help-seeking barriers on the relationship between masculinity and help-seeking behaviour.Results showed that when Filipino men's self-perception of masculinity increases, their help-seeking behaviour, specifically formal help-seeking, decreases. The following barriers act as moderators – Need for Self-Control and Self-Reliance, Concrete Barriers, and Distrust of Caregivers, significantly influencing the relationship between masculinity and formal help-seeking. Conversely, when seeking informal help, all identified barriers show no buffering effect, as Filipino men prefer informal help-seeking, consistent with the cultural context.Findings support the hypothesis that masculinity predicts their propensity to seek help. Add a one-liner recommendation based on the results. Future authors should focus on conducting localised research that examines the specific cultural factors influencing masculinity and help-seeking behaviours. Additionally, exploring the intersectionality of masculinity with other social factors can provide a more comprehensive understanding of the barriers men face in seeking help. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusions Pregnant women face the challenge of managing early labor on their own until they feel the need to seek professional support. However, professional support during such a vulnerable stage of labor may sometimes be insufficient. This study aims to understand pregnant women's care needs during early labor in order to improve the quality of care provided at the onset of labor.A scoping review was conducted following a systematic search strategy in May 2021 and in August 2022 concentrating on pregnant women in early labor with spontaneous onset of labor. A sensitive search strategy was used with five different databases. The articles were screened by two independent researchers. Data were extracted and mapped to answer the research question.52 articles were included. Major reasons for seeking professional help are to receive reassurance and get advice and information on how to cope with early labor. Furthermore, many women express the need for professional guidance. Several articles demonstrated women's preferences for hospital admission or a continuous care model. While some women want empowerment and empathy from a midwife, others require clear instructions on helpful measures or even clinical interventions within the process.Managing early labor without professional support creates a major challenge for pregnant women and nurtures insecurities and anxiety. Protecting women from unnecessary interventions is a well‐intentioned plan, yet a lack of support in early labor may sometimes jeopardize a positive birth experience. New ways need to be elaborated to support women‐centred and individualized approaches to providing early labor care. [ABSTRACT FROM AUTHOR]

Introduction: Human rights violations and violence against women are serious public health issues that have numerous detrimental repercussions on one's physical, emotional, sexual, and reproductive health. According to studies, women's perceptions and traits of violence are highly predictive of their likelihood of seeking help against violence. Even though intimate partner violence is a huge challenge nowadays in Africa, there is a low level of help-seeking behavior. Conducting this study at the East African level on help-seeking behavior can provide a clue for policy-makers. Therefore, this study aimed to reveal the prevalence of help-seeking behavior against intimate partner violence and determinant factors among women in East Africa. Method: Multilevel logistic regression analysis was carried out among East Africans using recent demographic and health survey data. A total of 7,387 participants aged 15 to 49 years were included in this study from East African countries. Individual- and community-level variables were considered to determine the associated factors with help-seeking behaviors against intimate partner violence with 95% CI and AOR. Results: The prevalence of help-seeking behavior against intimate partner violence among women was 38.07% with 95% CI (36.96%, 39.18%). Husbands drink alcohol [AOR = 1.46: 95% CI (1.33, 1.61)], women who have work [AOR = 1.33: 95% CI (1.19, 1.50)], and women with higher educational status [AOR = 1.36: 95% CI (1.16, 1.59)] were factors associated with help-seeking behavior against intimate partner violence. Conclusion: Approximately four out of 10 women were seeking help for intimate partner violence in East Africa. Husbands drinking alcohol, women's high educational status, and women having occupations were the factors that were associated with help-seeking behaviors against intimate partner violence. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Design Measurements and Sample Results Conclusion To investigate the prevalence of sexual and gender‐based violence (SGBV) among female college students, identify factors influencing intention to seek professional help among SGBV survivors, and compare help‐seeking determinants among survivors based on their prior utilization of healthcare services.A cross‐sectional online survey was employed among female students aged 18–24 years from two universities in Eswatini.A total of 271 female college students were recruited to assess SGBV experience, attitudes, social norms, perceived control, help‐seeking intention, and other factors not originally included in the theory of planned behavior. Data analyses utilized descriptive statistics, comparative analyses, and multiple regression methods.Among the participants, 73.1% reported experiencing one or more forms of SGBV, while only 43.4% sought professional help through health services. Help‐seeking intentions of survivors were significantly associated with positive attitudes, subjective norms, and marital status, collectively explaining 66% of the variance. In subgroup analyses, the subjective norm and attitude emerged as the most robust predictors of help‐seeking intentions.The results revealed a high prevalence of SGBV and a concerning trend of low help‐seeking behavior, with attitudes and subjective norms emerging as the most influential factors shaping intention. These results provide valuable insights for designing theory‐driven and culturally sensitive public health nursing interventions and educational programs aimed at effectively supporting SGBV survivors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Stigma surrounding mental health persists as a significant impediment to adequate support and help-seeking behaviors in Slovenia, despite advancements in psychiatric care and education. This study investigates stigma among first-year medical students at the University of Maribor, Slovenia and how the stigma changes after completing a course in mental health literacy. PARTICIPANTS: Participants were first-year medical students at the University of Maribor in the academic year 2023/2024. A total of 116 students participated in the baseline study, with 66 students participating in the follow-up study. STUDY METHOD: The intervention involved implementing the "Transitions" program, aimed at enhancing mental health literacy and reducing stigma. We conducted a baseline study and a follow-up study, then used Wilcoxon signed rank test for repeated measures to compare the differences in ranks before and after implementation of the program. FINDINGS: There was a significant reduction in stigma after intervention (Wilcoxon Z = −3.06, P <.01), suggesting a positive impact of the educational program. This reduction aligns with findings from similar programs globally, suggesting the efficacy of educational interventions in mitigating mental health stigma. CONCLUSIONS: The study emphasizes the importance of integrating mental health education into medical curricula to foster stigma reduction and enhance mental health literacy among future medical doctors. [ABSTRACT FROM AUTHOR]

Objective: Only approximately 20% of college students with an eating disorder (ED) seek treatment. One barrier to seeking treatment is weight discrimination. Past research demonstrates that experiencing weight discrimination is associated with increased ED risk and decreased in‐person treatment engagement. Weight discrimination may be a particularly relevant treatment barrier for students who have a higher body weight given their higher likelihood of experiencing weight discrimination. Methods: College students with a probable ED diagnosis (N = 372; Mage = 23.94; 73.12% women, 18.55% men, 6.18% another gender; 11.29% Asian, 4.57% Black, 12.63% Hispanic, 83.60% White, 4.84% Native American, and 0.54% another race) completed an online self‐report survey that included the Clinical Impairment Assessment (CIA), Experience of Weight Discrimination (EWD) Scale, and a 0–100 scale to indicate interest in participating in virtual guided self‐help ED treatment. Results: Linear regression showed significant positive relationships between weight discrimination and ED‐related psychiatric impairment and treatment interest. Discussion: Elevations in CIA scores corroborate past literature that suggested that weight discrimination was positively related to ED psychopathology. Contrary to past research, college students who experienced weight discrimination had greater treatment interest. Students who experience weight discrimination may view virtual self‐guided treatment as less weight‐stigmatizing due to the "do‐it‐yourself" approach and no in‐person interactions. Findings highlight the potential impacts of weight discrimination on acceptability of ED‐related care. Future research is needed to identify ways to reduce weight discrimination and promote weight‐inclusive practices in the medical system. [ABSTRACT FROM AUTHOR]

Objective: To explore barriers and facilitators to mental health care among the student service member and veteran (SSM/V) population, develop an integrative model of mental health service use, and identify health communication opportunities. Participants: Participants were 21 current and former SSM/Vs recruited online and via snowball sampling. Methods: We conducted an emergent thematic analysis of in-depth interviews that took place in February 2021. Results: We identified eight major themes. Two were contextual (military culture, SSM/V identities), three were navigational (career repercussions, recognizing need, service availability/quality), and three were paths forward (high-quality accessible services, veteran peers/spaces, relevant outreach). Conclusions: We recommend higher education institutions promote SSM/V spaces, position mental health care as utilitarian, improve everyday mental health literacy, highlight service accessibility and quality, and deliver communications that reflect the diversity of SSM/V identities beyond the "warrior" archetype. [ABSTRACT FROM AUTHOR]

Objectives: Common mental disorders affect high proportions of university students. This systematic review aims to summarize the barriers and facilitators to help-seeking for depression and anxiety among university students and provide evidence to improve mental health services. Methods: EMBASE, MEDLINE, and PsycINFO were searched for eligible papers. Inclusion criteria: (1) published between 1990 and 2021, (2) written in English, (3) had qualitative or quantitative methodology, (4) involved university students, (5) students had depression or anxiety, (6) students were explicitly asked about barriers and facilitators, (7) >60% of study population had mental illness. Results: Ten studies were included into this review. The most common barriers were self-reliance, stigma, and poor mental health literacy. Good mental health literacy and social encouragement were significant facilitators. Conclusions: Universities could encourage help-seeking by targeting stigma and increasing mental health literacy. Future research could explore the role of self-reliance in help-seeking and identify more facilitators. [ABSTRACT FROM AUTHOR]

Rural Australian youth exhibit high rates of mental ill-health, exacerbated by reduced access to mental health services. While the need for innovative solutions is well-established rural youth themselves are frequently excluded from the dialogue, creating a significant gap in evidence and the development of relevant service provision that reflects young people's lived experiences. Drawing on the concepts of individualism and healthism and research highlighting the continuing importance of relationships and trust in the lives of young people in a digital society, we aim to better understand how rural youth understand mental health and navigate mental health services and information. Using a qualitative methodology, we held 2 small focus groups with a total of 8 young people in rural Tasmania to identify aspects of rural mental healthcare that require improvement and to contribute to developing new and innovative solutions. Findings indicate that rural Tasmanian youth face numerous structural, social, and cultural barriers to positive mental health. Rural self-reliance and generational differences in attitudes towards mental health can negatively affect youths' help-seeking behaviours. Findings from this study suggest a need to combine technology-and community-based approaches creating a multi-generational approach to combat mental ill-health among rural youth. [ABSTRACT FROM AUTHOR]

Background: Insomnia commonly co‐occurs with alcohol use disorder (AUD) and predicts poorer outcomes for those with AUD. Insomnia and AUD are individually associated with increases in systemic inflammation. Insomnia and inflammation both serve as risk factors for relapse in AUD. However, little is known about the relationship between insomnia and systemic inflammation in individuals with AUD. Therefore, the present study examined the relationship between the severity of insomnia symptoms and plasma levels of inflammatory cytokines in a sample of treatment‐seeking individuals with an AUD. Methods: This secondary analysis included 101 (61M/40F) individuals with an AUD. Participants were categorized into groups based on their scores on the Insomnia Severity Index: no insomnia (n = 47), subthreshold insomnia (n = 37), and clinical insomnia (n = 17). Participants provided blood samples to measure plasma levels of four peripheral markers of inflammation (IL‐6, IL‐8, TNF‐α, and CRP). Inflammatory marker levels were compared between groups. Interactive effects of sex and AUD severity were examined. Results: There was a significant main effect of insomnia group on log IL‐8 levels (F = 6.52, p = 0.002), such that individuals with AUD and clinical insomnia had higher log IL‐8 levels compared to both the no insomnia and subthreshold insomnia groups (ps ≤ 0.05). Sex and AUD severity interacted with this relationship, such that men with clinical insomnia and AUD and individuals with severe AUD had higher log IL‐8 levels. There were no significant effects of insomnia on IL‐6, TNF‐α, or CRP levels. Conclusion: The present study identified a specific elevation in IL‐8 levels in individuals with an AUD and clinical insomnia that was not identified in other markers of peripheral inflammation (IL‐6, TNF‐α, CRP). Sex and AUD severity interacted with insomnia symptoms, indicating that those with clinical insomnia and severe AUD or male sex may be the most vulnerable to the inflammatory consequences associated with AUD and clinical insomnia symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Barriers to help‐seeking for illicit drug use cross psychosocial (e.g., knowledge of where to seek help, attitudinal beliefs like being afraid of what people will think) and structural (e.g., service availability) domains. Along with people who use illicit drugs, it is important to consider the perspectives of other key groups who are often involved in the help‐seeking and recovery process. This study aimed to examine the perceived barriers to help‐seeking for people who use crystal methamphetamine ('ice') among key groups (people who use crystal methamphetamine, families and friends, health workers) as well as the general community. Methods: A cross‐sectional online survey open to all Australian residents (aged ≥18 years) was conducted November 2018–March 2019. Four key groups of interest were recruited to examine and compare perceived barriers to help‐seeking for crystal methamphetamine use. Results: Participants (n = 2108) included: people who use/have used crystal methamphetamine (n = 564, 39%), health workers (n = 288, 26.8%), affected family/friends (n = 434, 13.7%) and general community (n = 822, 20.6%). People who used crystal methamphetamine demonstrated increased odds of reporting attitudinal (OR 1.35; 1.02–1.80) or structural (OR 1.89; 1.09–3.27) barriers, or a previous negative help‐seeking experience (OR 2.27; 1.41–3.66) compared to knowledge barriers. Health workers demonstrated decreased odds of reporting attitudinal compared to knowledge barriers (OR 0.69; 0.50–0.95). Discussion and Conclusions: Perceived barriers to seeking help for crystal methamphetamine use differed among key groups involved in treatment and recovery. Acknowledging and addressing the mismatches between key groups, through targeted interventions may better support people to seek help for crystal methamphetamine use. [ABSTRACT FROM AUTHOR]

The article focuses on promoting health equity to address gender-based violence (GBV) through innovative research, practice, and advocacy. Topics include violence training and education for healthcare professionals, the barriers and facilitators of help-seeking behaviors among GBV survivors, and the intergenerational and long-term effects of violence on health outcomes.

The Longborough Festival Opera, as reviewed by Roland Matthews in the Wagner Journal, presents a powerful and intimate production of Wagner's Ring cycle. The production showcases a close-knit family of performers who bring to life themes of greed, loss, love, and redemption. The opera festival's impact on the music scene is notable, with loyal artists contributing to the success of the ambitious project. The production's focus on intense audience involvement and nuanced characterizations in an intimate setting sets it apart, despite some unconventional staging choices. [Extracted from the article]

Purpose: To present the first 14 years' data from 1 academic institution using the American Foundation for Suicide Prevention's online Interactive Screening Program (ISP). The ISP probes suicide risk factors in healthcare workers, utilization of mental health services, levels of engagement, and seeks to reduce barriers to help-seeking. Design: Data from all healthcare system students, medical trainees, physicians, nurses, and staff who completed the ISP's online Stress and Depression Questionnaire between May 1, 2009, and April 30, 2023, were tabulated and analyzed for features related to burnout, depression, suicide risk, treatment, and engagement with program counselors. Results: 5368 individuals engaged in ISP screening. Findings included 39.9% experiencing depression symptoms, 53.9% symptoms of burnout, and 10% suicidal ideation. In this self-selecting group, medical students reported depression symptoms less than physicians in practice, nurses almost 3 times more than physicians, and females more than males. Suicide risk was indicated by multiple domains of distress, with 49.4% in the highest risk tier. At the time of completing the questionnaire, 13.1% were receiving counseling/therapy. After receiving feedback, more than one-quarter of all participants (27.6%) engaged with the program counselors, with an additional 941 individuals who were not already receiving counseling or therapy accepting referrals to mental health providers. Conclusion: The unattended high distress levels throughout the healthcare training and workforce demonstrated the need for safe screening and referral, while the level of engagement and referrals generated by the ISP attested to its effectiveness. [ABSTRACT FROM AUTHOR]

BACKGROUND: We aimed to better understand the impact of statewide legislation removing personal belief exemptions (PBEs) for the measles, mumps, and rubella (MMR) school immunization requirement and factors associated with resulting health‐seeking behaviors. METHODS: We used chi‐squared tests and logistic regression models to determine individual‐ and school‐level characteristics associated with holding a MMR PBE and with post‐law MMR immunization status among students linked to the Washington State Immunization Information System. RESULTS: Of students with a MMR PBE pre‐law change, 43.0% completed the MMR vaccine series and 40.4% sought another exemption type. Religious exemptions made up most new MMR exemptions signed (71.8%), followed by medical exemptions (18.5%), and religious membership exemptions (9.7%). Students were more likely to complete the vaccine series post‐law change if they attended a school with a low school‐level MMR exemption rate, a public school, or held a lower number of school‐required immunization exemptions. CONCLUSIONS: This study confirms previous concerns that parents might replace their PBE with another exemption type; however, nearly half the students in the cohort completed the MMR vaccine series. Our findings suggest that targeted immunization policies can increase MMR coverage 1‐year post‐law change but must account for a replacement effect when exemption categories are eliminated. [ABSTRACT FROM AUTHOR]

Beyond navigating normative developmental tasks, Black American adolescents cope with race-related experiences that are distinct to their racial-ethnic group. However, little is known about how Black American adolescents, particularly those in racially homogenous communities, experience and cope with race-related stress. Using qualitative measures, this study investigates how Black American adolescents in urban, racially homogenous environments experience race-related stress and the coping methods used to combat it. Qualitative data via individual interviews with 20 high school seniors revealed that these adolescents experience race-related stress in individual, institutional, and cultural contexts, which evoked intense negative emotions. Seeking support from family and friends and social referencing positive cultural artifacts were the most widely utilized coping strategies. Implications of the protective nature of racially homogenous environments and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a critical period for mental health and social exclusion, a key social determinant of mental health. Early intervention approaches are key to mitigating the impact of mental ill-health during adolescence, however social exclusion can create additional barriers to accessing care. Aim: We aimed to better understand help-seeking experiences of adolescents facing co-occurring social exclusion and mental ill-health, including sources of support, barriers and preferences for service provision. Method: Cross-sectional data were analysed, from the 2022 Mission Australia Youth Survey (N = 18,800). Adolescents aged 15 to 19 years were recruited from around Australia, through schools, community organisations and digital platforms. Indices of four domains of social exclusion (housing, finances, relational and education/employment) were created using existing Youth Survey variables, and supplemented with demographic characteristics, psychological distress and help-seeking behaviours (perceived need, mental health supports, barriers to access and preferences). Relationships between social exclusion domains, mental health concerns and help-seeking behaviours were explored using logistic regression models. Results: A total of 9,743 young people reported having needed mental health support, yet only 58.1% reportedly sought support (n = 5,565). Social exclusion domains were associated with different help-seeking behaviours: housing challenges with higher help-seeking (OR = 1.28; 95% CI [1.15, 1.42]); relational difficulties and edu-employment issues with lower (OR = 0.75; 95% CI [0.68, 0.83] and OR = 0.82; 95% CI [0.75, 0.89]). Stigma, confidentiality concerns, cost and not knowing where to seek help were common barriers to help-seeking; those experiencing social exclusion more likely to report these. Participants reported a strong preference for face-to-face support. Conclusions: This study highlights the additional needs and challenges faced by adolescents dealing with both social exclusion and mental ill-health. With greater barriers to help-seeking, concerted efforts are needed to reduce stigma, improve mental health literacy and increase access to trusted information sources. Further initiatives should focus on structural factors that socially exclude young people and exacerbate inequitable access to mental healthcare. [ABSTRACT FROM AUTHOR]

Objective: The impact of eating disorders in adolescents extends to the whole family, particularly the parents. These parents are uniquely positioned as their children's case manager, feeder, and advocator, often with little experience or training to guide them. This investigation aimed to develop an in-depth understanding of the experience of parents seeking help for children with eating disorders. Method: Semi-structured interviews were conducted with eight parents who had accessed treatment for their child's eating disorder within the past 3 years through the Australian health system. Interpretative phenomenological analysis was used to understand their experience. Results: Two main themes and six subthemes were identified: Parental Gauge on High ("trusting parental instincts", "desperation for a compass and map" and "discarded expertise"), and Disappointment in the Healthcare System ("GP's casual responses to serious cases", "treatment lucky dip" and "the whirlwind of re-engagement"). Conclusions: The findings highlight the difficulties in identifying symptoms and seeking initial help as well as the ongoing toll on parents to navigate the health system and support their children. Findings of the study suggest a need for ongoing, inclusive, and holistic support to help parents navigate care for their children. KeyPoints: What is already known about this topic: Early intervention for eating disorders improves prognosis, however there is often a delay in seeking treatment. In adolescents, this delay is often due to parents not recognising symptoms or not understanding the seriousness of disordered eating behaviour. Parents play a key role in recognising symptoms, seeking help, and providing ongoing support. What this topic adds: Parents felt that health professionals locked them out of their children's treatment and dismissed their input. Limited (or no) training on how to feed their children made mealtimes traumatic for parents and children, further worsening distress and limiting their children's intake. Parents felt dissatisfaction with healthcare in Australia, particularly about GP's dismissal of symptoms and difficulty navigating the public system. [ABSTRACT FROM AUTHOR]

The internet has revolutionized how we live, providing unprecedented convenience and up-to-date information. Consequently, an increasing number of individuals are turning to the internet for health-related information, despite research suggesting a correlation between this behavior and health anxiety. Therefore, drawing on cognitive – behavioral theory, we explore the link between online health information seeking and health anxiety via a systematic review and meta-analysis of cross-sectional studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis, we ran searches in multiple databases, including PubMed, Web of Science, Embase, Elsevier/Science Direct, Cochrane Database, China National Knowledge Infrastructure, VIP Chinese Database, and Wanfang Data. Our searches identified 16 studies eligible for review, involving 4,920 participants across seven countries. The random-effects meta-analysis revealed a significant positive correlation between online health information seeking and health anxiety (r = 0.28, 95% confidence interval [0.16, 0.41], p <.0001), despite considerable heterogeneity. Furthermore, meta-regression analysis demonstrated that the identity characteristics of the sample, female percentage, sample size, and country all contributed to the heterogeneity across studies. Overall, this meta-analysis provides support for the association between online health information seeking and health anxiety, and helps to elucidate the cognitive – behavioral theory underpinning this phenomenon. [ABSTRACT FROM AUTHOR]

The notion of social solidarity involves formal and informal practices, with various levels of institutionalisation. It builds on normative assumptions and discourses of reciprocal expectations of mutual help, on (perceived) ideas of sameness or neediness in relation to, among other, class, ethnicity, and/or gender and on notions of deservingness that are entangled in such ideas. In this contribution, we discuss how the intersection between institutionalised social solidarity in European nation-states and notions of deservingness informs who is seen as worthy of being part of welfare arrangements. Where ideas of solidarity and deservingness intertwine with legal categorisations of belonging, the results are exclusionary policies that often restrict migrants' access to national welfare policies, and hence meaningful societal participation. Furthermore, we discuss migrants' experiences with expressions of solidarity beyond the national realm, exploring how ideas about migrants' deservingness become linked to their economic usefulness within the European (integration) project. [ABSTRACT FROM AUTHOR]

Women's agency in resisting violence and control within intimate relationships manifests in diverse forms, shaped by various social divisions and the socio-cultural contexts in which gender relations evolve. This research explores first-generation young Iranian immigrant women's responses to violence and control within their dating relationships in Canada. Employing an intersectional analysis, it delves into the multifaceted agency demonstrated by these women when confronting dating violence (DV). By contextualizing their agency within Collins's matrix of oppression, the study unveils how systems of oppression interlock to shape their agency. The findings underscored the substantial agency displayed by young women in asserting their self-determination and self-definition. This was evident in their ability to recognize the aggressor's controlling behaviors within their relationships and their outspoken critique of the deeply entrenched patriarchal and gendered norms prevailing in the dominant discourse within the Iranian community. The results underscore the pressing need for culturally sensitive interventions and education programs that move beyond mere DV awareness. [ABSTRACT FROM AUTHOR]

Background: The heterogeneity of persons with temporomandibular disorders (TMD) and the lack of effective treatments have called for a biopsychosocial model and the development of a more personalised treatment approach. Emphasis on phenotypes might be a beneficial approach. Objective: Identifying phenotypes among persons with TMD using potential prognostic factors, including personal characteristics and responses to clinical tests. Additionally, examining the distribution of TMD diagnoses within the identified phenotypes. Methods: A cross‐sectional study including 208 persons (85% females) seeking physiotherapy for problems in the temporomandibular area. All participants were examined clinically and answered questionnaires electronically. The phenotypes were identified using latent class analysis based on seven potential prognostic factors selected within pain, function and psychological domains. Table analysis was used to explore the distribution of TMD diagnoses within the identified phenotypes. Results: Most participants fit into one of three identified phenotypes. Phenotype 1 (32%) was characterised by functional disability, low psychosocial scores and low risk for developing chronicity and future work disability; Phenotype 2 (29%) by parafunctional habits, low psychosocial score and seeking treatment to reduce pain; and Phenotype 3 (39%) by high levels of mental distress, fear avoidance and a large risk of future work disability. Intra‐articular disorders dominated Phenotype 1, myalgia and TMD‐related headache Phenotype 2, while Phenotype 3 included all the different TMD diagnoses. Conclusion: The knowledge about the three identified phenotypes might be useful for clinicians treating persons with TMD and for the development of preventive strategies and more personalised treatment. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a public health problem. In Spain, although the prevalence of IPV is greater in immigrant women than in Spanish‐born women, immigrant women seem to access services to a lesser extent. This study aimed to explore and compare perceptions of barriers to and strategies for seeking formal help among Spanish‐born and immigrant women IPV survivors. A qualitative study was conducted based on three focus groups with women of Spanish (n = 9), Romanian (n = 4), and Latin American (n = 4) origin. The thematic analysis was supported by Atlas.ti. Three categories and 12 subcategories were identified: general characteristics of help‐seeking behavior (e.g., children as the main motivating factor), barriers (e.g., immigrant status, fear of the perpetrator), and strategies for accessing services (e.g., increasing education). Differences in help‐seeking behavior were found between groups. Relevant information for professionals to improve women's access to IPV support services is provided. [ABSTRACT FROM AUTHOR]

Sexual Assault Response Teams (SARTs) are community-based, multidisciplinary interventions that strive to coordinate the response to sexual assault. SARTs consist of sexual assault responders (e.g., rape crisis advocates, police, forensic examiners/Sexual Assault Nurse Examiners, and prosecutors) and seek to increase responder collaboration to improve survivors' help-seeking experiences. There is a lack of empirical research examining factors underlying SARTs' goals and what leads communities to form SARTs. Therefore, this study sought to examine the goals and motivations present in SART development using a multiple-methods approach with a national random sample of n = 172 SARTs. Exploratory factor analysis (EFA) was used to examine factors underlying SART goals, and qualitative thematic analysis was used to explore what motivators drove SART formation. Both qualitative and quantitative analyses underscored the importance of improving the accessibility and quality of services, improving the treatment of survivors, and increasing responder collaboration. The qualitative findings offered additional insight into the importance of community education and various community contextual factors (e.g., funding and policy requirements) that influence SARTs. Findings inform future research and practice on SART goals and functioning, such as how SART goals may relate to team structure, effectiveness, and capacity-building opportunities. [ABSTRACT FROM AUTHOR]

Female-perpetrated sexual violence research in Australia and elsewhere has been limited, part of a less common and arguably contentious field of criminology. Because of gendered social and cultural stereotypes, female sexual offending is often perceived as harmless or too rare to warrant attention. Utilizing Schippers' pariah femininities, this paper presents a critical criminological exploration of social media users' constructions of female sex offenders and their male victim-survivors. Examining 28 Facebook posts from 13 popular Australian newspapers, our findings identified social media users' tendency to question offence severity and sexualize offenders based on appearance, revealing how offender legitimacy and conceptions of harm are shaped by gendered expectations of "pretty women" and "lucky blokes." Conclusions suggest online discourse remains influenced by gendered stereotypes, though awareness of pariah femininities is growing, with further research needed worldwide to explore the impact of such social media attitudes and commentary on the incidence of and reactions to female sexual offending against men, including victim-survivors' help-seeking behavior. [ABSTRACT FROM AUTHOR]

The Internet offers help-seekers an abundance of resources that can potentially support their mental health. However, people often have trouble in finding personally relevant resources. Very few specialized mental health help-seeking technologies currently address this need. Instead, help-seeking typically begins with a known website or web-search. To understand how help-seeking technologies could be better designed, we conducted a study comparing existing technologies with two novel help-seeking prototypes. These prototypes were informed by empirically grounded design recommendations, which emphasize the need for connectedness, accessible and creditable information, personalization, and immediacy. Findings show that the resources recommended by current technologies are often experienced as 'overwhelming' or 'overly-medicalized'. The prototypes successfully improved connectedness, immediacy, and personalization, but were less successful in their ability to support symptom-based help-seeking. Based on our findings we contribute recommendations for integrated help-seeking technologies, which can guide people to mental health resources appropriate to both their personal preferences and current level of need. [ABSTRACT FROM AUTHOR]

This research evaluates whether third-party presence is associated with rape and sexual assault (RSA) victims help-seeking and reporting to police, addressing a gap in the literature about how the presence of a third-party is associated with victim behavior. This research uses secondary data from the National Crime Victimization Survey (NCVS). Findings indicate that third-party presence has no statistically significant association with help-seeking and marginal significance with police reporting. This research focuses on third-party presence as a precursor to understanding victim help-seeking behaviors and reports to police. This research raises questions about the expected role of third parties in RSA victimizations. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) is a problematic and important social phenomenon (World Health Organization [WHO], 2021) that has been repeatedly linked to attachment insecurities (Velotti et al., 2020). However, the mechanisms linking these two variables remain understudied. This study examines the direct and indirect associations between attachment insecurities (anxiety and avoidance) and perpetration of IPV (psychological, physical, sexual, coercive control) through the use of dysfunctional communication patterns (i.e., demand/demand, I demand/my partner withdraws, my partner demands/I withdraw) and lower relationship satisfaction. Methods: A sample of 613 men and non-binary people who consulted organizations providing help to individuals with relationship or IPV-related difficulties answered online questionnaires. A path analysis was conducted to test the direct and indirect associations between attachment insecurities and perpetrated IPV through communication patterns and relationship satisfaction. Results: The results showed a direct and positive association between attachment anxiety and perpetration of coercive control, and an indirect and positive association between attachment insecurities and psychological violence through the demand/demand pattern. The results also revealed an indirect and positive association between attachment anxiety and psychological violence, sexual violence, and coercive control through the I demand/my partner withdraws pattern. Finally, an indirect and positive association was observed between attachment insecurities and all types of violence studied through lower relationship satisfaction. Conclusions: This study provides key individual and relational correlates of IPV perpetration that can inform prevention and intervention among men and non-binary people. [ABSTRACT FROM AUTHOR]

Background: About one in five adults in the United States experience any mental illness (AMI), whereas 14.2 million experience serious mental illness (SMI). The perception of stigma among individuals experiencing mental illness is associated with care seeking behavior and treatment adherence. Purpose: Two factors that mitigate stigma are familiarity with someone experiencing AMI/SMI and general level of education. Heretofore, these factors have not been tested together to determine if familiarity moderates the relation between level of education and stigma of professional efficacy for treating mental illness. Methods: In fall 2020, an online survey in the state of Utah measured 1,300 adults' perceptions of stigma for AMI/SMI using a validated instrument. Data were analyzed using logistic regression. Results: Results indicate that familiarity (i.e. self or immediate family member versus other person) moderated level of education for stigma of professional efficacy for treatment of AMI but not SMI. Discussion: Participants viewed the professional efficacy of treating AMI and SMI differently. These findings have implications for educational interventions designed to mitigate public stigma for professional efficacy of treating mental illness. Translation to Health Education Practice: Emphasizes the National Commission for Health Education Credentialing Inc. assessment of needs and capacity, and evaluation and research competencies. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) . [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion A minority of individuals with eating disorders seek help from health professionals qualified to provide eating disorder care. This review assessed the proportion of individuals with eating disorders who had sought help or received treatment, as an update to an earlier review conducted more than a decade ago.Three databases were searched for studies that: (1) included a community sample of help‐seekers and non‐help seekers, (2) used a standardized eating disorder screening instrument, and (3) assessed the percentage of participants who had sought help specifically for eating disorder concerns.Of 972 articles, 21 studies met inclusion criteria, representing 37,423 participants. The pooled proportion reporting help‐seeking from any source (e.g., helpline, support groups, chat rooms as well as health professionals) was 30% and the pooled proportion reporting formal treatment seeking from health professionals (e.g., psychologist) specifically for eating disorder concerns was 32%. However, there was evidence of publication bias across studies.These rates suggest little to no improvement in the unmet need for treatment since the last review with studies continuing to focus on white adult women. Help‐seeking rates among other populations remain unclear and there is an urgent need to understand reasons for overall low help‐seeking rates. Clear definitions and measures of help‐seeking with appropriate distinctions between sources of help are needed to improve our understanding of help‐seeking pathways and identify solutions to facilitate help‐seeking. Better visibility of health professionals qualified to provide safe and effective eating disorder care could help reduce the substantial treatment gap. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion Implications To assess the feasibility of implementing a culturally responsive version of Gottman's Seven Principles relationship education program in a community‐based setting for married Arab American adults.To provide high‐quality couple and relationship education, it is necessary to acknowledge the population's needs and cultural backgrounds. One ethnic minority group that needs special attention is the Arab American community, which shares protective factors in terms of family support, religious beliefs, resiliency, and collectivist culture.We adapted Gottman's Seven Principles Program and conducted a qualitative feasibility study to examine recruitment capability, program acceptability, demand, and participant response among 16 Arab American married adults.The results emphasize the vital role that thoughtful cultural and linguistic program adaptation played in increasing the acceptability and engagement of Arab American participants. However, results identified the ongoing stigma in Arab American communities against overtly seeking help for marital issues.This feasibility study provides helpful methodological and practical guidance to inform the design of larger scale randomized trials examining the efficacy of culturally responsive marriage education programs.This study outlined actionable strategies, adaptations, venues, and communication channels to reduce barriers and optimize the delivery of marriage education to Arab American couples and families. [ABSTRACT FROM AUTHOR]

Couples appear to frequently experience relationship problems, yet estimates of the prevalence and prediction of three distinct help‐seeking steps, (1) recognition of serious relationship dissatisfaction, (2) considering help, and (3) receiving relationship help, are unknown for representative population samples. This is unfortunate as such knowledge may inform policy makers in the development of strategies to motivate couples to seek help. The prevalence of these steps along with reasons for not acquiring help was studied in a representative population sample of 1014 Dutch heterosexual couples. Multilevel Actor‐Partner Interdependence Modeling (APIM) analyses estimated the extent to which static socio‐demographic factors were predictive of help‐seeking behaviors. Of all partners, 28.6% reported having ever been seriously dissatisfied with their relationship (step 1), of which 86.2% had told their partner they were dissatisfied, on average 1.5 years after onset of the dissatisfaction. Of the seriously dissatisfied partners 36.4% considered professional relationship help (step 2) and 19.5% eventually received help (step 3), on average 3.7 years after the onset of dissatisfaction. Of these, 88.5% consulted a (couple) therapist. Main reasons for not acquiring help were that “things got better” (48.8%) and “the partner did not want relationship help” (35.4%), whereas financial considerations and shame were rarely endorsed. Although serious relationship dissatisfaction was common (i.e., 40.1% of all couples consisted of at least one partner who was ever dissatified), few couples sought help and they did so rather late. Waxing and waning of dissatisfaction often guided the decision to not seek help. Women and younger partners were more proactive in help‐seeking. Marital status, having children, and education were largely unrelated to help‐seeking. [ABSTRACT FROM AUTHOR]

Plain English Summary: In the United Kingdom, people can access public funding for In Vitro Fertilisation (IVF) treatment if certain criteria are met. Funding restrictions differ between geographical areas, but most areas restrict treatment to women with a Body Mass Index (BMI) below 30. This study explores the unexpected and unintended harms experienced by women restricted from NHS-funded IVF due to these BMI criteria. Posts from a popular infertility online forum were collected and thematically analysed. The study found moralising discourses around body weight which emphasized that women had personal control over their bodies and needed to 'work' to change their bodies to show deservingness for treatment. We conclude that NHS-IVF policies in the UK overlook the emotional and moral burdens placed on individuals due to rigid BMI criteria. As the impact of BMI limits on healthcare access is an under-researched topic, we believe this work is important for demonstrating the harms of BMI-restrictive policies. Background: Across the United Kingdom's National Health Service (NHS), women with a Body Mass Index (BMI) of > 30 face restrictions accessing In Vitro Fertilisation (IVF) treatment. This study asks: what are the (un)expected and (un)intended harms and consequences experienced by women restricted from accessing NHS-funded IVF due to BMI threshold criteria? Methods: Posts from a popular infertility online forum were collected and reflexively thematically analysed. Results: On the forum, users discussed how they struggled to lose weight, how they faced time pressures to meet BMI thresholds, and they shared knowledge on how to comply or appear compliant with BMI cut-offs. Our study found widespread moral discourses around body weight were reproduced in the forum, particularly commonplace narratives that body weight is under personal control, that people with a high BMI should 'work' to change their bodies, and that this work helps demonstrate deservingness for IVF treatment. Moralising discourses around weight were linked to the responsibilities of a hoped-for future of motherhood, as users performed deservingness through emphasising their commitment to meeting the BMI threshold. Conclusion: We conclude that NHS-IVF policies in the United Kingdom do not consider the burdensome emotional and moral work placed on people seeking treatment due to inflexible upper-limit BMI criteria. [ABSTRACT FROM AUTHOR]

Numerous universities nationwide announced urgent implementation of closed campus management due to the epidemics of COVID-19 in Chinese universities since March 2022, and a large number of students were under quarantine. This study aims to explore how embodied experiences (i.e., centralized quarantine and self-quarantine) and mediated experiences (i.e., exposure to media sources, pandemic information overload, and online help seeking) influence the acquisition of learned helplessness during the campus epidemics among the Chinese university students, besides, how do these two types of experiences interact with each other to elicit learned helplessness is another interested research question. The data was collected nationwide via an online survey platform from March 22nd to April 16 2022 immediately after the outbreak of campus epidemics. A total of 1267 valid student samples were retained. Hierarchical regression analysis showed that embodied experience of centralized quarantine is positively related to learned helplessness. Mediated experience of information access from friends on social media and government official media as well as online help seeking are negatively related to learned helplessness. Information access from overseas media and pandemic information overload are positively related to learned helplessness. Besides, the interaction between self-quarantine and pandemic information overload is positively related to learned helplessness. Theoretical contributions and intervention strategies aimed at enhancing authoritative communication and managing information overload during public health crisis were discussed. [ABSTRACT FROM AUTHOR]

Background: While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden. Methods: A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18–84 years old, 3,779 answered the survey during February–May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes. Results: Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30–44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45–64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65–84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining. Conclusions: Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented. [ABSTRACT FROM AUTHOR]

Background: Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001–2010 and 2015–2018. Methods: We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models. Results: The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35–49 years and remained stable over time, except for slight increase in those aged 65–79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches. Conclusion: The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents' socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD. [ABSTRACT FROM AUTHOR]

Background: Military personnel often face unique challenges in maintaining optimal oral health. This study investigated the oral health status, caries experience, and associated factors among a sample of Iranian soldiers, employing a structural equation modeling (SEM) approach to explore the complex interplay of socioeconomic and behavioral determinants. Methods: A cross-sectional study was conducted among 658 male soldiers aged 18–30 years from three military barracks in Fars province, Iran. Data were collected through a structured instrument and clinical oral examinations. The study employs the DMFT index, which measures caries experience based on decayed, missing, and filled teeth, along with the Simplified Oral Hygiene Index (OHI-S) to assess overall oral health status. Structural equation modeling was employed to analyze the complex relationships between socioeconomic factors, oral health behaviors, and oral health outcomes. Results: The mean DMFT score was 3.57 ± 5.91, and the mean OHIS score was 0.56 ± 1.42. SEM analysis revealed that socioeconomic status (SES) indirectly influenced DMFT and oral hygiene scores, mediated by drug use, oral hygiene practices, dietary sugar consumption, and dental visit frequency. Lower toothbrushing frequency was significantly associated with higher DMFT (Estimate = -0.064, p < 0.001) and OHIS scores (Estimate = -0.637, p < 0.001). Drug use (smoking, qalyan, alcohol) was linked to poorer oral health outcomes, while more frequent dental visits were associated with lower DMFT and OHIS scores. Conclusion: This study reveals the complex interplay between socioeconomic conditions, oral health behaviors, and oral health outcomes among Iranian soldiers. The findings highlight the need for targeted interventions to address modifiable risk factors and improve access to preventive dental care within military settings. Future longitudinal studies are warranted to elucidate further the causal pathways between these factors and oral health outcomes in military populations. [ABSTRACT FROM AUTHOR]

Background: Surf therapy is gaining popularity for improving mental health. However, there is limited research evidence to substantiate these claims. Therefore, this systematic review aimed to assess randomized or non-randomized studies analyzing the efficacy of surf therapy in improving symptoms of mental illness compared to non-exercising controls and/or alternative intervention, and to identify evidential gaps to inform future research. Methods: PRISMA 2020 reporting guidelines were followed. Eligibility criteria included participants of any age and sex, explicitly diagnosed with any mental health disorder, while exposed to surf therapy and compared to non-exercising controls and/or alternative interventions. The primary outcome consisted of changes in symptoms of mental illness scored from baseline to post-intervention. Any randomized or non-randomized trial design was considered. We searched Cochrane Library, CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus and Web of Science databases (December 7, 2023), without language or publication date restrictions and without filters. Risk of bias was assessed using RoB 2. A meta-analysis could not be conducted due to heterogeneity of the studies; therefore, a narrative synthesis of individual study results was performed. Results: Of 5,666 records, three randomized controlled studies were included in the review. Overall, the findings of the three studies suggest no robust consistent evidence of improvement in mental health symptoms when comparing surf therapy to wait-list control groups or other nature-based exercise interventions (hike therapy). Certainty of evidence should be considered very low, as it is based on three randomized controlled trials. Conclusion: Although we believe that surf therapy provides an interesting approach, robust evidence is scarce. Routes for future well-designed, controlled studies are discussed. Other: No funding to report. Registration: PROSPERO CRD42021277060. [ABSTRACT FROM AUTHOR]