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An online qualitative survey explored perceived training, readiness, and needs of recent SW graduates serving older adults. Over half (N = 14) held a master's in social work, with 70% having taken an introductory aging course. Nearly halfcompleted other aging-specific coursework, and 80% did fieldwork with older adults. Participants indicated moderate proficiency in assessing issues like lossestransitions (46.7%), and physical health (53.3%), and advanced expertise in cognitive assessments (60.0%) and caregiver stress management (53.3%). Training deficiencies were noted in disaster readiness, telehealth, and resource coordination. Findings underscore the need for educationfor early-career social workers, ensuring their effective support to older adults. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care has become a global health concern because of its impact on patient safety and nursing care quality. It is a critical indicator of nursing care quality and adverse patient outcomes. However, data regarding the magnitude and reasons for missed nursing care is limited in the study area. This study aimed to determine the magnitude and reasons for missed nursing care among nurses working in South Gondar zone public hospitals. Methods: An institution-based cross-sectional study design was conducted among nurses working in South Gondar zone public hospitals from December 12, 2023, to January 20, 2024. The data was collected through self-administered MISSCARE survey tools. The collected data were entered into EpiData V.4.2 and then exported to SPSS V.25 for analysis. The statistical significance of the association between outcome variables and independent variables was declared at a P-value less than 5% (0.05) at 95% CI. Result: The magnitude of missed nursing care in the study area was 51.7% (95% CI: 46.89–55.47%). Medications administered as ordered (69.8%), skin/wound care (69.8%), vital signs assessed as ordered and accordingly (68.8%), and IV/central line site care and assessments according to hospital policy (66.2%) were among the nursing care elements that were frequently missed. Material resource (76.7%), teamwork (69.1%), labor resource (65.5%), and communication (56.3%) were the main reasons for missed nursing care. Inadequate number of staff 2.9 (1.75, 4.75), training (CPD) in nursing care 1.9 (1.16, 3.14), equipment's not available 3.9 (2.16, 6.89), and medication were not available. 4.4 (2.48, 7.76) were associated with missed nursing care. Conclusion: The proportion of commonly missed nursing care was high. After adjusting for demographic variables, labor resources, material resources, and communication were reasons for commonly missed nursing care. Increasing the number of nurses, investing in nurse training, working on equipment availability, and increasing medication availability could minimize frequent omissions of nursing care. [ABSTRACT FROM AUTHOR]

Purpose: Cochlear implantation is a well-established option for early intervention. Children with hearing impairment and their parents are users of intervention services, with parents being more suited to provide insight into their experiences. The purpose of the current study was to describe the experiences of parents of children with cochlear implants (CIs) in the South African context. Methods: A qualitative research design was employed. Non-probability, purposive sampling was used. Seven, online semi-structured interviews were conducted with parents of children with CIs. Data were analysed using inductive thematic analysis. Results: Participants expressed feelings of certainty and assurance in the CI journey. Participants extended gratitude to the healthcare professionals involved in their children's CI journey. Feelings of doubt and stress were noted when coming to terms with the decision of cochlear implantation and financial stressors were noted as a challenge. Many participants found it challenging transitioning their children into school. Conclusions: Parents conveyed having no regrets with their decision of cochlear implantation for their child and were grateful for the support provided by healthcare professionals. However, financial, and educational challenges remain. Findings suggest the need for more financial support for cochlear implantation in South Africa, and for adequate inclusive educational settings. IMPLICATIONS FOR REHABILITATION: Parental involvement and family-centred care are important to the success of cochlear implantation in children. Parents do report positive experiences with regard to cochlear implantation Financial stressors and schooling remain a challenge for parents to navigate through the CI journey. Counselling, provision of information, and ongoing support by healthcare professionals is recommended to assist parents in making informed decisions regarding cochlear implantation and schooling. [ABSTRACT FROM AUTHOR]

The aim of conducting a systematic review of the available literature on antibiotic self-medication was to obtain comprehensive data on prevalence, reasons, common antibiotics, self-treated diseases, and drug and information sources of antibiotics used for self-medication worldwide. PubMed, ScienceDirect, SpringerLink, and Taylor & Francis Online were used to perform a comprehensive search on articles published between 2011 and 2020 in the English language. Studies focusing on the prevalence of antibiotic self-medication and its associated factors were included in this review. AXIS Appraisal tool for Cross-sectional studies (AXIS tool) was used for quality assessment of the included articles. A total of 76 studies from diverse geographical locations, including 62668 individuals, were included in this systematic review. The prevalence of SMA in the included studies ranges from 2.6% to 86.5%. Major reasons for non-prescribed use of antibiotics include healthcare costs and time constraints. Respiratory tract infections, fever, and prophylaxis of various symptoms appeared to be prominent self-treated health issues. Pharmacy or superstore, leftovers, and relatives or friends were the most common sources of acquiring antibiotics for self-medication. Similarly, the majority tend to self-medicate with antibiotics based on information obtained from a pharmacy, previous prescription, or personal experience. Self-medication with antibiotics was considered a pervasive issue, with penicillin being the most commonly self-medicated antibiotic. Lack of public awareness and little attention of researchers to not only self-medication but also other related issues such as antibiotic resistance, necessitates the immediate development and execution of public health policies and multifaceted interventions to ensure rational use of antibiotics eventually reducing antibiotic resistance. [ABSTRACT FROM AUTHOR]

Purpose: Worldwide, trans people are known to take hormones without prescription or take higher or lower doses than prescribed. The study's goal was examination of the social context behind provision and receiving of gender-affirming hormonal therapy (GAHT) in Russia, as well as collection of opinions on the organization of healthcare. Methods: Semi-structured interviews with 20 trans individuals and 6 endocrinologists. Results: Trans respondents started GAHT between 2004 and 2022. Over that period, the number of trans-competent endocrinologists increased and it became easier to receive the diagnosis F64.0 "transsexualism" (ICD-10), which qualifies one to obtain GAHT. However, the majority still took hormones without supervision. The reasons for self-medication included: the lack of the diagnosis, high cost of appointments and tests, age under 18, and self-perceived understanding of principles of GAHT. Most endocrinologists learnt about GAHT after being approached by a trans patient. They received information from advanced training courses and academic literature. The specialists had diverse opinions on the ideal policy of providing GAHT to trans people, but all claimed that in Russian political realities they found the diagnosis "transsexualism" a necessary prerequisite for initiating GAHT to safeguard both doctors and patients. Conclusions: The lack of strict law enforcement in the pharmacological sphere in Russia enabled many trans people to initiate GAHT without supervision. Trans-competent endocrinologists were available for those who needed them. Under current political circumstances it is unlikely that the informed consent model (prescription without a psychiatric diagnosis) can be implemented in Russia. [ABSTRACT FROM AUTHOR]

Hypoglycemia will inevitably occur. Being prepared and implementing a treatment plan should help to restore euglycemia and resolve hypoglycemia symptoms. The plan comprises fast-acting carbohydrates and, importantly, ready-to-use glucagon for self-administration when carbohydrates are not working or for third-party administration when the affected person is unwilling or unable to swallow (e.g., unconscious or in a coma). [ABSTRACT FROM AUTHOR]

Objective: People may consume alcohol to cope with the stressors and anxieties of the COVID-19 pandemic. The present study applied the self-medication hypothesis, tension reduction hypothesis, and alcohol myopia theory to understand COVID-19 alcohol coping as a mediator of the pathways from COVID-19 anxiety to alcohol use and alcohol consequences. Methods: Participants (N = 477) were undergraduate college students. The mean age was 22.14 (SD = 5.66) years. Gender distribution included 73% females, 26% males, and 1% transgender. Racial categories included 70% White, 11% Latino, 5% Black, 5% Asian, and 9% multiracial. They completed the Coronavirus Anxiety Scale, the COVID-19 Alcohol Coping Scale developed and validated in the present study, measures of drinking frequency and drinking quantity, and the Alcohol Myopia Scale to assess alcohol consequences. Results: First, confirmatory factor analysis supported the measurement structure of the COVID-19 Alcohol Coping Scale. Second, a general structural equation model containing only latent factors provided evidence for the following pathways: COVID-19 anxiety to COVID-19 alcohol coping to overall alcohol use to alcohol myopia consequences. Third, a specific structural equation model separated the overall alcohol use factor into two measures of drinking frequency and drinking quantity. Results found that COVID-19 alcohol coping uniquely explained drinking frequency (but not drinking quantity), indicating that the pursuit of alcohol to cope with the pandemic was related to more frequent days of alcohol use but not more concentrated use on drinking days. Tests of indirect effects corroborated the mediational pathways in the explanatory models. Conclusions: The research offers insights into understanding that the risk connections from COVID-19 anxiety to alcohol behavioral outcomes are mediated by alcohol use to cope with the pandemic. [ABSTRACT FROM AUTHOR]

Higher levels of social capital (SC) are associated with better health status. However, there is little evidence of the impact of SC on biological health outcomes in the early ages. To identify the association between SC in adolescence and inflammation levels in early adulthood. Prospective study using data from 2435 participants from the Epidemiological Health Investigation of Teenagers in Porto cohort. SC was assessed at age 17 through a self‐administered questionnaire, and high‐sensitivity C‐reactive protein (hs‐CRP) and leucocytes were measured in a fasting blood sample at 17 and 21 years‐old. A principal components analysis was performed to identify the domains of SC. Simple linear regressions were performed to assess the association between SC components and inflammatory status at 17 and 21 years old. Pathway analysis was performed to assess the direct, indirect, and total effects of SC on hs‐CRP and leucocyte levels. We did not find a significant total effect between SC at 17 years‐old and hs‐CRP at 21 years‐old. However, the Trust/Reciprocity dimension showed a significant direct effect between SC and hs‐CRP levels at 21 (β = −0.065, 95% CI: −0.129; −0.001), as well as a significant total effect (β = −0.075, 95% CI: −0.139; −0.011). Regarding leucocyte levels, total SC at 17 years‐old was associated with leucocytes levels at 21 (β = −0.115, 95% CI: −0.205; −0.024). Significant direct (β = −0.104, 95% CI: −0.194; −0.014) and total effect (β = −0.107, 95% CI: −0.199; −0.015) of Trust/Reciprocity on leucocyte levels were observed. Adolescents with higher SC have a low inflammatory level in early adulthood, especially those with greater levels of trust/reciprocity. [ABSTRACT FROM AUTHOR]

Background: Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health‐related consequences has several disadvantages. The aim of the present study was to examine the consistency of self‐reported lifetime abstention and never‐binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol‐related morbidity among lifetime abstainers was examined by linking survey data to alcohol‐related morbidity data in a national patient register. Methods: Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow‐up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid‐August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow‐up survey in 2020. Data in both waves were collected by self‐administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol‐related morbidity was obtained from the Danish National Patient Register. Results: In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol‐related health condition. Conclusion: The present research reaffirms previous studies which have found self‐reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non‐negligible proportion of lifetime abstainers had been diagnosed with an alcohol‐related health condition. [ABSTRACT FROM AUTHOR]

Background: Plantar heel pain is described as sharp pain at the medial plantar aspect of the calcaneus and medial longitudinal arch of the foot. There are various treatment options that usually need a clinician or a therapist for application. The present case report aimed to describe the outcomes of self-executed cross-friction massage using a fascia ball in a patient with recent-onset plantar heel pain. Case description: The patient was a 42-year-old man who reported plantar heel pain during the first steps in the morning along with decreased function of the foot and ankle lasting about three months. He was instructed to self-execute cross-friction massage using a fascia ball daily in the evening at home for six weeks. Outcomes: Pain during treatment decreased from a Numeric Pain Rating Scale (NPRS)-score of 8/10 and from a Short-Form McGill Pain Questionnaire (SF-MPQ)-score of 34/60 at initial treatment to NPRS- and SF-MPQ-scores of 0/10 and 0/60, respectively, after about three weeks. The patient reported no pain and restored function after six weeks of treatment, and in the follow-up measurements. Discussion: Daily self-executed cross-friction massage using a fascia ball may be a useful alternative intervention for treating recent-onset plantar heel pain. [ABSTRACT FROM AUTHOR]

Background: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. Method: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. Results: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). Conclusions: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS. [ABSTRACT FROM AUTHOR]

Objectives: The use of nonprescribed antibiotics increases the risk of antibiotic resistance, which is a primary public health concern of the 21st century. This study explores structural and cultural determinants of antibiotic misuse among immigrants living in the United States who arrived from home countries with easier access to antibiotics. Methods: Adopting a qualitative approach, we interviewed 34 immigrants living in the United States and who had traveled back to their home countries within 1 year of the interview. We followed the steps of constructive grounded theory to analyze the data. Results: We found two primary influences of immigrants' use of nonprescribed antibiotics. The first was structural barriers to health care access in the host country, including insurance coverage, cost of an emergency department visit, cost of missing a paid day of work, complexity of the healthcare system, and communication issues with health care providers. The second was participants' cultural assumptions, including their experiences of antibiotics use, beliefs about antibiotics, a habit of self-medication, and uncertainty about future medical needs. Conclusions: This study informs policymakers concerned with combating antibiotic resistance. Promoting antibiotic stewardship among immigrants from countries with lax antibiotic-prescribing practices and improving access to appropriate channels for preventative and same-day care may reduce the inappropriate use of antibiotics. [ABSTRACT FROM AUTHOR]

Purpose: Snakebites represent a pressing global public health concern, with India shouldering a disproportionate burden and often dubbed the "snakebite capital." Traditional and spiritual healing methods prevail in India, yet their efficacy and potential adverse health consequences warrant investigation. This study seeks to elucidate the perspectives of healthcare providers and caretakers regarding snakebite treatment practices, with a specific emphasis on traditional healing modalities. Methods: An exploratory study was conducted among ten healthcare providers–five traditional and five modern treatment providers, two snake trappers/catchers and 120 snakebite victims or their caretakers across three districts of Odisha, India. Data were collected through in-depth interviews and analysed using content analysis. Results: The analysis revealed five main categories: various snakebite treatment practices, care-seeking pathways of victims, perspectives of patients and caretakers on treatment, traditional healers' views on modern treatment, and allopathic doctors' views on traditional treatment. Treatment practices observed included allopathic treatment, cold treatment, spiritual healing practices at temples, brass plate treatment, mantra enchanting, herbal treatment, and self-medication. Reasons for treatment delay included strong community beliefs in traditional healing, lack of control over irrational treatment by traditional healers, suboptimal care at primary and secondary healthcare facilities, and poor community literacy on snakebites. Conclusions: The study emphasizes the need for improved snakebite preparedness strategies, community literacy, active involvement in prevention programs, and strong political commitment to control irrational treatment practices. [ABSTRACT FROM AUTHOR]

Background: Telemedicine represents an important strategy to facilitate access to medication abortion (MAB) procedures, reduces distance barriers and expands coverage to underserved communities. The aim is evaluating the self-managed MAB (provided through telemedicine as the sole intervention or in comparison to in-person care) in pregnant people at up to 12 weeks of pregnancy. Methods: A literature search was conducted using electronic databases: MEDLINE, Embase, Cochrane (Central Register of Controlled Trials and Database of Systematic Reviews), LILACS, SciELO, and Google Scholar. The search was based on the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework, and was not restricted to any years of publication, and studies could be published in English or Spanish. Study screening and selection, risk of bias assessment, and data extraction were performed by peer reviewers. Risk of bias was evaluated with RoB 2.0 and ROBIS-I. A narrative and descriptive synthesis of the results was conducted. Meta-analyses with random-effects models were performed using Review Manager version 5.4 to calculate pooled risk differences, along with their individual 95% confidence intervals. The rate of evidence certainty was based on GRADE recommendations. Results: 21 articles published between 2011 and 2022 met the inclusion criteria. Among them, 20 were observational studies, and 1 was a randomized clinical trial. Regarding the risk of bias, 5 studies had a serious risk, 15 had a moderate risk, and 1 had an undetermined risk. In terms of the type of intervention, 7 compared telemedicine to standard care. The meta-analysis of effectiveness revealed no statistically significant differences between the two modalities of care (RD = 0.01; 95%CI 0.00, 0.02). Our meta-analyses show that there were no significant differences in the occurrence of adverse events or in patient satisfaction when comparing the two methods of healthcare delivery. Conclusion: Telemedicine is an effective and viable alternative for MAB, similar to standard care. The occurrence of complications was low in both forms of healthcare delivery. Telemedicine services are an opportunity to expand access to safe abortion services. Plain English summary: Globally, unsafe abortion causes 47,000 deaths and 5 million sexual and reproductive dysfunctions in young pregnant people due to complications of the procedure. This practice is related to barriers to accessing safe abortion services secondary to health system limitations and inequities in the distribution of resources. Telemedicine has proven to be an efficient care alternative to reduce distancing gaps, decrease waiting time and rationalize the costs derived from the procedure. Consequently, several health systems in the world use this model with differences in treatment schemes, weeks of gestation, pregnancy confirmation methods and measurement of reported outcomes. For this reason, evaluating the effectiveness and safety of self-managed medication abortion (MAB) by telemedicine is a support for decision makers who consider implementing or expanding remote care services. This systematic review integrated studies that evaluated MAB only by Telemedicine or in comparison with standard care on pregnant people with 12 weeks gestation or less. Available studies until January 2023 were chosen. Screening and selection of studies, data extraction, and risk of bias assessment were performed by expert reviewers. Aspects such as the effectiveness, safety, and satisfaction of the procedure, among other outcomes, were reviewed. A narrative and descriptive synthesis was carried out, as well as several meta-analyses of the differences in risks between Telemedicine and in-person care. The meta-analysis of studies comparing telemedicine care with standard services reveals that the type of care provided does not affect the effectiveness and safety of MAB, nor does it affect user satisfaction, follow-up, or medication adherence. [ABSTRACT FROM AUTHOR]

Introduction: Self-medication, particularly for oral and dental health problems, stands as a significant health and social concern. Therefore, the current systematic review and meta-analysis study was conducted to evaluate the prevalence and underlying causes of self-medication for oral and dental health problems. Method: Articles published until August 30, 2023, were searched in Scopus, PubMed, and Web of Science databases. A manual search was also done in Google Scholar, references, citations, and Gray literature. The screening of articles was done independently by two members of the research team. The quality of reporting in the articles was evaluated using the JBI Critical Appraisal Checklist For Analytical Cross-Sectional Studies. Meta-analysis was performed using the fixed effects model in Stata software (StataCorp, version 16). Results: The results of 37 studies involving 12,110 participants with a mean age of 32 years and 48% male were analyzed. Most of the studies were conducted in low- and middle-income countries. The overall prevalence of self-medication was estimated at 59% [95%CI: 55–63%], with 58% [95% CI: 53–63%] among dental patients, and 60% [95% CI: 52–67%] in the general public. Analgesics (60%) and antibiotics (19%) were the most commonly used drug categories. In terms of the mean proportion, having previous experience, unbearable pain, and lack of time had the highest percentages, and in terms of the number of repetitions among the reviewed articles, economic problems, lack of time, and limited access were the most repeated reasons. The most significant related factors in self-treatment were female gender, higher education, and occupation. Pharmacies were the primary source of self-treatment medications. Conclusion: The results showed a very high prevalence of self-medication for oral health problems, necessitating prompt and effective interventions. It is recommended to focus on regulating the consumption of analgesics and antibiotics, addressing financial issues, and overseeing the pharmacy operations. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the effect of integrating custom-designed hand therapy video games (HTVG) with contralaterally controlled functional electrical stimulation (CCFES) therapy. Methods: Fifty-two stroke survivors with chronic (>6 months) upper limb hemiplegia were randomized to 12 weeks of CCFES or CCFES + HTVG. Treatment involved self-administration of technology-mediated therapy at home plus therapist-administered CCFES-assisted task practice in the lab. Pre- and post-treatment assessments were made of hand dexterity, upper limb impairment and activity limitation, and cognitive function. Results: No significant between-group differences were found on any outcome measure, and the average magnitudes of improvement within both groups were small. The incidence of technical problems with study devices at home was greater for the CCFES + HTVG group. This negatively affected adherence and may partially explain the absence of effect of HTVG. At end-of-treatment, large majorities of both treatment groups had positive perceptions of treatment efficacy and expressed enthusiasm for the treatments. Conclusion: This study makes an important contribution to the research literature on the importance of environmental factors, concomitant impairments, and technology simplification when designing technology-based therapies intended to be self-administered at home. This study failed to show any added benefit of HTVG to CCFES therapy. Clinicaltrials.gov (NCT03058796). IMPLICATIONS FOR REHABILITATION: Contralaterally controlled functional electrical stimulation (CCFES) is an emerging therapy for upper limb rehabilitation after stroke that is designed, in part, to be self-administered at home. While movement-soliciting video games have shown promise in rehabilitation, this study failed to show a significant added benefit of integrating CCFES with hand therapy video games. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of making every component of rehabilitation technology as user friendly and trouble-free as possible. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of assuring that the home environment is conducive to home-based therapy. [ABSTRACT FROM AUTHOR]

Background: Inadequate water supply, poor sanitation and hygiene (WASH) facilities in schools, insufficient puberty education and a lack of hygienic menstrual hygiene management (MHM) items (absorbents) cause girls in developing countries like Ethiopia to view menstruation as shameful and uncomfortable. However, there was little evidence of female MHM practice and associated factors among secondary school girls in eastern Ethiopia. Objective: To assess MHM practice and associated factors among secondary school girls in eastern Ethiopia. Design: Institutional-based cross-sectional study design was conducted. Methods: A total of 473 secondary schoolgirls were selected using a stratified sampling technique. Data were collected using a self-administered structured questionnaire, double-entered to Epidata version 3.1 and exported to SPSS version 26 for analysis. Descriptive analysis was computed using frequency, percentage, mean and standard deviations. Multivariable logistic regression was applied to assess the association of the school water, sanitation and hygiene facilities with MHM. Adjusted odd ratio (AOR) with its 95% confidence interval was computed to show the strength of the association between dependent and independent variables. The goodness of fit of the model was tested by the Hosmer–Lemeshow goodness of fit test. Results: Out of 473 study participants, 72.93% of them (95% CI: 68.74–76.76) reported good MHM practices. The study also found that availability of continuous water supply (AOR = 2.40, 95% CI: (1.42–4.01)); types of toilet (AOR = 2.01, 95% CI: (1.20–3.40)), confined space (AOR = 3.02, 95% CI: (1.49–4.76)) and having females' toilets alone inside in the school (AOR = 2.70, 95% CI: (1.20–4.40)) were significantly associated with female students' good MHM practice. Conclusion: The survey revealed that some of the secondary schoolgirls practiced poor menstrual hygiene management (MHM), which needs further improvement. The study also found that the availability of continuous water supply in the school, types of toilet facility in the school, availability of private space to manage periods at school, learning about MHM in schools and availability of female toilets kept locked inside were factors significantly associated with MHM practice of students, which require integration of Zonal Health and education bureau to jointly work towards the improvement of school WASH facilities. [ABSTRACT FROM AUTHOR]

Background: The Turkish and Syrian earthquake on February 6th 2023, was one of the deadliest earthquakes in the last decade. It affected approximately 26 million people and left at least 50.000 dead. In this paper, we analyzed the psychological impact and the relationship between mental health factors, earthquake-related experiences and stressors, and resources related to the earthquake, 4 months after the event. Methods: We conducted an analytical cross-sectional study, applying a survey to 320 adults (18–93 years old) in Adiyaman, Turkey. Post-traumatic stress disorder (PTSD) symptoms were assessed using the PC-PTSD, general psychiatric morbidity using the GHQ-12, together with questions focusing on suicidality, drug abuse, as well as experiences, related stressors and received support related to the earthquake. Results: We found a high prevalence of general mental health symptoms, and of PTSD. Fear of aftershocks and the loss of close family members were found to be risk factors for such symptoms. We didn't find significant differences in the GHQ or the PC-PTSD scores when considering ethnicity, religion or financial income. Conclusions: High levels of general mental health symptoms and PTSD symptoms were found 4 months after the earthquake and need to be addressed in all groups, independently from potential religious, social or ethnic backgrounds. The results indicate a large psychiatric and material burden on the entire sample and some priority needs. [ABSTRACT FROM AUTHOR]

Globally, it is estimated that more than 50% of antibiotics are obtained without a prescription. The main purpose of this study is to determine the knowledge and practice of primary caregivers about self-medication in children with antibiotics, as studies on self-medication is lacking in India, also, it will help is assessing parents' knowledge and attitude towards self medication. This cross-sectional study conducted in the urban community of Shastri Nagar, Patna, aimed to evaluated antibiotic use in children aged 0-12. From January 2023 to March 2023, 173 caregivers were randomly selected through house visits. Data collection used a pre-tested questionnaire, ensuring confidentiality. In this study of 173 participants, caregivers in an urban community demonstrated varying knowledge regarding antibiotic use in children. Mothers and postgraduates possessed better awareness of antibiotic consequences. Fathers exhibited better understanding of side effects. Knowledge on antibiotics' action was seen among mothers, those aged 30-39, with family income of Rs. 20,000-40,000 and those with family members in medical field. Fathers had more incorrect beliefs about antibiotics treating viral infections. Common conditions for self-medication included cough/cold, fever and diarrhea, with hospitals being the primary source of antibiotics. Majority obtained information from pharmacies but awareness about antibiotic course completion and versatility was limited. Caregivers' antibiotic knowledge varied; mothers and postgraduates were more aware, while fathers understood side effects better. [ABSTRACT FROM AUTHOR]

Background: Hearing Voices Groups (HVGs) are a peer support system for people with acoustic-verbal hallucinations. Few empirical studies have assessed their effectiveness. The main objective of this study is to evaluate a wide range of effects of HVGs and to compare them to those of regular therapeutic groups. Method: This comparative study is based on the responses of 20 French-speaking voice- hearers to an original self-administered questionnaire on the effects of their participation in a HVG in addition to a recovery assessment, the STORI. Our control group is composed of participants in Metacognitive Training programs (MCT, n = 14). Results: Results show a good homogeneity between the two populations in terms of sociodemographics, diagnosis, care pathways, and stages of recovery. The averages of the total satisfaction scores are very similar (162.15/230 for the HVG and 165.28 for the MCT groups) and indicate a very positive appraisal. Some differences can be observed in the type of benefits derived. Discussion: HVGs can be considered as settings that favour recovery and could have a complementary role, especially for users who would otherwise tend to leave or avoid the conventional field of psychiatric treatment. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and factors associated with self-medication among students with medical and non-medical backgrounds in Peshawar, Khyber Pakhtunkhwa. Study Design: Cross-sectional study. Setting: Medical and Non-medical Universities of Peshawar. Period: May to October 2022. Methods: For this comparative analysis, sample size was calculated based on the formula of Cochran, taking a 95% confidence level with 5% precision. The sampling was conducted using a non-probability convenience approach. Data was collected using a structured questionnaire and analyzed with the help of SPSS v.25. Results: A study sample of 427 participants with a 95% response yielded 212 medical students and 215 non-medical students. The prevalence of self-medication among medical and non-medical students was 35.36% and 39.35%, respectively. The occurrence of self-medication was reported as 7% daily, 11% weekly, 11% fortnightly, and 71% monthly. Among the reasons for self-medication, headache was the most common (49.65%), followed by cough/sore throat/cold (31.85%), fever (26.46%), generalized body aches (17.56%), heartburn/indigestion (14.75%), nausea/vomiting (9.36%), constipation (4.91%), anxiety/depression (4.68%), and insomnia (3.51%), while 8.89% constitutes other factors like allergies, skin rashes, and weight loss. The main reason for self-medication was the mild nature of the illness, which accounted for 31.85% of cases. Conclusion: The study indicated a considerable number of student population involved in self-medication practices. The prevalence of this behavior was slightly more common among non-medical students than medical students. Various factors contributed to self-medication ranging from physical symptoms to mental health issues. [ABSTRACT FROM AUTHOR]

Early menarche has been associated with adverse health outcomes, such as depressive symptoms. Discovering effect modifiers across these conditions in the pediatric population is a constant challenge. We tested whether movement behaviours modified the effect of the association between early menarche and depression symptoms among adolescents. This cross-sectional study included 2031 females aged 15–19 years across all Brazilian geographic regions. Data were collected using a self-administered questionnaire; 30.5% (n = 620) reported having experienced menarche before age 12 years (i.e., early menarche). We used the Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Accruing any moderate–vigorous physical activity during leisure time, limited recreational screen time, and having good sleep quality were the exposures investigated. Adolescents who experienced early menarche and met one (B: –4.45, 95% CI: (–5.38, –3.51)), two (B: –6.07 (–7.02, –5.12)), or three (B: –6.49 (–7.76, –5.21)), and adolescents who experienced not early menarche and met one (B: –5.33 (–6.20; –4.46)), two (B: –6.12 (–6.99; –5.24)), or three (B: –6.27 (–7.30; –5.24)) of the movement behaviour targets had lower PHQ-9 scores for depression symptoms than adolescents who experienced early menarche and did not meet any of the movement behaviours. The disparities in depressive symptoms among the adolescents (early menarche vs. not early menarche) who adhered to all three target behaviours were not statistically significant (B: 0.41 (–0.19; 1.01)). Adherence to movement behaviours modified the effect of the association between early menarche and depression symptoms. [ABSTRACT FROM AUTHOR]

Self-medication (SM) forms an important part of public health strategy. Nonetheless, little research has been performed to understand the current state of self-medication in the European Union (EU). Utilizing data from the third wave of the European Health Interview Surveys, this study finds an estimated SM prevalence of 34.3% in the EU (95%CI = 34.1-34.5%; n = 255,758). SM prevalence, as well as SM prevalence inequality between men and women, varies substantially between EU member countries. Via multivariable analysis, we also identify a number of variables associated with SM, most notably the substantial impact of health systems on SM behavior (Adjusted Odds Ratio [AOR] = 4.00; 95% Confidence Interval [95%CI] = 3.81–4.21). Several demographics are also associated with greater SM prevalence, including those aged 25–44 (versus ages 75+: AOR = 1.21; 95%CI = 1.12–1.31), women (AOR = 1.74; 95%CI = 1.68–1.81), immigrants born in other EU states (AOR = 1.16; 95%CI = 1.04–1.30), those with higher education (AOR = 1.83; 95%CI = 1.60–2.09), and urban dwellers (AOR = 1.14; 95%CI = 1.04–1.30). Additionally, long-standing health problems (AOR = 1.39; 95%CI = 1.33–1.45), visits to doctors (both general practitioners and specialists) (AOR = 1.21, 95%CIs = 1.15–1.26, 1.17–1.26), and unmet needs for health care due to waiting lists (AOR = 1.38; 95%CI = 1.23–1.55) or inability to afford medical examinations/treatment (AOR = 1.27; 95%CI = 1.12–1.42) serve as conditioners for SM. We also find that smoking (AOR = 1.05; 95%CI = 1.01–1.10), vaping (AOR = 1.19; 95%CI = 1.06–1.32), drinking alcohol (AOR = 1.23; 95%CI = 1.19–1.28), and higher levels of physical activity (AOR = 1.27; 95%CI = 1.22–1.32) are factors associated with SM. Analysis of these variables reveals that though women self-medicate more than men, the patterns that govern their consumption are similar. [ABSTRACT FROM AUTHOR]

Background: Palliative care provides holistic support, addressing physical, psychological, social, emotional, and spiritual dimensions of suffering, known as "total pain", to improve patients' quality of life. Patients often rely on healthcare professionals, particularly nurses, for support. This study aimed to develop and validate questionnaires assessing nurses' perceptions of psychological, social, and spiritual issues in palliative care and their effectiveness in managing them. Methods: Two self-rated questionnaires were created: the Psychological, Social, and Spiritual Problems of Palliative Patients' Questionnaire and the Effectiveness in Coping with the Psychological, Social, and Spiritual Challenges of Palliative Care Patients. The study surveyed 237 nurses caring for palliative patients in Split Dalmatian County, Croatia. Results: The questionnaires demonstrated high reliability with Cronbach's α values of 0.98 and 0.99. Factor analysis revealed four factors for the first questionnaire and three for the second. Nurses primarily perceived patients as experiencing fear and emotional/spiritual suffering, with the greatest difficulty coping with the fear of the disease outcomes. Nurses acknowledged the need for improvement in addressing patient challenges, highlighting gaps in the Croatian system. Conclusions: Ongoing efforts are crucial to prioritize palliative care globally, with nursing professionals playing a vital role in symptom management. [ABSTRACT FROM AUTHOR]

(1) Background: The rise of online health resources and AI has reshaped the diagnosis and treatment of disease, altering the relationship between patients and healthcare professionals and encouraging self-medication. However, questionnaires validated in the literature on self-medication seem to lack questions on the possible causes that induce such behaviors, including items that explore trust toward websites and artificial intelligence. The aim of this study is to design and validate the content of a questionnaire designed to assess self-medication in health professionals, delving into the underlying etiologies, the pharmacological categories involved and the degree of confidence placed in clinical assessments derived from AI tools. (2) Methods: Validation study of the content of an instrument consisting of two phases: 1. The content validation phase involved evaluation by a selected group of health experts, who, using a Likert-type scale, analyzed the clarity, coherence and relevance of the items. 2. Pilot study of health professionals who have indicated the practice of self-administration of medications. (3) Results: In the first phase of the study, the experts considered most of the questionnaire items to be clear, representative and consistent with the construct to be measured. In its second phase, the preliminary results of our pilot study suggest a significant trend toward self-medication among healthcare workers, along with a strong inclination to use online resources to search for health-related information. (4) Conclusions: The development of a validated instrument to measure the influence of the different causes that lead healthcare personnel to practice self-medication, guaranteeing validity and efficacy, allows us to establish strategies to reduce this growing problem. [ABSTRACT FROM AUTHOR]

Introduction: In Poland, the area of self-medication requires scientific and organizational evaluation. So far, no solutions sanctioning self-medication have been introduced. Therefore, the aim of this study was to recognize and analyze the practical experience of outpatient physicians regarding self-medication of their patients, as well as self-medication of children by their caregivers. Methods: This study enrolled 386 participants and used a Computer-Assisted Web Interview thatwas disseminated online from4th of July 2023 to 23rd of August 2023. The survey was addressed to outpatient healthcare physicians working in Poland. Results: In doctors' perspective the main three reasons for choosing selfmedication in Poland were: taking advice from other people - family members or friends (59.1%), finding information regarding treatment online (52.9%) and ability to self-medicate in this kind of symptoms/disease (51.6%). Among adult patients, in 72.1% of cases, an independent decision to start antibiotic therapy was made. Such a decision occurred in 39.8% of pediatric patients. Children caregivers were more likely to visit the physician immediately with symptoms than in the case of adult patients (42.2% vs. 22.1%, p < 0.001). Conclusions: Self-medication in Poland requires educational and organizational support at various levels - both social (information campaigns, school education), the healthcare system (increasing the role of medical professionals, including pharmacists), and finally in the area of legislation. Two areas seem to be particularly alarming - the use of antibiotics by adults and children and the mental health of both populations. [ABSTRACT FROM AUTHOR]

Background: Although a variety of drug delivery devices have been launched in recent years, few studies have comprehensively investigated the market trends of combination drugs and medical devices approved or certified in Japan and the regulatory challenges related to their approval. Among the drug delivery devices, autoinjectors are more convenient than traditional prefilled syringes and are designed with safety features to prevent needlestick accidents, allowing self-injection by patients. Therefore, autoinjectors have been incorporated into the treatment of various diseases and have shown significant growth among drug delivery devices. Aim: This study aimed to investigate the market trends of combination drugs approved in Japan, especially those with autoinjector formulations, and to explore the challenges in the regulatory aspects of combination drugs. Methods: Information on the number of marketed drugs and medical devices was obtained from the Pharmaceuticals and Medical Devices Agency (PMDA) database using specific definitions. We looked at the annual changes in the number of drug delivery devices approved and certified as combination drugs or medical devices and the number of canceled certifications. We also examined the classification and main certification criteria for Japanese medical device nomenclature. Results: The study suggested that the number of combination drugs with autoinjector formulations is increasing, replacing previously approved or certified pen-type medication injectors. Moreover, 53% of all drug products were approved for autoinjector formulations after the initial authorization approval in Japan, and more than half of them obtained approval for additional formulations for autoinjectors within five years of the initial authorization approval, with the largest number of cases obtaining approval for additional formulations two years later. Conclusion: The lack of clear regulatory requirements for autoinjectors may lead to confusion among applicants. Furthermore, there are challenges in filing regulatory applications, thus hindering the rapid launch of combination drugutilizing devices with superior usability. [ABSTRACT FROM AUTHOR]

To mitigate COVID-19 exposure risks in methadone clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary modification of regulations in March 2020 to permit, with state concurrence, extended take-home methadone doses. The modification allowed for up to 28 days of take-home methadone for stable patients and 14 days for those less stable. Using both interrupted time series and difference-in-differences methods, this study examined the association between the policy change and fatal methadone overdoses, comparing states that permitted the expansion of take-home doses with states that did not. The findings suggest the pandemic emergency take-home policy did not increase methadone-involved mortality. [ABSTRACT FROM AUTHOR]

Purpose: To develop a new instrument to identify barriers to self-administered home-based task-oriented practice post-stroke and test its content validity. Materials and methods: The sample consisted of individuals with stroke and neurological rehabilitation professionals. The study consisted of two steps: (1) Instrument development, involving three processes; a data search in the literature, interviews with the target population and an open questionnaire (online) sent to professionals; and (2) Testing the content validity of the instrument by asking individuals with stroke and professionals about the comprehensiveness and relevance of the items and additionally asking individuals with stroke about the comprehensibility of the items. For each item in the instrument, the threshold validity scores were ≥0.80 in the Content Validity Index and ≥0.75 for the Kappa agreement. Results: The preliminary version was developed with 46 items. The content validation was performed in three rounds. The last version of the instrument Barriers to self-administered home-based task-oriented practice post-stroke (BASH-TOP-Stroke) contained 34 items in five response categories, in which the higher the value presented, the greater the number of barriers. The content validity for the items was excellent. Conclusions: The study provides a new instrument to help identify barriers to self-administered home-based task-oriented practice post-stroke. IMPLICATIONS FOR REHABILITATION: Barriers to self-administered task-oriented home-based exercises can be specific to this form of practice. Understanding barriers to self-administered task-oriented home-based exercises is essential to increase the amount of practice for optimizing motor recovery. The Barriers to self-administered home-based task-oriented practice post-stroke (BASH-TOP-Stroke) questionnaire was developed to evaluate barriers to self-administered task-oriented home-based exercises in individuals post-stroke. BASH-TOP-Stroke has excellent content validity based on patients and professionals and could help to identify strategies that may reduce barriers to self-administered home-based task-oriented practice after stroke. [ABSTRACT FROM AUTHOR]

Introduction: Sexual victimization (SV) is common among college women, with approximately half of those who have experienced SV meeting criteria for posttraumatic stress disorder (PTSD) within a year. Both SV and PTSD are associated with alcohol misuse among college women, often explained by the self-medication hypothesis. Existing literature focuses on overall PTSD severity rather than potential day-to-day fluctuations in specific symptoms, which might play a crucial role in understanding alcohol misuse risk. Studies also examine only same-day or next-day associations between PTSD and drinking, neglecting the potential for longer-term changes. Methods: This study explores the short-term longitudinal stability and timelagged predictive dynamics of PTSD symptoms, affect, and drinking behavior among 174 female college heavy episodic drinkers over four weeks. Participants were categorized into three groups: those with a history of SV and PTSD (n = 77), women with SV but without PTSD (n = 59), and women without prior trauma history (n = 38) to be able to examine differences by trauma exposure, and PTSD. We compared the longitudinal stability of PTSD symptom networks, affect (arousal, positive affect, and negative affect), and drinking behavior across groups. Support vector regression determined which PTSD symptom networks and affect best predict drinking behavior at specific time lags within a 0-7 day range. Results: The PTSD group showed higher longitudinal stability for PTSD symptom networks (adjusted ps <.049) and arousal (adjusted ps <.048), but lower stability for negative affect (adjusted p =.013) and drinking behavior, including alcohol cravings (adjusted p =.019) and consumption (adjusted ps =.012), compared to the comparison groups. This suggests individuals with PTSD have more stable symptoms and arousal levels but greater fluctuations in negative affect and alcohol-related behaviors. Secondary analysis revealed PTSD symptom networks optimally predicted alcohol cravings with a three-day time lag (r=.88, p <.001) and consumption with a four-day time lag (r=.82, p <.001). Discussion: These findings challenge assumptions regarding immediate effects of PTSD and affect on drinking behavior and underscore the need for therapeutic approaches that consider longer-range effects. Future research should expand on these findings by incorporating longer-range assessments and exploring a broader range of symptom interactions. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) poses a significant global health threat, driven by factors such as irrational antibiotic use and limited healthcare infrastructure. Addressing knowledge gaps and promoting responsible antibiotic use among medical professionals is crucial to combat this growing problem. Objectives: This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding antibiotics and antimicrobial resistance among medical students at a medical college in North India. Methods: A cross-sectional study was conducted between October to December 2023, involving 201 medical students. Data was collected through a self-administered questionnaire covering demographic details, knowledge about antibiotics and antimicrobial resistance, attitudes toward antimicrobial resistance, and practices related to antibiotic use. Statistical analysis was performed using SPSS 20.0. Results: Participants demonstrated a mean knowledge score of 7.9±1.3, with 131 students exhibiting poor knowledge and 70 showing good knowledge regarding antibiotics and AMR. While positive attitudes towards prudent antibiotic use were prevalent, some risky behaviours such as keeping leftover antibiotics and self-medication were observed. Practices varied, with most participants completing full treatment courses but some discontinuing prematurely. Conclusion: The KAP assessment highlighted mixed findings among medical students regarding antibiotic use and AMR. While positive attitudes and practices were evident, knowledge gaps and risky behaviours persisted. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to map the adverse reactions in the oral mucosa and face caused by the use of natural products. Methodology: This review was performed according to the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with a protocol registered in the Open Science Framework (DOI 10.17605/OSF.IO/R57D8). The search was carried out systematically using PubMed, Scopus, Web of Science, Embase, LILACS, and LIVIVO databases, as well as gray literature through Google Scholar and OpenGrey. Reports of clinical cases on the adverse effects of natural products on the oral mucosa or perioral region of the face resulted from inappropriate use or self-medication were included. Data from the included studies were described in a narrative form. Results: Seven hundred and six studies were identified, and after removing duplicates and applying the eligibility criteria, 28 studies were included. The year of publication ranged from 1976 to 2022. The studies were conducted in 19 countries. Fifty patients were mentioned in the included studies and 34 were female (68%). The natural products most related to adverse reactions were propolis (n = 17), with manifestations such as perioral eczema, edema, erosions, erythema, allergic contact dermatitis, and garlic (n = 9), with manifestations such as chemical burn, burning sensation, vesicles and blisters, crusts, and ulcerations. Conclusion: Propolis and garlic were the natural products with the most reported adverse effects on the oral mucosa and perioral region. [ABSTRACT FROM AUTHOR]

Many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic‐pituitary‐adrenal (HPA) axis, but the results are controversial. Our objective was to study differences in stress response axis activity between patients with autoimmune disease and healthy people. The study sample consisted of 97 women divided into four groups: 37 healthy women (HW), 21 with systemic lupus erythematosus (SLE), 21 with Sjögren's syndrome (SS), and 18 with systemic sclerosis (SSc). After being exposed to a stress task, participants' skin conductance and salivary cortisol levels were measured in order to assess their response to psychological stress. Diurnal cortisol concentrations were assessed by measuring salivary cortisol in samples collected five times over one day. In addition, self‐administered questionnaires were used to assess psychological variables. A time × group interaction effect was found (p = 0.003) in salivary cortisol secretion in response to stressful challenge. The healthy group presented normal activation, the SS and SLE groups showed no activation, and the SSc group presented a similar activation pattern to the HW group, except at the time of recovery. Total cortisol production (AUCg) was higher in the SSc group than in the HW group (p = 0.001). Differences were also observed in the cortisol AUCg collected over one day between healthy women and patients with SLE (p = 0.004) as well as with SSc (p = 0.001): women with SLE and SSc presented higher total hormone production than healthy women. Patients with autoimmune disease present a different HPA axis response, which may contribute to the harmful effects of stress in these diseases. [ABSTRACT FROM AUTHOR]

Introduction: Methoxyflurane (MEOF) (Penthrox™) is an inhaled, self-administered, nonopioid analgesic approved by Health Canada for the short-term relief of moderate to severe acute pain associated with trauma or interventional medical procedures. In this pilot study, we evaluated the feasibility of using MEOF as an anesthetic agent in 11 patients undergoing outpatient cystoscopic procedures. Methods: The average duration of the procedure was 24 (range 20–35) minutes and this included 10 minutes of administration time of the drug and five minutes of wait time before the procedure. The average monitoring time from start to end of the procedure was 23 (range 20–35) minutes and this included 15 minutes of monitoring post-procedure. On a scale of 0–10, patients on average rated the pain 4/10 (standard deviation [SD] 2.6). Results: Global performance was on average 3/4 (SD 1.3) for the patients and 3/4 (SD 1.1) for the operator. Of the 11 patients, four reported adverse events; two experienced euphoria, one experienced dizziness, and one was unable to tolerate the medication. Two patients noted their adverse events to be of moderate intensity, while the other two were of mild intensity. None of the adverse events was deemed serious. Conclusions: Our findings in this pilot study provide proof of principle for the design of a randomized control trial to evaluate MEOF as an anesthetic in an outpatient cystoscopic procedural setting. As more urologic procedures are being performed in an outpatient setting, this may offer significant clinical benefit. [ABSTRACT FROM AUTHOR]

Background: Health care providers (HCPs) caring for autistic children report more perceived psychological and emotional distress related to their job. However, not much is known about what can be done to mitigate such distress, especially in countries with limited mental health resources, such as Jordan. Objective: This study aimed to examine the association between coping strategies (problem-focused, emotion-focused, and avoidant) and perceived emotional and psychological distress among HCPs of autistic children in Jordan. Methods: In this cross-sectional study, a convenience sample of 180 HCPs working with autistic children in Jordan were recruited through autism centers and social media using an online self-administered questionnaire. Results: The multiple linear regression analysis revealed that 31% of the variability in perceived emotional distress was explained by its significant association with problem-focused coping, emotion-focused coping, and avoidant coping. Likewise, 39% of the variability in perceived psychological distress was explained by its significant association with gender, having an immediate family, area of specialty, problem-focused coping, emotion-focused coping, and avoidant coping. Conclusions: The study shows that problem-focused coping significantly decreases perceived emotional distress, whereas emotion-focused and avoidant coping significantly increase perceived emotional distress. Avoidant coping significantly increases perceived psychological distress. Understanding the association between coping strategies and perceived emotional and psychological distress among HCPs can assist mental health nurses in identifying at-risk providers and providing timely emotional and psychological support. [ABSTRACT FROM AUTHOR]

Unofficial reports have alerted that Tawjihi (high school) students in Jordan are experiencing high levels of depression with increasing suicidal ideations and attempts. The aims of this national study were to estimate the point prevalence of depressive symptoms among Tawjihi students in Jordan and to identify student characteristics associated with severity of depression. The study was conducted in collaboration with the Jordanian Ministry of Education. Data were collected using anonymous self-administered questionnaires. A total of 1208 Tawjihi students (51% females) completed and returned the questionnaires. About 12% reported having learning difficulties, and 3% received a psychiatric diagnosis. Almost 62% were studying 3–7 h per day, and 73% reported watching TV for less than an hour per day or not at all. Seemingly, 37% were using their mobiles for less than an hour per day or not at all. About 37% reported they were not performing any activity other than studying. About 25% of the sample reported moderate to severe depressive symptoms, while 19% had mild symptoms. The most prevalent moderate to severe symptom was crying (25.5%) followed by changes in sleep pattern (23%) and self-criticalness (22.7%). Suicidal thoughts or wishes presented in almost 6% of the sample. Depressive symptoms were significantly higher among students who were females, pursuing the literacy streams, having lower Grade Point Averages (GPAs), residing with families with lower monthly incomes, residing in rural regions, reporting a learning difficulty, reporting a psychiatric diagnosis, and spending more time with their mobiles and less time on TV. With the substantial lack of primary mental health services in the country, there is a need to proactively screen all Tawjihi students in Jordan for depression. Addressing depression among Tawjihi students requires considering all individual, family, social, and contextual risk factors that may lead to the rise in depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Outpatient parenteral antimicrobial treatment (OPAT) is a safe and effective therapy used in several settings across Australia. As OPAT services expand their inclusion criteria to include complex patient populations, there is an increased need for selecting appropriate patients to receive either healthcare‐administered OPAT (H‐OPAT) or self‐administered OPAT (S‐OPAT). Aims: To describe patient demographics, diagnosis, microbiology and outcomes of patients treated by H‐OPAT and S‐OPAT within the Sunshine Coast Hospital and Health Service, Australia. Methods: Data on demographics, diagnoses, treatment and outcomes on all patients treated by H‐OPAT and S‐OPAT from March 2017 to December 2019 were collected retrospectively. Results: One hundred and sixty‐five patients (62.26%) were enrolled in H‐OPAT and 100 patients (37.74%) in S‐OPAT. S‐OPAT patients were significantly younger. H‐OPAT patients were more comorbid. Bone and joint infections were the most treated infections and were more likely to be treated by S‐OPAT. There was no difference in treatment duration, cure and complication rates between S‐OPAT and H‐OPAT. Longer duration of therapy was associated with more complications. Treatment failure was associated with infections due to multiple organisms, number of comorbidities and treatment of surgical site, skin and soft tissue infections. Conclusions: There were significant differences in demographics between H‐OPAT and S‐OPAT without any difference in outcomes. Overall failure and complication rates were low. Higher rates of treatment failure were predicted by the diagnosis, number of comorbidities and number of organisms treated. [ABSTRACT FROM AUTHOR]

Around 91% of migraine patients use over-the-counter medicines to treat attacks, often without further treatment or medical consultation. This therapeutic principle is established in most countries, regardless of how the healthcare system is otherwise structured or financed. Using Germany as an example, the basis for an expansion of attack therapy with rizatriptan as an over-the-counter triptan is described. To achieve the best possible tolerability and safety in the context of self-medication, the lowest possible dose should be selected to provide the most favourable tolerability and safety profile in the context of self-medication through low dosages. The lowest approved dose of rizatriptan is 5 mg. This was investigated in three randomized controlled trials with 752 patients. The results show that rizatriptan at a dose of 5 mg is more effective than the triptans naratriptan 2.5 mg, almotriptan 12.5 mg and sumatriptan 50 mg, which were previously available for self-medication in Germany. There was no significant difference in the frequency of adverse events with rizatriptan 5 mg compared to placebo. Rizatriptan 5 mg does not have a higher side effect potential than sumatriptan 50 mg, which is already exempt from the prescription requirement. The reasons given show that rizatriptan in a dose of 5 mg for the treatment of acute migraine attacks fulfils the requirements for a transfer from prescription to pharmacy-only status at least as well as sumatriptan 50 mg, naratriptan 2.5 mg and almotriptan 12.5 mg. From a clinical care perspective, it is desirable for affected patients to have other options available for self-medication. Non-responders to other substances also have a further treatment option with rizatriptan 5 mg, with the same or even better risk–benefit profile, to treat migraine attacks safely, effectively and in a tolerable manner as part of self-medication. [ABSTRACT FROM AUTHOR]

Purpose: Functional foods have been marketed as promoting health and reducing the risk of disease. While the market of functional foods is increasing across the globe, little is known about how actual and subjective health status are related to functional food choices and existing research evidence is inconsistent. Therefore, the purpose of this paper is to systematically explore the relationship between functional food choices and perception related dimensions vs medical dimensions. Design/methodology/approach: The study used data collected from a large-scale mail survey in Japan (N = 8,368) and a representative Internet survey in Lithuania (N = 900). It used structural equation modeling (SEM) to test the proposed conceptual model. Findings: The general results indicated that functional foods could be used to maintain one's subjective health status – the frequency of using functional food products was positively related to consumers' subjective health status (p = 0.04). However, if consumers were experiencing health-related issues (self-reported disease symptoms or current medical treatment), there was no systematic relationship between such experience and the usage of functional food products. Originality/value: To the best of the authors' knowledge, this study is among the first to systematically analyze the relationship between subjective health status, self-reported disease symptoms, current medical treatment and the frequency of using different functional food product groups. The findings indicated that it is important to simultaneously consider different underlying factors, such as specific to functional food targeted disease symptoms and specific food product groups, which contributed to a more thorough understanding of functional food consumption. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate clinicians' perspectives regarding their usage of rehabilitation technology in their day-to-day practice and uncover the factors that impact clinicians' use of rehabilitation technology in their daily practice. An online survey was used to gather cross-sectional data from American occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and speech language pathologists. This survey used Likert-scale, multiple choice, and free-response questions. Approximately half (n = 56/105, 53.3%) of our clinicians reported using rehabilitation in their daily practice. Less than 20% (n = 18/105, 17.1%) of the respondents strongly agreed that they felt comfortable implementing new rehabilitation technology, and few reported that their workplace encouraged (n = 16/85, 18.8%) or strongly encouraged (n = 14/85, 16.5%) the use of rehabilitation technology in practice. Additionally, excluding the 2011–2020 graduate clinicians that reported that they had not learned about rehabilitation technology in school or fieldwork, few reported feeling prepared (n = 14/97, 14.4%) or very prepared (n = 4/97, 4.1%) to use rehabilitation technology after graduation. Our findings have revealed a sizable knowledge-to-practice gap in regard to clinicians' preparedness to engage with and advocate for rehabilitation technology in their day-to-day practice. There is a great need for more robust educational instruction at the scholastic level for students in order to prepare future clinicians to engage with rehabilitation technology in the field. For practicing professionals in the workplace, in-service training, clear training protocols, and technology support for clinicians are needed to remediate the current knowledge-to-practice gap. [ABSTRACT FROM AUTHOR]

Background: Dysmenorrhea and its associated pain disable adolescents in their daily activities and also affect the social and mental behavior. The vehement practice of self-medication alarms health-care professionals for conducting periodic awareness programs. Aims and Objectives: We aimed to assess the knowledge about dysmenorrhea and to compare the level of understanding and practices among medical students. Materials and Methods: It was a prospective, observational, cross-sectional, and questionnaire-based study conducted among medical students in a tertiary care hospital. Results: There was no difference in distribution regarding knowledge and attitude of the study population toward dysmenorrhea among the three groups regarding treatment of dysmenorrhea and health education. In contrast, response about contraindications and adverse effects of medications used was observed in only half of the 1st-year students. Half of the study participants, daily activities were affected and led to absenteeism. The negative emotions such as depression, anger, anxiety, and irritability are most noted and the majority of the students felt like distancing themselves during menstruation. Conclusion: The present study concludes that dysmenorrhea, a major problem among adolescents, had an impact on the quality of life including psychological disturbances. Thus, the awareness patterns and practices need to be analyzed periodically among adolescents for better improvement and management of dysmenorrhea. [ABSTRACT FROM AUTHOR]

Purpose: Outpatient parenteral antimicrobial therapy (OPAT) offers several key advantages, including enhanced patient quality of life, reduced healthcare costs, and a potential reduction of nosocomial infections. It is acknowledged for its safety and effectiveness. This study provides the first systematic clinical data for Germany, where OPAT has not yet been widely adopted. The aim is to establish a foundational reference point for further research and integration of OPAT into the German healthcare system. Methods: This prospective observational study descriptively analyses data obtained from a cohort of patients receiving OPAT. Both in- and outpatients from all medical specialties could be recruited. Patients administered the anti-infective medications themselves at home using elastomeric pumps. Results: 77 patients received OPAT, with a median duration of 15 days and saving 1782 inpatient days. The most frequently treated entities were orthopaedic infections (n = 20, 26%), S. aureus bloodstream infection (n = 16, 21%) and infectious endocarditis (n = 11, 14%). The most frequently applied drugs were flucloxacillin (n = 18, 23%), penicillin G (n = 13, 17%) and ceftriaxone (n = 10; 13%). Only 5% of patients (n = 4) reported to have missed more than one outpatient dose (max. 3 per patient). Only one catheter-related adverse event required medical intervention, and there were no catheter-related infections. Conclusion: The study demonstrates that OPAT can be safely conducted in Germany. In preparation for its broader implementation, crucial next steps include creating medical guidelines, fostering interdisciplinary and inter-sectoral communication, as well as creating financial and structural regulations that facilitate and encourage the adoption of OPAT. Trial registration number: NCT04002453. [ABSTRACT FROM AUTHOR]

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Aim: To determine the occurrence of occupational stress among Palestinian nurses, and their associated sources and risk factors. Design: A cross‐sectional descriptive design. Methods: A total of 250 registered nurses from eight governmental hospitals, using a convenience sampling method. Data collection were conducted using the 30‐items self‐reported Occupational Stress Scale from December 2022 to March 2023. Descriptive statistics, independent sample t‐test, one‐way ANOVA, and multiple linear regression analysis were applied to analysis data. Data analysis included descriptive statistics, independent sample t‐test, one‐way ANOVA, and multiple linear regression analysis. Results: The prevalence of high occupational stress levels was 64.8% (Mean = 3.9 out of 5). The main sources of stress are too much responsibility and work, understaffing, lack of promotion and recognition, inadequate pay, time pressure, and management style. The results regression analysis demonstrated that male nurses with a Masters or PhD degree and those working in fixed shifts experienced higher occupational stress. Moreover, participants who worked overtime hours were more susceptible to stress. Conclusions: The research indicates that occupational stress presents a notable challenge for nurses in the Gaza Strip, Palestine. It suggests that in order to alleviate this stress, decision‐makers in healthcare policy and hospital management should prioritize the execution of strategies aimed at addressing the primary stressors and risk factors identified. Reporting Method: This study adhered to the STROBE guidelines. Public Contribution: A total of 250 registered nurses were taken part in this study by answering a self‐administered study survey. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis, characterized by reduced bone mass and increased fracture risk, presents a significant public health challenge. Dual-energy X-ray Absorptiometry (DEXA) scans offer a reliable means of assessing bone mineral density (BMD) and detecting osteoporosis. The aim of this study is to assess awareness, attitude, and practice of women in the Jazan region toward DEXA scan. Methods: Data were collected through a self-administered online questionnaire. Statistical analysis was conducted using SPSS version 29.0. The total knowledge scores of participants were calculated to assess potential associations with sociodemographic data. A p-value of less than 0.05 was considered statistically significant. Results: Among 400 women, 230 (57.5%) had low knowledge scores primarily due to poor knowledge of the DEXA scan procedure. Merely 39 women had undergone a DEXA scan mainly due to medical prescription (n = 22, 56.4%). Total knowledge scores were significantly higher among women with high monthly incomes (p = 0.019) and those working in medical-related jobs (p = 0.017). Conclusions: This study underscores the need for targeted interventions to improve awareness of DEXA scans among women in Jazan City. Additionally, the findings suggest that socioeconomic factors may influence awareness levels, emphasizing the importance of tailored educational strategies to reach diverse demographics. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of self-medication with antibiotics and its causative factors in South Waziristan. Material and Methods: A cross-sectional study was conducted in the Tehsil Wana of South Waziristan, Khyber Pakhtunkhwa. A total of 400 participants were selected using a convenient random sampling technique. Data was collected by using a structured questionnaire after obtaining informed consent. The questionnaire included demographics, socioeconomic variables, and information on self-medication with antibiotics i.e. reason for self-medication, source of procurement, symptoms that lead to self-medication, and type of antibiotic used. Results: Of 400 subjects, 373 (93.25%) agreed to participate. The frequency of antibiotic self-medication in the study area was 84.5%. The most common reason for self-medication with antibiotics was saving money (38%). The common antibiotic used by most study participants was Amoxicillin/Clavulanic acid (42%) with respiratory tract infections as the most common indication for their usage (62%). A significant association between self-medication of antibiotics was observed with age, marital, education, and economic status of the respondents (p<0.05). No significant association of self-medication was found with gender distribution (p-value 0.438). Conclusion: The study showed a significantly high prevalence of self-medication practices with antibiotics, revealing a strong association with socio-demographic factors. A multi-sectoral approach is needed to deal with this alarming situation in this war-affected underdeveloped district of Khyber Pakhtunkhwa. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to understand students' ability to search the Internet for COVID-19 information and apply it to evaluate the veracity of specific statements. Participants: Undergraduate students (N = 239) at a US university completed a Web-based questionnaire in September–October 2020. Methods: The questionnaire included self-reported measures of online health information literacy, COVID-19 knowledge, and anxiety along with exercises on searching and evaluating COVID information online. Results: Students reported moderate levels of information literacy (76%, 3.8 out of 5), but did not perform as well while searching the Internet for COVID-19 information (average accuracy: 65%, 10.5 out of 16 points). Students with higher Internet exercise scores reported higher GPA, higher household income, and liberal political views, and were more likely to follow public health measures [ie, social distancing, mask wearing, and not self-medicating with (hydroxy)chloroquine]. Conclusions: University students may overestimate their information literacy while struggling with searching the Internet for accurate COVID-19 information. [ABSTRACT FROM AUTHOR]

Purpose: To identify self-medications used by patients as initial treatment for various eye problems and to analyze associated complications. Study Design: Cross sectional. Place and Duration of Study: Al-Khidmat teaching hospital, (University of Lahore) from October 2021 to September 2022. Method: This study included 117 patients using traditional eye medications (TEM) and over the counter (OTC) ophthalmic drugs before presenting in ophthalmic outdoor. A semi structured questionnaire was used as a tool to collect the data. All patients aged 18 years and above were directly questioned. For patients below 18 years, responses were collected from the patients themselves when possible; otherwise, the accompanying parent provided the information. Age, gender, educational status and area of residence were recorded. The symptoms compelling the use of TEM/OTC or both, the source and type of medication, diagnosis and any complications that resulted due to self-medication were documented. Complete ocular examination was done. MS Excel was used to record and analyze data. Results: There were 48% males and 52% females. Rosewater was the most frequently used TEM by 54.7%. Steroids-antibiotic combination eyedrops/ointments were used by 31.6%. Symptoms for which self-medication was done, were redness (64.1%), watering (35.9%), itching (32.5%) and discharge (26.5%). Symptoms did not improve in 54.7%, 26.5% required ophthalmic consultation and only 18.8% had temporary relief. Twelve percent developed complications. Conclusion: Self-medication with TEM or OTC drugs should be discouraged as these can cause detrimental effects on eyes. [ABSTRACT FROM AUTHOR]

Self-medication is a global public health problem, particularly among University students at the beginning of their careers. This study aims to determine awareness and attitude toward self-medication practices among Foundation Year - Health Science Students at PNU in Riyadh, Saudi Arabia. We conducted a cross-sectional survey using convenient sampling techniques to identify study participants. After obtaining written consent, we emailed them an online questionnaire that included information on sociodemographics, knowledge, students' awareness of self-medication, and reasons for self-medication. We computed means and standard deviations to report continuous variables, frequencies, and proportions to report categorical variables, which were analyzed by Excel software. The mean age and body mass index were 19.17 ±2.23 and 22.91±4.25, respectively. About 75% of the students mentioned they had used selfmedication in the past. One-third of respondents mentioned that self-medication can cause harm, and 58.8% mentioned that selfmedication can cause harm sometimes. The most common resource for self-medication was pharmacy stores, followed by families and friends. The most common reasons to self-medicate were multiple, including economical, saving time, convenience, quick relief of the symptoms, no availability of a medical service, and minor illness. The reasons reported by students were multiple, including common cold, headache, fever, and dysmenorrhea, followed by insomnia. The burden of self-medication is alarming among university students, with about three-fourths of them reporting using drugs to self-medicate. These findings can help policymakers and university administrators raise awareness among students about the negative impact of medications on their lives. [ABSTRACT FROM AUTHOR]