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Introduction: A number of medications have been demonstrated to lower blood glucose. However, current-day management has failed to achieve and maintain the optimal glycemic level for diabetic patients. Patients’ non-adherence is among the most contributing factors. Therefore, the aim of this study was to explore the prevalence of non-adherence to anti-diabetic medications and associated factors. Methods: A hospital based cross-sectional study was conducted from November 2020 to January 2021. A systematic random sampling technique was used. Data were collected by structured questionnaire adapted from different literatures. Then, data were entered into SPSS version 25 and analyzed. To determine the association of dependent and independent variables, multiple logistic regression was done. P-value 60 years (AOR = .276, 95% CI = .124-.611) attending higher education (AOR = 6.203, 95% CI = 1.775-21.93), retired (AOR = 7.771, 95% CI = 1.458-41.427), housewife (AOR = 7.023, 95% CI = 1.485-33.215), average monthly income 1001birr-2000 birr (AOR = .246, 95% CI = .067-.911) and social drug use (AOR = 3.695, 95% CI = 1.599-8.542). Forgetfulness, not affording, side effects, misunderstanding of instructions, and poly-pharmacy were identified reasons for non-adherence. Conclusions and Recommendations: Patients’ adherence to anti-diabetic medications in the current study is sub-optimal. Age, monthly income, level of education, occupational status, and social drug use were associated with adherence. Forgetfulness, not affording, and side effects were reasons identified to contribute to non-adherence. Therefore, adherence counseling, use of alarms, and the way to mitigate non-affordability, including anti-diabetic medications into a program drug should be considered.

Social media plays a significant role in adolescents' lives, with both positive and negative effects. Implementing interventions to mitigate the negative aspects and enhance the positive ones could improve adolescents' well-being. Unfortunately, there is a scarcity of evidence-based interventions available. To fill this gap, we have developed a school-based program based on combining evidence-based and consensus-based approaches, incorporating input from adolescents, school personnel, researchers, and municipal advisers. This paper describes the program's content and principles, and presents the results from a pilot evaluation, which assesses feedback from pupils and teachers, thereby informing potential enhancements and the program's overall significance. The intervention description encompasses theoretical perspectives, behavior change techniques, and procedural details. Pupils (n = 266; 16+ years) evaluated the program concerning satisfaction, relevance, importance, and usefulness through a questionnaire. Additionally, exploratory focus group interviews were conducted with seven teachers and eleven pupils to gather their perspectives on the program's relevance, impact, and potential changes to the theme-based teaching. Results from the pilot showed an average score of 7.3/10 for overall satisfaction with the program. Sub-questions assessing perceived relevance, engagement, and usefulness averaged between 6.7 and 7.5. Gender differences were observed, with boys tending to rate the program lower than girls. In focus group interviews, the pupils expressed increasing awareness of their own and others' social media use, that the topic was important and exciting, and that the program generally worked well. The pupils' evaluation indicates the need for this kind of program described in this study.

Abstract Background The intensive use of social media among adolescents has caused concern about its impact on their mental health, but studies show that social media use is linked to both better and worse mental health. These seemingly contradictory findings may result from the diverse motivations, interactions, and experiences related to social media use, and studies investigating specific facets of social media use in relation to mental health and well-being, beyond general usage metrics, have been called for. Aspects of self-presentation on social media, such as feedback-seeking and upwards social comparison have been linked to worse mental health, however, there is a need for more studies exploring the relationship between self-presentation on social media and adolescent mental health over time. Aim The aim of this study was to explore the cross-sectional and longitudinal relationship between aspects of self-presentation and depression, anxiety, and well-being among adolescents. Methods This study utilised both cross-sectional and longitudinal datasets from the LifeOnSoMe-study, comprising 3,424 and 439 participants, respectively (OSF preregistration https://doi.org/10.17605/OSF.IO/BVPS8 ). Latent Class Analysis (LCA) was used to identify similar response patterns within the Self-Presentation and Upwards Social Comparison Inclination Scale (SPAUSCIS). Regression models and first differencing methods were applied to evaluate the cross-sectional and longitudinal associations between focus on self-presentation and mental health and well-being among adolescents. Results A strong emphasis on self-presentation was linked to increased levels of depression and anxiety in both males and females, and reduced well-being in females when compared to those with lower or intermediate self-presentation focus. The effect sizes ranged from small to medium. Furthermore, an escalation in self-presentation focus over time was associated with a slight increase in symptoms of anxiety and depression; however, the association with well-being did not reach statistical significance. Conclusion The results of the present study suggest that a heightened focus on self-presentation, which includes behaviours such as seeking feedback, employing strategic self-presentation tactics, and engaging in upward social comparisons, is associated with an elevated risk of reduced mental health.

Abstract Background Social media use, perfectionism, and disordered eating have all increased over the last decades. Some studies indicate that there is a relationship between self-presentation behaviors and being exposed to others’ self-presentation on social media, and disordered eating. Studies also show that the relationship between focus on self-presentation and highly visual social media is stronger than for non-visual social media, hence facilitating upward social comparison. Nevertheless, no previous studies have investigated the link between adolescents’ focus on self-presentation and upward social comparison on social media, and perfectionism and disordered eating, which is the aim of the present study. Method The present study is based on a cross-sectional survey from the “LifeOnSoMe”-study (N = 3424), conducted in 2020 and 2021. Respondents were high school students (mean age 17.3 years, 56% females) in Bergen, Norway. Multiple regression analysis was performed, where SPAUSCIS, a measure of self-presentation and upward social comparison, was the independent variable. Perfectionism and disordered eating were dependent variables. Self-reported age, gender, and subjective socioeconomic status were used as covariates, as well as frequency and duration of social media use. Regression models were performed to compare proportions across the median split of SPAUSCIS. Results The multiple regression analysis showed that increased focus on self-presentation and upward social comparison on social media were positively associated with both perfectionism (standardized coefficient 0.28) and disordered eating. A stronger association for girls than boys was found for disordered eating (standardized coefficient 0.39 for girls and 0.29 for boys). There was no gender moderation for perfectionism. Conclusions Findings suggest that focus on self-presentation and upward social comparison on social media is associated with perfectionism and disordered eating. We recommend promoting a healthy use of social media. This could be established by increasing adolescents’ ability to reflect on and think critically about self-presentation and upward social comparison on social media.

Purpose: This paper aims to develop a framework to understand better how individual employees' Big Five personality traits determine the salience that employee stakeholder groups receive from their project managers. Design/methodology/approach: Using a quantitative approach and convenience sampling, we surveyed three higher educational institutions in Pakistan working on major educational projects. Findings: The findings indicate that agreeableness, openness, and extraversion significantly impact the salience received by project managers, while openness had a moderate impact, and neuroticism had a significant negative impact on project managers' salience. Research limitations/implications: As the research focused on Pakistani employees in the educational sector, it cannot be generalized to other sectors. Therefore, researchers should consider studies in different industries and other stakeholder groups. Practical implications: The results will allow project managers to identify and prioritize individuals within stakeholder groups. As agreeableness plays a significant positive role in the salience given to employees, managers may need to consider their biases as other personality traits may result in better project outcomes. Originality/value: This study highlights that project managers value employees with extraversion, agreeableness, conscientiousness, and openness traits and rebuke neurotic traits. Additionally, employees who show enthusiasm, prioritize tasks, are efficient, open to new experiences, and are less dissatisfied receive increased attention from managers. Keywords: stakeholder salience theory, stakeholder theory, salience, stakeholders, Big Five personality traits, INTRODUCTION The role of projects within an organization is crucial for its overall success (Soderlund, 2005). Therefore, industries and organizations increasingly adopt a project-based approach, and the responsibilities of project [...]

The three responsibilities of the environment, society, and economy are used to model how sustainability can be incorporated into an organization’s mission, goals, and practices. There are many worker problems embedded in the concept of sustainability. From the perspective of sustainable development, occupational health and safety (OSH) refers to promoting safety, security, health and welfare of workers. Using an integrated sustainability approach offers a way to rethink worker protection approaches and raises new exploration issues and innovation opportunities. This paper aims to present the connections between OSH and sustainable development taking into account the needs of the economic environment. It focuses on Safety and Health’s Core Role in Sustainability. Researchers have also tried to advance the road to sustainable development through innovation and improvement of occupational and health security.

Abstract Oligomeric species arising during the aggregation of α-synuclein are implicated as a major source of toxicity in Parkinson’s disease, and thus a major potential drug target. However, both their mechanism of formation and role in aggregation are largely unresolved. Here we show that, at physiological pH and in the absence of lipid membranes, α-synuclein aggregates form by secondary nucleation, rather than simple primary nucleation, and that this process is enhanced by agitation. Moreover, using a combination of single molecule and bulk level techniques, we identify secondary nucleation on the surfaces of existing fibrils, rather than formation directly from monomers, as the dominant source of oligomers. Our results highlight secondary nucleation as not only the key source of oligomers, but also the main mechanism of aggregate formation, and show that these processes take place under conditions which recapitulate the neutral pH and ionic strength of the cytosol.

Abstract A growing body of research highlights the continuum between dark and bright personality traits impacting individual prosocial or antisocial tendencies. However, the interplay between personality dimensions and actual criminal behavior and its reoccurrence is not fully elucidated. We aimed to explore the cumulative predictive value of the bright and dark core of personality for criminal history in differentiating a general community sample (N = 282) from a large sample of inmates (N = 296), with (n = 129) or without (n = 167) criminal history while controlling for age, sex and impression management. Predictors of first-time offending were higher levels of Neuroticism, Openness, Dark Factor, Sadism, and Deceitfulness. Criminal recidivism was predicted by high Neuroticism and Deceitfulness. Finally, higher levels of Extraversion were negatively related to criminal behavior and history, highlighting a potential protective effect of displaying assertive and sociable tendencies. The findings highlight the relevance of considering the dark personality core complementary to the typical personality dimensions in the risk assessment, prediction, and reduction of criminal behavior.

Andrea De Giacomo,1 Francesco Craig,2,3 Silvia Medicamento,1 Federica Gradia,1,* Dario Sardella,1,* Angela Costabile,2 Emilia Matera,4 Marco Turi5,6 1Department of Translational Biomedicine and Neurosciences (DiBraiN), University Hospital, Bari, Italy; 2Department of Cultures, Education and Society, Calabria University, Rende (CS), Italy; 3Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Brindisi, Italy; 4Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University Hospital, Bari, Italy; 5Department of Human and Social Sciences, Salento University, Lecce, Italy; 6Fondazione Stella Maris Mediterraneo, Potenza, Italy*These authors contributed equally to this workCorrespondence: Andrea De Giacomo, Department of Translational Biomedicine and Neurosciences (DiBraiN), University Hospital, Piazza Giulio Cesare, 11, Bari, BA, 70124, Italy, Email andrea.degiacomo@uniba.itPurpose: Recent literature has focused attention on the presence of autistic-like symptoms in children with Attention Deficit/Hyperactivity Disorder (ADHD), who often exhibit social difficulties, posing challenges for a distinct clinical diagnosis. The current study aimed to identify the specific pattern of autistic symptoms in subjects with ADHD or Autistic Spectrum Disorder (ASD), examining similarities or differences at both the domain and individual item levels.Patients and Methods: In this study, we enrolled 43 school-age children divided into the following: the ADHD group (n=25) consisted of children initially referred for ASD symptoms but subsequently clinically diagnosed with ADHD, and the ASD group consisted of 18 children with ASD. We used the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2), to examine relative differences in the presence of symptoms such as deficits in communication and social interaction, and restricted and repetitive behaviors in these two groups. Comparison between groups was conducted to explore differences in IQ, age, ADOS-2 domains, and externalizing and internalizing problems among the groups.Results: We found significant differences between the groups when comparing summary scores of ADOS-2 domains (Social Affect, Restricted and Repetitive Behavior, and Total Score). Interestingly, at the individual item level, the ADHD group exhibited a similar level of atypical behaviors compared to the ASD group in two items related to the social-communication area: “Pointing” and “Gestures”. Additionally, the frequencies of “Stereotyped/idiosyncratic words or phrases”, “Mannerisms”, and “Repetitive interests and behaviors” also showed similarities between groups.Conclusion: These findings indicate the importance of exploring and developing potential transdiagnostic domains that could be targeted for treatments specifically designed for children with ADHD.Keywords: autistic spectrum disorders, attention deficit hyperactivity disorder, autism diagnostic observation schedule-2, autistic-like symptoms, social difficulties

Summary: Kaspar Hauser’s parentage has been the subject of research and debate for nearly 200 years. As for his possible aristocratic descent through the House of Baden, there is suspicion that he was swapped as a baby, kidnapped, and kept in isolation to bring a collateral lineage to the throne. In the last 28 years, various genetic analyses have been carried out to investigate this possible aristocratic origin. Previous results using less sensitive Sanger and electrophoresis-based methods were contradictory, and moreover, the authenticity of some samples was disputed, thus leaving the question open. Our analyses using modern capture- and whole genome-based massively parallel sequencing techniques reveal that the mitochondrial DNA haplotypes in different samples attributed to Kaspar Hauser were identical, demonstrating authenticity for the first time, and clearly different from the mitochondrial lineage of the House of Baden, which rules out a maternal relationship and thus the widely believed “Prince theory”.

Abstract Background Traditional dosing of chemotherapy drugs based on body surface area may overdose small dogs, leading to an increased frequency of adverse events (AEs). Hypothesis/Objectives Evaluate the frequency of hematologic and gastrointestinal AEs in dogs with newly diagnosed lymphoma treated with vincristine weighing ≤15 kg in comparison to dogs weighing >15 kg. We hypothesized that dogs weighing ≤15 kg would experience a higher frequency of AEs. Animals One hundred and thirty‐eight dogs with newly diagnosed lymphoma were treated with vincristine. Methods A multicenter retrospective study reviewing hematologic data and medical record information. Complete blood counts were performed no more than 24 hours before vincristine administration and then between 4 and 8 days post‐administration. Data were evaluated using logistic regression or ordinal logistic regression. Results Thirty‐eight dogs weighing ≤15 kg and 100 dogs weighing >15 kg were included. The median vincristine dose for both groups was 0.6 mg/m2. Seventeen (12.3%) instances of neutropenia occurred with no significant difference in overall frequency or grade between groups. Thirty initially asymptomatic substage A dogs (29.4%) experienced gastrointestinal AEs. Because of the widespread use of gastrointestinal supportive care medications, statistical comparison between groups could not be performed. Seven instances of hospitalization occurred (5.0%) and the risk of hospitalization did not differ significantly between groups (P = .37). Conclusions and Clinical Importance Vincristine dosed at ≤0.6 mg/m2 does not increase the risk of hematologic AEs in dogs weighing ≤15 kg.

Abstract Background Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months. Methods This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD. Results After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and − 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p

Abstract GCaMP is a genetically encoded calcium indicator (GECI) widely used in neuroscience research. It measures intracellular Ca2+ level by fluorescence changes as it directly binds to Ca2+. In this process, the effect of this calcium buffer on the intracellular calcium signaling and cell physiology is often not taken into consideration. However, growing evidence from calcium imaging studies shows GCaMP expression under certain conditions can generate aberrant activity, such as seizures. In this study, we examined the effect of GCaMP6 expression in the dentate gyrus (DG) on epileptogenesis. We found that viral expression of GCaMP6s but not GCaMP6f in the DG induces tonic–clonic seizures several weeks after viral injection. Cell-type specific expression of GCaMP6s revealed the granule cells (GCs) as the key player in GCaMP6s-induced epilepsy. Finally, by using slice electrophysiology, we demonstrated that GCaMP6s expression increases neuronal excitability in the GCs. Together, this study highlights the ability of GCaMP6s in DG-associated epileptogenesis.

Abstract Background Although gaming problems are associated with poor mental health, few population-based studies have examined its association with self-harm and suicidality. This study investigates the association between gaming problems, non-suicidal self-harm and suicidality within the past year, stratified by sex among Norwegian full-time students. Methods Data derived from the Norwegian Students’ Health and Wellbeing Study 2022 (N = 59,544). The respondents were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers based on the Game Addiction Scale for Adolescents. Log-link binomial regression models, stratified by sex, adjusted for age, were used to estimate the risk ratio of non-suicidal self-harm (ideation and behavior) and suicidal behaviors (ideation and attempt) across different levels of gaming problems. Results Among females, the risk of non-suicidal self-harm and suicidal ideation increased from non-gamer to problem gamer, with no differences between problem and addicted gamers. Among males, the risk of non-suicidal self-harm increased from non-gamers to engaged gamers, but no differences were observed between engaged, problematic, and addicted gamers. No sex × gaming category interaction was observed for suicide attempts. Engaged and addicted gamers had higher risks of suicide attempt than non-gamers and recreational gamers. Conclusions Gaming problems are associated with increased risk of non-suicidal self-harm and suicidal ideation among females. Among males, no differences were observed between engaged, problem and addicted gamers. The results highlight sex when studying health related outcomes and their association to level of gaming problems. Longitudinal studies are warranted to uncover the temporal mechanisms between IGD, non-suicidal self-harm and suicidality.

AbstractThis paper investigates the factors that influence visitors’ intention to reuse virtual reality (VR) in theme parks in Malaysia, specifically focusing on perceived usefulness, perceived ease of use, enjoyment, and compatibility, as well as the mediating role of visitor satisfaction. A field survey was conducted with 357 visitors using a quantitative research design, and the collected data was analyzed using SPSS and Smart-PLS software. The results indicate that perceived ease of use, enjoyment, and compatibility positively influence visitors’ intention to reuse VR, while visitors’ satisfaction mediates the relationship between perceived ease of use, compatibility, and intention to reuse VR. The study recommends that park owners and administrators ensure customers’ ease of use of VR and create innovative ideas and materials to enhance enjoyment, as retaining old customers is more feasible and less expensive than acquiring new ones. The study’s limitations include a small sample size and limited geographic scope, suggesting the need for future research to increase generalizability and incorporate variables such as subjective norms. Theme park managers can use the study’s findings to incorporate VR technology into their roller coasters and create a variety of VR experiences for visitors. Overall, the study advances theoretical understanding of related constructs and offers practical insights for theme park management.

ObjectivesThe purpose of this study was to assess serum concentrations of gabapentin in cats with chronic kidney disease (CKD) vs clinically healthy cats.MethodsFive healthy cats were enrolled in a pharmacokinetic study. A single 20 mg/kg dose of gabapentin was administered orally and blood was obtained at 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 8, 12, 24 and 36 h via a jugular catheter. Serum gabapentin concentrations were measured using liquid chromatography coupled to tandem mass spectrometry. Non-compartmental pharmacokinetic analysis was performed. The same five healthy cats plus 25 cats with stable International Renal Interest Society stage 2 (n = 14) and 3 (n = 11) CKD were enrolled in a limited sampling study. Cats in both groups received a single 10 mg/kg dose of gabapentin, and serum gabapentin concentrations and compliance scores were obtained 3 and 8 h post-administration.ResultsCats with CKD had significantly higher dose-normalized serum gabapentin concentrations than normal cats at 3 h (P = 0.0012 CKD vs normal 10 mg/kg; P = 0.008 CKD vs normal 20 mg/kg) and 8 h (P

Introduction: Effective and adequate maternal health service utilization is critical for improving maternal and newborn health, reducing maternal and perinatal mortality, and important to achieve global sustainable development goals (SDGs). The purpose of this systematic review was to assess adolescent maternal health service utilization and its barriers before and during SDG era in Sub-Saharan Africa (SSA). Methods: Systematic review of published articles, sourced from multiple electronic databases such as Medline, PubMed, Scopus, Embase, CINAHL, PsycINFO, Web of Science, African Journal Online (AJOL) and Google Scholar were conducted up to January 2024. Assessment of risk of bias in the individual studies were undertaken using the Johanna Briggs Institute (JBI) quality assessment tool. The maternal health service utilization of adolescent women was compared before and after adoption of SDGs. Barriers of maternal health service utilization was synthesized using Andersen's health-seeking model. Meta-analysis was carried out using the STATA version 17 software. Results: Thirty-eight studies from 15 SSA countries were included in the review. Before adoption of SDGs, 38.2 % (95 % CI: 28.5 %, 47.9 %) adolescents utilized full antenatal care (ANC) and 44.9 % (95%CI: 26.2, 63.6 %) were attended by skilled birth attendants (SBA). During SDGs, 42.6 % (95 % CI: 32.4 %, 52.8 %) of adolescents utilized full ANC and 53.0 % (95 % CI: 40.6 %, 65.5 %) were attended by SBAs. Furthermore, this review found that adolescent women's utilization of maternal health services is influenced by various barriers, including predisposing, enabling, need, and contextual factors. Conclusions: There was a modest rise in the utilization of ANC services and SBA from the pre-SDG era to the SDG era. However, the level of maternal health service utilization by adolescent women remains low, with significant disparities across SSA regions and multiple barriers to access services. These findings indicate the importance of developing context-specific interventions that target adolescent women to achieve SDG3 by the year 2030.

Background: Frequent use of delayed sternal closure and prolonged stays in critical care units contribute to surgical site infections among pediatric patients undergoing cardiothoracic (CT) procedures. Bundled interventions to prevent or reduce surgical site infections (SSIs) have shown prior success, but limited data exist on sustainability of these efforts especially during the Coronavirus Disease 2019 (COVID-19) pandemic. Here, we re-examine the SSI rates for pediatric CT procedures after the onset of the pandemic. Methods: In a single academic center providing regional quaternary care, we created a multidisciplinary CT-surgery SSI Prevention workgroup in response to rising CT SSI rates. Bundle elements focused on daily chlorhexidine bathing, environmental cleaning, monthly room changes, linen management, antimicrobial prophylaxis, and sterile techniques for beside and operating room procedures. CDC surveillance definitions were used to identify superficial, deep or organ space SSIs. To assess the bundle’s sustainability, we compared SSI rates during years impacted by the COVID-19 pandemic (2021–2023, period 2) to pre-pandemic rates (2017–2019, period 1). Data from 2020 were excluded to account for bundle implementation, pandemic restrictions, and a minor decrease in surgical volumes. Rates were calculated as surgical site infection cases per 100 procedures. Mean rates across both periods were compared using paired t-tests (Stata/SE version 14.2). Results: Excluding the year 2020, the average SSI rate per 100 CT procedures increased from 1.07 in period 1 to 1.56 in period 2(p=0.55). Concurrently, the average SSI rate per 100 CT procedures with delayed closures increased from 1.49 in period 1 to 1.97 in period 2(p=0.67). Figure 1 shows SSI rates and procedure counts for 2017–2023. Coagulase negative Staphylococci most frequently caused SSIs in period 1 while methicillin-susceptible Staphylococcus aureus (MSSA) was most frequently identified in period 2. During period 2, the estimated compliance with SSI prevention bundle remained stable and reached 95% for pre-operative chlorhexidine baths and use of appropriate antimicrobial prophylaxis. Monthly room changes with dedicated environmental cleaning reached 100% compliance. Conclusion: Despite staffing shortages and resource limitations (e.g., discontinuation of contact isolation for MRSA colonization) during the COVID-19 pandemic, SSI rates for pediatric CT surgeries showed a slight, but non-statistically significant, increase in post-pandemic years as compared to pre-pandemic years. implementation of bundled interventions and improved surveillance methods may have sustainably impacted these SSI rates. Reinforcing bundle adherence as well as identifying additional prevention interventions to incorporate in pre-, intra-, and post-operative periods may improve patient outcomes.

In this study, we analyzed the emotional and motivational aspects characterizing the profile of university students with Specific Learning Disorders (SLD). We assessed 61 university students, 32 with SLD (age = 23.6) and 29 in the control group (age = 23.00). The results highlighted that individuals with SLD exhibit higher levels of anxiety and depression and lower resilience compared to the control group. The Multidimensional Perfectionism Scale – Short Form, which explores perfectionism, did not reveal differences between the groups. Conversely, lower scores emerged in SLD students for the intrinsic motivation sub-scales of the Academic Motivation Scale. This indicates less engagement in studying out of personal cognitive curiosity. The Self-Regulated Knowledge Scale – University, which measures various cognitive strategies, showed significantly lower scores in the SLD group for knowledge linking, knowledge training, and knowledge critique. This suggests a lower frequency with which SLD students attempt to connect new knowledge with what they already possess, apply their knowledge, ask questions, and critically analyze what they have learned. Therefore, psychological and motivational consequences are evident in this population and can impact well-being and quality of life.

ABSTRACT BACKGROUND: The impact of metabolic syndrome (MetS) on healthcare costs remains unclear in the literature. OBJECTIVES: To determine the impact of MetS on primary healthcare costs of adults, as well as to identify the impact of physical activity and other covariates on this phenomenon. DESIGN AND SETTING: This cross-sectional study was conducted in the city of Presidente Prudente, State of São Paulo/Brazil, in 2016. METHODS: The sample comprised 159 older adults (> 50 years) of both sexes (110 women) who were identified from their medical records in the Brazilian National Health Service. Healthcare costs (US$) were assessed through medical records and divided into medical consultations, medications, laboratory tests, and total costs. MetS was assessed using medical records. RESULTS: The Brazilian National Health Service spent more on consultations (US$ 22.75 versus US$ 19.39; + 17.3%) and medication (US$ 19.65 versus US$ 8.32; + 136.1%) among adults with MetS than among those without MetS, but the costs for laboratory tests were similar (P = 0.343). Total costs were 53.9% higher in adults with MetS than in those without the diagnosis of the disease (P = 0.001). Regarding total costs, there was an increase of US$ 38.97 when five components of MetS were present (P = 0.015), representing an increase of approximately 700%, even after adjusting for sex, age, and physical activity. CONCLUSION: In conclusion, the presence of the MetS is responsible for increasing primary care costs among older adults, especially in those related to medicines.

ABSTRACT BACKGROUND: The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE: To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING: Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS: Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS: In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01. CONCLUSION: The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.