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The way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU. In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction. Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0–5) vs 0 (0–6); P =0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P =0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction. Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary. NCT05234216. [ABSTRACT FROM AUTHOR]

Research on parent–child interaction (PCI) and its impact on children's weight status is a thriving study area. However, their potential pathways have not been established. This study investigated the association between PCI and children's body-mass index z score (BMIz) examining the role of appetite self-regulation (ASR) as a mediator. Mediation analysis. We included children from 33 kindergartens in Wuhan with parents' consent, measuring children's height and weight, and calculating BMIz. To assess the PCI quality, we utilized the Brigance Parent–Child Interactions Scale. Additionally, children's ASR was tested by satiety responsiveness (SR) and food responsiveness (FR) using the Children's Eating Behavior Questionnaire. Quantile regression was employed to examine the PCI-BMIz association, while mediation analysis was conducted to explore ASR's mediating effect on the relationship between PCI and BMIz. Of 3973 children (53.88% boys) included in the analysis, the mean BMIz was 0.24 ± 1.13. The results revealed that children with poorer PCI quality have higher BMIz across all selected BMIz percentiles, except for the 5th percentile. Furthermore, these associations were significant across most percentiles, whether for boys or girls. Mediation analysis suggested that these associations were partially mediated by children's ASR (ind FR = −0.026, P FR < 0.001; ind SR = −0.058, P SR < 0.001), with stronger effects observed among boys. The variation in how strongly BMIz was linked to PCI across different percentiles suggests that children with poorer PCI have higher BMIz. The link is partially mediated through children's ASR. It's important to pay attention to the PCI quality in children with higher BMIz levels, especially in boys. [ABSTRACT FROM AUTHOR]

• We explore the moderating role of bus satisfaction based on the examination of the antecedents and consequences of affective motivation for private cars. • The moderating effect of bus satisfaction on the relationship between symbolic motivation and affective motivation is significantly negative. • Bus satisfaction evinces a significantly positive moderating effect on the relationship between affective motivation and private car ownership and use. • The decision to own and use a private car is heavily influenced by bus satisfaction. China started implementing a public transport priority policy in 2004 to encourage people to use public transit, especially buses, and reduce reliance on private cars. This paper used 334 questionnaire survey data from Changzhou City, China, and explored the moderating role of bus satisfaction based on the examination of the antecedents and consequences of affective motivation for private cars through two studies. Study 1 explored the antecedents of affective motivation for private cars and the moderating effect of bus satisfaction. The empirical results revealed that instrumental motivation is the most relevant predictor of affective motivation favoring private cars, followed by symbolic motivation. The moderating effect of bus satisfaction on the relationship between symbolic motivation and affective motivation was significantly negative. Study 2 explored the consequences of affective motivation for private cars and the moderating effect of bus satisfaction. Empirical results indicate that decisions regarding private car ownership and use are significantly negatively influenced by bus satisfaction. Bus satisfaction has a significantly positive moderating effect on the relationship between affective motivation and private car ownership and use. The marginal effect of bus satisfaction on the probability of simultaneously owning and using private cars is significantly negative, and it strengthens the influence of affective motivation in promoting both ownership and use of private cars. These results demonstrate that for individuals with experience using both buses and private cars, the public transport priority policy focused on improving bus service quality can effectively reduce private car ownership and use. These results can serve as evidence to support policymakers in continuing to enhance the public transport priority policy. [ABSTRACT FROM AUTHOR]

To meet the increasing demands of genetic risk assessment for genitourinary cancers due to expanded clinical guidelines, we established an academic/industry partnership to create a streamlined workflow to overcome the barriers to access to care. Genome Medical offers multilingual genetic counseling. A pilot program evaluated patients at risk for hereditary genitourinary syndromes. Between January 1, 2020 and January 07, 2022, all patients in need of germline testing were offered hybrid in-clinic telehealth pre-test counseling and when indicated, genetic testing. Post-test counseling was offered based on results and encouraged if positive. Testing results, patient satisfaction, and costs were evaluated. A total of 146 of 182 (80.0%) patients agreed to participate, with 130 (89.0%) completing pre-test counseling. Median age was 65 (range 22-95), with 91% being male and approximately 60% having prostate cancer. The median time from referral to pre-test counseling was 11 days (IQR 7-20). After assessment, testing was recommended for 127 (97.7%) of which 123 (96.8%) completed testing. The median time from testing to result release was 15 days (IQR 10-20.8). Forty (32.5%) had post-test counseling. Reimbursement by private insurers increased annually from $17.2 to $52.4. Patient satisfaction was high with a mean Genetic Counselor Satisfaction Scale of 27.9 out of 30. Our program provided high patient satisfaction, rapid access to genetic counseling, prompt genetic testing, timely release of results, and was cost-effective compared to traditional models. This approach is scalable across community and academic settings and across cancer types. [ABSTRACT FROM AUTHOR]

Women veterans are at elevated risk for suicide and experience a high prevalence of suicidal ideation (SI) and suicide attempt (SA) history. Knowledge regarding SI/SA correlates among women veterans who use reproductive health care services is limited, inhibiting development of evidence-based, gender-sensitive suicide prevention programming tailored to meet women veterans' needs and preferences. This study aimed to 1) describe the prevalence and characteristics of SI and SA among women veterans using Veterans Health Administration (VHA) reproductive health care services and 2) provide an initial exploration of associations between fertility-, pregnancy-, and parenting-related factors with SI and SA to guide future research. Post-9/11 women veterans (n = 352) who used VHA reproductive health care in fiscal year 2018 completed a cross-sectional survey on reproductive health, mental health, and parenting. Approximately 30% and 12% experienced SI and SA(s), respectively, after military service; 10% reported past-month SI. Infertility, pregnancy loss, age at first pregnancy, and parental status were not significantly associated with SI or SA history, although notable effect sizes were observed for infertility and age at first pregnancy; further research is warranted. Among parents, parental functioning was not associated with SI/SA, but lower parental satisfaction was significantly associated with past-month SI (prevalence ratio, 3.36; 95% confidence interval, 1.19–9.46; adjusting for demographics, military characteristics, mental health symptoms). Postmilitary SI and SA(s) are common among women veterans accessing VHA reproductive health care services. Those with low parental satisfaction may be at particularly high risk. Findings can guide future research and inform clinical care to facilitate suicide prevention. [ABSTRACT FROM AUTHOR]

Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and ∼2.5h and ∼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention. • Evidence suggests that loneliness is causally associated with depression. • It is unclear whether momentary vs. chronic feelings of loneliness cause depression. • Features of social interactions (e.g., quantity) may buffer against subsequent depression. • Results showed that loneliness was associated with depression at the same time point and ∼2.5 and ∼5 hours later. • Neither social interaction quantity, satisfaction, self- and other-disclosure, nor responsiveness moderated this association. [ABSTRACT FROM AUTHOR]

The concept of the "new norm" implies a shift in societal behavior, and the COVID-19 pandemic is suspected to have long-term effects on customer perceptions of public transportation service factors such as crowdedness and cleanliness as mentioned in the literature. To assess the existence of a new norm in passenger behavior, a six-wave longitudinal customer satisfaction survey was conducted, comprising four waves before the pandemic and two waves after, in addition to an interview panel survey. Employing the SEM-MGA approach, we modelled the longitudinal sample, utilizing a confirmatory factor analysis framework grounded in passenger satisfaction literature specific to the Tehran metro. A MGA model was introduced, and the Importance-Performance Analysis was employed to identify alterations in the significance and execution of satisfaction factors across each survey wave and model. Three main factors of cleanliness, crowdedness, ventilation, were examined to assess the new norm. Each factor consistently emerged as a significant factor in passenger satisfaction, pre and post-COVID-19. In conclusion, our findings indicate that the COVID-19 pandemic did not have an observable long-term impact on public transportation passengers' perceptions of cleanliness and ventilation. This suggests that authorities may consider returning to pre-pandemic operational practices to conserve valuable resources. Moreover, our study underscores passengers' adaptability and the system's reversion to pre-pandemic norms in this regard. • To assess the existence of a new norm in users' behavior, a six-wave longitudinal customer satisfaction survey was conducted. • An MGA model was introduced, and the Importance-Performance Analysis was employed to identify alterations in users' behavior. • Three main factors of cleanliness, crowdedness, and ventilation were examined to assess the new norm. • Socio-demographic data from the samples were analyzed to determine the optimal cluster structure. [ABSTRACT FROM AUTHOR]

• Outpatient hysteroscopy and outpatient operative Myosure procedures are both well tolerated with a high success rate (99%) and patient satisfaction rate (96%). • There was no association between pre-existing pain and actual pain for outpatient hysteroscopy procedures. • There was no statistical evidence that age, parity, tubal status or menopausal status were associated with higher operative Myosure pain scores. • There was a weak association with anticipated pain scores and actual pain scores for both the diagnostic hysteroscopy and operative Myosure. Abnormal uterine bleeding (AUB) affects women of all ages and is one of the most common reasons for referral to a gynaecological clinic. Operative hysteroscopic procedures allow for a see-and-treat approach to AUB, and these techniques have been shown to be feasible and acceptable in the outpatient setting. To assess if there is an increase in pain scores for women who are undergoing an operative hysteroscopic procedure with Myosure LITE® (Hologic; mechanical hysteroscopic tissue removal system) compared to outpatient diagnostic hysteroscopy alone. A prospective cohort study was performed. All participants attending the outpatient hysteroscopy clinic at Mercy Hospital for Women completed a pre-and post-procedure questionnaire. This included a visual analogue scale (VAS) for any pre-existing pain, anticipated pain, and actual pain experienced during procedure. Factors influencing overall satisfaction and willingness to attend again were also assessed. Data was entered into RedCap® for analysis. A difference in VAS of 10 mm or more was considered clinically significant. An alpha of p < 0.05 was assigned for statistical significance. Between February 2020 and November 2022, 208 women underwent outpatient diagnostic hysteroscopy followed by an operative hysteroscopy with MyoSure®. To allow for standardisation of analgesia, only participants who had a cervical block before their Myosure® procedure were included for analysis (n = 111). There was statistical evidence (t(1 1 1) = 2.36, p = 0.02) of a lower mean VAS pain score for operative Myosure (36.5 mm, 95 % CI: 31.1–41.8 mm) compared to outpatient diagnostic hysteroscopy (44.1 mm, 95 % CI: 39.0–49.2 mm). The mean difference in VAS pain score was estimated as 7.7 mm (95 % CI: 1.2–14.1 mm) lower for Myosure compared to hysteroscopy. Given the threshold for clinical significance was considered as 10 mm difference in VAS, the variance in pain scores is under the likely clinically significant range. There was no significant difference in pain scores for diagnostic hysteroscopy with or without paracervical block (mean difference = 1.42; 95 % CI: −6.35 to 9.20). There was no association between pre-existing pain, and actual pain for hysteroscopy, or Myosure (p = 0.997 and p = 0.065 respectively). The anticipated pain score was weakly associated with actual pain during the operative Myosure procedure (p = 0.02), and with outpatient diagnostic hysteroscopy (p = 0.019). Outpatient hysteroscopy procedures are generally well tolerated. The pain experience with operative Myosure was less than that reported during the diagnostic hysteroscopy by the same patient although this is unlikely of clinical significance. Importantly, Myosure was not more painful than the initial diagnostic procedure, and most patients were satisfied with the outcome and would choose to have the procedure again in an outpatient setting. This is in keeping with other studies which have shown a high degree of patient tolerance and satisfaction with this approach. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare a traditional fronto-orbital remodeling and advancement (FORA) with the dynamic cranioplasty for trigonocephaly (DCT). The authors analyzed patients who underwent surgery for trigonocephaly. Perioperative data were compared. Parents were asked to use a visual analog scale to evaluate the pre- and postoperative distance between the eyes, the forehead shape, and the global appearance of the face. A panel of observers was asked to grade pre- and postoperative photographs using a similar visual analog scale. Pre- and postoperative anthropometric data were collected and analyzed in a subset of the study population aged 9 years or older. The total sample size was 51 patients (DCT n = 39; FORA n = 12). Durations of surgery and anesthesia were shorter in the DCT group (115 vs 194 min, p = 0.001; 226 vs 289 min, p = 0.001). Patients in the DCT group received similar preoperative ratings to those in the FORA group, but significantly higher postoperative ratings by parents for all three questions. There were no significant differences in postoperative ratings by the panel or postoperative anthropometric data. DCT is safe and effective. It is preferred over FORA because it is associated with shorter durations of surgery and anesthesia, while providing higher degrees of parental satisfaction and similar aesthetic and anthropometric outcomes. [ABSTRACT FROM AUTHOR]

Although the Favard classification is commonly utilized by surgeons to describe the supero-inferior morphology of the glenoid when treating rotator cuff arthropathy (RCA), its utility in prognosticating patients' clinical state before and after reverse shoulder arthroplasty (RSA) remains unproven. We assessed the prognostic value of the Favard glenoid classification on preoperative clinical state and postoperative clinical and radiographic outcomes in RSA. A prospectively collected, multicenter database for a single-platform shoulder arthroplasty system was queried for patients with RCA who underwent RSA with a minimum 2-year clinical follow-up. Differences in patient reported outcome scores (PROMs) (Simple Shoulder Test, American Shoulder and Elbow Surgeons, Shoulder Pain and Disability Index, visual analog scale pain, Shoulder Function score), combined patient-reported and clinical-input scores (Constant, University of California Los Angeles, Shoulder Arthroplasty Smart), active range of motion values (forward elevation, abduction, external rotation [ER], internal rotation [IR]), radiographic outcomes (humeral radiolucency line rates, scapular notching rate), and the incidence of postoperative complications and revision surgery were compared by glenoid deformity type per the Favard classification. Comparisons were performed to assess the ability of the Favard classification to prognosticate the preoperative, postoperative, and improved state after RSA. 400 RSAs performed for RCA were included. Comparison of outcomes between Favard glenoid types resulted in 6 pairwise comparisons of 12 clinical outcome metrics, yielding 72 total Favard glenoid pairwise comparisons for each clinical state (preoperative, postoperative, improvement). Of the 216 possible pairwise Favard glenoid type/metric comparisons, statistical significance was only reached for 3% of the combinations (7/216). Among E0, E1, and E2 glenoids, the only statistically significant pairwise comparison identified among all three clinical states was a more favorable preoperative American Shoulder and Elbow Surgeons score for E0 vs. E2 glenoids. Preoperatively, E3 glenoids had poorer ER, IR, and Shoulder Arthroplasty Smart scores compared to E0 glenoids and poorer ER compared to E2 glenoids. Postoperatively, E3 glenoids had a poorer IR score compared to E0 glenoids and poorer ER compared to E1 glenoids. No pairwise differences in preoperative to postoperative improvement were found. There were no statistically significant pairwise differences in humeral lucency rate, scapular notching rate, complication rates, or revision rates between Favard glenoid types. Although useful for describing degenerative changes to the glenohumeral joint, the Favard classification offers little prognostic information regarding patient outcomes before and after RSA aside from poorer preoperative and postoperative axial rotation in E3 glenoids. Alternative glenoid classification systems or predictive models should be considered for more precise prognoses of patients undergoing RSA for RCA. [ABSTRACT FROM AUTHOR]

To compare paediatric oncologic vascular access ports located on the anterior thoracic wall to ports on the lower lateral thoracic wall, in terms of perceived port-related hindrance and scar-quality. A cross-sectional survey study including paediatric oncology patients (≥8-<19 yrs), caregivers (in patients <8 yrs), survivors (>22 yrs with only anterior ports) and nurses of the Princess Máxima Center, the Netherlands, was performed. The survey consisted of questions regarding satisfaction, hindrance during daily life, and port position preference. For survivors, scar-quality was assessed using the validated Patient and Observer Scar Assessment Scale (POSAS 2.0); a high score (i.e., a displeasing scar) was defined as a score higher than the third quartile of the median for that question. In total, 147 participants were included; 83 patients/caregivers, 31 survivors, and 33 nurses. Overall, 81 % was satisfied with the position of their port. Satisfaction, hindrance and complications did not differ between anterior and lower lateral ports. For the anterior position, minimal pressure on the port during daily life was a mentioned reason to prefer this position. For the lower lateral position, less visibility of the scar and easiest access were mentioned. Of all survivors with an anterior port scar, one in five had a displeasing scar and all scars observed were widened. Female patients preferred a lower lateral port, and scar-quality was better for left-sided port scars. The port position should be chosen together with patients/caregivers based on the (dis-)advantages of each position, as identified by this study. II. • Satisfaction, hindrance and complications did not differ between anterior and lower lateral ports. • The most ideal port position should therefore be chosen together with patients/caregivers based on the (dis-)advantages of each position. [ABSTRACT FROM AUTHOR]

To document the change of clinical (wrist motion and grip strength) measurements and Patient-Rated Wrist Evaluation (PRWE) scores at 9 weeks and 3, 6, and 12 months after distal radius fracture (DRF) in women 50 years and older with exclusively isolated, displaced, and low-energy DRFs treated by either closed and/or open reduction and to relate these outcomes to their radiographic results. In this retrospective single-institution cohort study, patients' post-DRF clinical measurements and PRWE scores were prospectively collected from December 2007 through September 2018 and stratified according to their final radiographic values of volar/dorsal tilt, ulnar variance, and radial inclination. Of the 1,319 women identified, 1,126 (85%) were treated nonsurgically, and 193 (15%) were treated operatively. At 12 months, patients averaged restoration (ratio of injured and uninjured sides' values) of 96% pronation, 95% extension, 91% supination, 81% flexion, and 80% (77% nondominant, 85% dominant) grip strength. The mean PRWE score was 39.5 at week 9 and 14.4 at 12 months with 54% of patients scoring <10 and 13% scoring zero. The mean volar/dorsal tilt, ulnar variance, and radial inclination values in those treated nonsurgically were 1.4° dorsal, +3.9 mm, and 18.0°, respectively. Analogous values in patients treated surgically were 6° volar, +2.6 mm, and 22°, respectively. Volar tilt ≥25°, dorsal tilt >10°, ulnar variance >+7.5 mm, and radial inclination ≤13° were thresholds beyond which motion and grip strength were reduced and/or PRWE scores increased. In general, older patients experienced more residual deformity and were less likely to have undergone surgery. Generally, outcomes were satisfactory for patients with radiographic results within identified thresholds for acceptable fracture reduction. Outcomes were significantly less favorable for patients with radiographic results beyond these thresholds; for these patients, early surgical intervention should be considered. Low-energy DRFs should prompt bone density investigation. Therapeutic 2b. [ABSTRACT FROM AUTHOR]

Chest masculinization is the most common surgical intervention in transgender men. Studies indicate good patient-reported postoperative satisfaction, but only recently has a patient-reported outcome instrument, the BODY-Q Chest module, been developed and validated for this patient group. This study aimed to evaluate postoperative patient-reported satisfaction and health-related quality of life (HRQoL) using the BODY-Q Chest module and the 15D after surgical chest masculinization in transgender men. The data comprised all patients receiving chest masculinization from 2005 to 2018. The patients were invited by letter to complete the BODY-Q Chest module and the 15D questionnaire in May 2020. Of the 220 patients invited, 123 completed the survey, resulting in a response rate of 56%. The median chest and nipple scores were 76 and 68 out of 100, respectively. The number of secondary corrections was negatively associated with the chest score (p value < 0.001). The 15D index score was lower compared with the age-standardized male population (p value < 0.001), but similar to the age-standardized female population. Psychiatric comorbidity was associated with lower 15D index scores (p value < 0.001). There were no statistically significant differences between the BODY-Q Chest module scores or the 15D index score among the different surgical techniques. The postoperative satisfaction with chest masculinization was good and in line with previous literature. HRQoL resembles that of the reference population. The periareolar technique is not associated with better satisfaction despite causing less scar burden. The negative association between the chest score and number of secondary corrections is unsettling and requires further examination in a prospective setting. [ABSTRACT FROM AUTHOR]

We examine how mortgage brokers affect borrower confusion about key mortgage features and assess whether brokers mitigate confusion by educating borrowers. Drawing from two lab-in-the-field experiments, we first show a correlation between the attributes borrowers find most confusing and those they find least important. Second, we show that borrowers who secure loans directly from lenders demonstrate lower confusion levels compared to those using brokers, even after accounting for self-selection bias. Despite this, broker users exhibit higher decision satisfaction and confidence after taking a loan. Third, using responses from discrete choice experiments to implement a causal mediation analysis with a single IV, we evaluate the influence of broker use, financial literacy, and subjective confusion on borrowers' willingness to pay for specific mortgage attributes. Our findings reveal that broker users are willing to pay more for attributes that increase the value and duration of loans, increasing broker commissions. [ABSTRACT FROM AUTHOR]

This study aimed to assess the trends of healthy aging and investigate its determinants in the middle-aged population. This was a longitudinal study. The sample comprised 3043 participants aged 45–59 years from the China Longitudinal Study of Health and Retirement 2011–2018. We plotted the prevalence across four waves and used ordered logistic models to investigate the determinants of cumulative times of healthy aging. We enrolled 3043 middle-aged people in our study. The prevalence of healthy aging is 28.2% at baseline but subsequently decreased to 19.72% at wave 4. Active socializing consistently ranked the lowest among the five dimensions. Participants with older age (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.94–0.97), low monthly income (OR = 0.82, 95% CI: 0.69–0.97) or lived in urban (OR = 0.81, 95% CI: 0.70–0.94) were less likely to have per time increase in healthy aging. Participants with more than primary school degree (OR = 1.79, 95% CI: 1.31–2.46), high life satisfaction (OR = 2.38, 95% CI: 1.86–3.06), and good self-report health (OR = 1.97, 95% CI: 1.66–2.34) were more likely to have healthy aging. The number of middle-aged individuals in China who achieved healthy aging is declining and eventually less than one in five, which was far from ideal. Particular attention should be paid to older, women, urban dwellers, individuals with low income, low life satisfaction or poor self-report health. It is urgent to develop public health policies to improve the health and well-being of the middle-aged population. [ABSTRACT FROM AUTHOR]

Current antiretroviral therapy (ART) regimens are highly effective; therefore, to differentiate between various regimens, considering patient-reported outcomes is essential. This study aimed to assess patient satisfaction with their current ART regimens and investigate factors associated with the Human Immunodeficiency Virus Treatment Satisfaction Questionnaire: Status (HIVTSQs) score. This cross-sectional, multicenter study was conducted in Japan between April and December 2021. Patient-reported satisfaction with ART was assessed using the Japanese version of the HIVTSQs. Binary logistic regression was used to identify factors associated with a low total HIVTSQs score. A total of 679 patients completed the questionnaire. The median total HIVTSQs score was 58 (interquartile range: 52.5–64). In the multivariable logistic regression analyses, a total HIVTSQs score in the lowest quartile (indicating low satisfaction) was independently associated with twice- or thrice-daily regimens compared with single-tablet, once-daily regimens (adjusted odds ratio: 2.80, 95% confidence interval: 1.29–6.06, p = 0.009) and depression (adjusted odds ratio: 2.30, 95% confidence interval: 1.32–4.01, p = 0.003). Satisfaction with the current ART regimen was high. Depression and twice- or thrice-daily ART regimen were associated with low HIVTSQ. Switching to a single-tablet, once-daily regimen may improve patient satisfaction in patients receiving twice- or thrice-daily regimens. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate existing staging recommendations for peri-implantitis and its applicability for auricular bone anchoring. In this cross-sectional study, 44 patients treated with 47 ear epitheses and 128 implants were analyzed over 191.6 months (mean). Peri-implant sulcus depth, sulcus fluid flow rate, and peri-implant skin reaction, as well as cleaning habits and patients' quality of life, were analyzed. Mixed effect linear and mixed effect ordered logistic regression models were used. Two of the 128 implants were lost (1.6 %). A total of 14.5 % of all patients presented light erythemas, 19.4 % showed stage 2, 4.8 % stage 3, and 12.9 % an acute infection according to Holgers. A correlation between skin reaction and sulcus fluid flow rate was observed, when grouping patients with acute signs of inflammation. Concerning patient satisfaction, 58.1 % of the patients were highly satisfied with their epitheses, 39.5 % very satisfied, and one patient was just satisfied. Younger age correlated with lower satisfaction rates. Implant-retained auricular epitheses are a safe, highly sufficient and satisfying way of extending ear reconstruction. Sulcus depth and skin reaction are quick and valuable assessment tools in auricular implants, but skin reaction alone was clinically insufficient to predict peri-implant pocket inflammation. [ABSTRACT FROM AUTHOR]

Breast augmentation ranks among the most popular plastic surgery procedures. Yet, reports on post-operative patient-reported quality of life (QoL) and satisfaction remain conflicting. A systematic review was conducted following the PRISMA guidelines. Three databases were searched for eligible studies that reported pre-and/or post-operative Breast-Q™ augmentation scores for patient QoL (psychosocial, sexual, and physical well-being) and/or satisfaction. A total of 39 studies (53 patient cohorts and 18,322 patients) were included in the quantitative synthesis. The pairwise meta-analysis revealed significant improvements in patient-reported psychosocial (MD: +38.10) and sexual well-being (MD: +40.20) as well as satisfaction with breast (MD: +47.88) (all p < 0.00001). Physical well-being improved slightly after breast augmentation (MD: +6.97; p = 0.42). The single-arm meta-analysis yielded comparable results, with Breast-Q™ scores in psychosocial and sexual well-being as well as satisfaction with breast increasing from 37.2, 31.1, and 26.3 to 75.0, 70.6, and 72.7, respectively (all p < 0.00001). Physical well-being improved by 8.1 (75.8 pre-operatively to 83.9 post-operatively; p = 0.17). Subgroup analyses highlighted higher QoL and satisfaction following breast augmentation for purely esthetic purposes and alloplastic mammaplasty. Although patient-reported physical and sexual well-being increased in the long term, psychosocial well-being was the highest in the short term. Patient satisfaction with breast, psychosocial, and sexual well-being increased significantly after breast augmentation. In contrast, patient-reported physical well-being yielded ambivalent results, varying by mammaplasty technique and post-operative follow-up time. Plastic surgeons should be sensitized about our findings to refine eligibility criteria and gain a deeper understanding of the patients' perceived surgical experience. CRD42023409605. [ABSTRACT FROM AUTHOR]

Older adults living in elderly caring social organizations (SOs) are prone to suffer from depression. Many studies have found correlations between environmental and quality-of-life factors and depression; however, evidence from elderly caring SOs is rare, particularly in China. A cross-sectional study was conducted among service recipients in elderly caring SOs in Anhui and Chongqing, China. Data on demographic and health-related characteristics, living environment factors, and service quality satisfaction factors in 2171 older adults were used for analysis. The binary logistic regression model was conducted to estimate the association between living environment and service quality satisfaction factors and depression. Our results indicated that living environment factors in terms of exposure to suitable temperature and humidity (OR = 0.655; 95 % CI: 0.446, 0.963), green coverage >30 % (OR = 0.432; 95 % CI: 0.337, 0.553) were associated with lower odds of developing depression. Also, an opposite relationship was found in the noise factor (OR = 1.985; 95 % CI: 1.395, 2.823). Higher satisfaction with admission and discharge services, dietary services, entertainment services, and psychological support services were also found to be associated with a lower risk of depression. A cross-sectional design precluded determining whether living environment, service quality satisfaction, and depression are causally related. Measurement of living environment factors and service quality satisfaction factors needs to be further clarified comprehensively. Enhancing the living environment and the quality of the services provided to seniors in the elderly caring SOs is conducive to the reduction of the likelihood of depression. • The prevalence of depression among older adults in Chinese elderly caring social organizations was found to be 23.8 %. • Living environment factors in terms of temperature and humidity, green space, noise were associated with depression. • Higher satisfaction with service quality was found to be associated with a lower risk of depression. [ABSTRACT FROM AUTHOR]

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation. A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation). The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation. The cross-sectional nature of the current study precludes definitive conclusions regarding causation. These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality. • Being partnered buffers TNB minority stress effects on depression and suicidality. • Buffering effects applied only to satisfying romantic relationships • Buffering effects most evident for interpersonal minority stressors • General interpersonal satisfaction did not buffer minority stress effects. [ABSTRACT FROM AUTHOR]

Burnout is a pervasive issue among medical students, exhibiting a high prevalence that jeopardizes their academic success and may also predispose them to more severe affective disorders such as depression. This study aims to explore the complex relationships between psychological capital (PsyCap), general social support, educational satisfaction, and burnout, and how these factors collectively influence dropout intentions. A non-probabilistic convenience sample was collected through an online survey from first- and second-year medical students at a Faculty of Medicine in Portugal. The survey employed psychometric instruments to measure burnout (BAT-12), social support (F-SozU K-6), PsyCap (CPC-12R), satisfaction with education, and dropout intentions (Screening Instrument for Students At-Risk of Dropping Out). Structural equation modeling was applied to analyze the data from 351 participants. The model demonstrated a significant positive association between burnout and dropout intentions (β ̂ = 0.37; p < 0.001), underscoring burnout as a direct correlate of dropout intentions alongside educational satisfaction (β ̂ = −0.25; p = 0.003) and PsyCap (β ̂ = −0.22; p = 0.005). Higher social support is associated with reduced burnout (β ̂ = −0.28; p < 0.001) and increased educational satisfaction (β ̂ = 0.22; p = 0.002). The non-probabilistic sampling method prevents the generalization of the findings. The cross-sectional data do not permit the inference of temporal relationships between the studied variables. These findings emphasize the importance that burnout may have on dropout intentions, and contribute to the understanding of affective syndromes such as burnout in educational settings. • PsyCap is inversely related to burnout and dropout intentions. • Social support is associated with reduced burnout and increased educational satisfaction. • High levels of burnout are related to stronger dropout intentions. • Satisfaction with education is negatively associated with dropout intentions. [ABSTRACT FROM AUTHOR]

Remaining pain and functional limitations may cause dissatisfaction in patients after total knee arthroplasty (TKA). Furthermore, anxiety and depression are associated with remaining postoperative symptoms and dissatisfaction. We investigated if patient-reported anxiety or depression increased the risk of dissatisfaction 1 year after TKA in patients who improved in pain or function. Data on primary TKAs due to osteoarthritis between 2017 and 2019 were obtained from the Swedish Knee Arthroplasty Register. Out of 14,120 patients, 9,911 completed the Knee injury and Osteoarthritis Outcome Score and satisfaction rate with the result of the surgery. According to the Outcome Measures in Rheumatology—Osteoarthritis Research Society International criteria patients were classified as responders (improved in pain or function) or nonresponders. Anxiety and depression were assessed through EuroQol-5 Dimension 3 levels. Log-linear regression models estimated the risk ratios (RRs) for dissatisfaction in all patients and stratified by age groups (< 65, 65 to 74, and > 74 years). There were 8,745 patients who were classified as responders whereas 11% were defined as dissatisfied. The proportion of patients who reported anxiety or depression was 35% preoperatively and 17% postoperatively. Anxiety or depression increased the risk of dissatisfaction preoperatively (RR 1.23, 95% confidence interval = 1.09 to 1.40) and postoperatively (RR 2.65, confidence interval 2.33 to 3.00). Patients younger than 65 years reported preoperative anxiety or depression to a greater extent but did not have an increased risk of dissatisfaction. Patient-reported anxiety or depression preoperatively and postoperatively are important and potentially treatable factors to consider, as they were found to increase the risk of dissatisfaction after TKA despite improvements in pain or function. [ABSTRACT FROM AUTHOR]

• VR Photsoscan environments were created in under 48 hours and were created between sessions. • High levels of satisfaction with VR Photoscan environment. • VR technology successfully implemented within a standard treatment protocol for PTSD. • Implemented within a routine community mental healthcare setting. • VR assisted with imaginal reliving, memory updating, and stimulus discrimination. Revisiting what happened during (or after) a traumatic event is an important part of the treatment process in trauma-focused cognitive therapy (TF-CT). However, clinicians may have difficulty helping patients to intentionally retrieve these memories in order to engage with their content. As such, clinical tools to support the access and delivery of imaginal exposure content within treatment may prove to be particularly useful for therapists. This case report introduces work undertaken with Mr. A, a 38-year-old male, who 2 years prior had experienced a city centre assault. Initial assessment revealed a PCL-5 score of 64 and he met DSM-5 criteria for posttraumatic stress disorder (PTSD). Mr. A received 10 sessions of TF-CT wherein the traditional imaginal exposure components were implemented via a newly developed virtual reality (VR) development workflow called "VR Photoscan." After 10 sessions, results showed PCL-5 scores decreased from 64 to 19 and Mr. A no longer met DSM-5 PTSD criteria. VR Photoscan was used during 4/10 sessions and included (1) reliving, (2) memory updating, and (3) stimulus discrimination activities. Mr. A also reported VR Photoscan as helpful regarding preparation for site visits. In conclusion, VR Photoscan technology provided a more visceral exposure experience which supported Mr. A to revisit the trauma memory. He reported high levels of satisfaction with the quality of the virtual environment and no issues using the VR technology. Produced with lower costs and shorter development times than typical computer-generated environments, VR Photoscan may be more easily implemented within routine care, although further research is required. [ABSTRACT FROM AUTHOR]

Few studies have evaluated postnatal anxiety and posttraumatic stress (PTS) before and during the Covid-19 pandemic using comparable data across time. We used data from two national maternity surveys in England to explore the impact of the pandemic on prevalence and risk factors for postnatal anxiety and PTS. Analysis was conducted using population-based surveys carried out in 2018 (n = 4509) and 2020 (n = 4611). Weighted prevalence estimates for postnatal anxiety and PTS were compared across surveys. Adjusted risk ratios (aRR) were estimated for the association between risk factors and postnatal anxiety and PTS. Prevalence of postnatal anxiety increased from 13.7 % in 2018 to 15.1 % in 2020 (+1.4 %(95%CI:-0.4–3.1)). Prevalence of postnatal PTS increased from 9.7 % in 2018 to 11.5 % in 2020 (+1.8 %(95%CI:0.3–3.4)), due to an increase in PTS related to birth trauma from 2.5 % to 4.3 % (+1.8 %(95%CI:0.9–2.6); there was no increase in PTS related to non-birth trauma. Younger age (aRR = 1.31–1.51), being born in the UK (aRR = 1.29–1.59), long-term physical or mental health problem(s) (aRR = 1.27–1.94), and antenatal anxiety (aRR = 1.97–2.22) were associated with increased risk of postnatal anxiety and PTS before and during the pandemic, whereas higher satisfaction with birth (aRR = 0.92–0.94) and social support (aRR = 0.81–0.82) were associated with decreased risk. Prevalence of postnatal PTS was significantly higher during the pandemic, compared to before the pandemic, due to an increase in PTS related to birth trauma. Prevalence of postnatal anxiety was not significantly higher during the pandemic. Risk factors for postnatal anxiety and PTS were similar before and during the pandemic. • Prevalence of postnatal anxiety was not significantly higher during the pandemic compared to before the pandemic. • Prevalence of postnatal PTS was significantly higher during the pandemic compared to before the pandemic. • The increase in postnatal PTS during the pandemic was attributable to a rise in postnatal PTS related to birth trauma. • Risk factors for postnatal anxiety and postnatal PTS were similar before and during the pandemic. [ABSTRACT FROM AUTHOR]

Public transport (PT) success depends on targeted interventions, ranging first from push measures that discourage car use to pull measures that encourage PT use, and second from hard measures that intervene at physical infrastructures to soft measures that intervene at psychological elements of individuals' behaviors. Focusing on soft-pull policy measures, and through a scoping review of 36 publications, we categorize these measures into three overarching groups: 1) Internally motivating strategies that gradually but firmly instill pro-sustainability attitudes and norms in people's mind; 2) Satisfaction increasing strategies that primarily help retain current users especially those who feel forced to use PT and secondary attract new riders by improving the service factors and modifying travelers' inaccurate perceptions of the service; 3) Stimulating PT-use and car-habit disrupting strategies such as attractive incentives and tailored information that encourage auto-drivers to give PT a try and break their car-habit. This review provides an analytical evaluation of each approach, offering recommendations for policy makers and PT service providers, along with identifying research gaps and suggesting future research directions. • Non-physical soft-pull measures empower people to choose PT voluntarily. • Internally motivating, satisfaction increasing, and PT-use stimulating strategies. • Internally motivating strategies instill pro-sustainability attitudes and norms. • Satisfaction increasing measures help retain current users and attract new riders. • Stimulating strategies include attractive incentives that break car-use habits. [ABSTRACT FROM AUTHOR]

• People have cognitive and affective responses to stimuli during travel. • These responses are mediated by appraisal and are highly individualised. • Within-trip experiences affect travel satisfaction, attitudes, and mode choice. • Naturalistic research can elucidate the individuality of within-trip experiences. • Understanding individuality is needed for equitable active travel modal shift. Modest shifts from car use to active travel can result in substantial health, emissions, and economic improvements that result in cleaner, greener, and healthier cities. To achieve modal shift towards active travel, the transport field has long considered how psychosocial factors outlined by theories such as the theory of planned behaviour underpin travel mode choice. Recent models of travel behaviour detail how travel satisfaction – a person's cognitive and affective evaluations of their travel – influences mode-related attitudes which in turn influences desires and intentions to use a specific travel mode. In this conceptual paper, we introduce the concept of within-trip subjective experiences – cognitive and affective responses to individual events and stimuli during travel – and propose potential mechanisms for how within-trip experiences affect travel satisfaction and mode-related attitudes. Specifically, people have emotional and cognitive reactions to individual stimuli (e.g., near miss incident, pleasant scenery, heavy traffic) which are mediated by the process of appraisal. Over the course of a trip, the sum of these subjective reactions form the basis of their within-trip experience, which heavily shape perceptions of travel satisfaction and subsequently influence attitudes and intentions to use a specific mode. Furthermore, within-trip subjective experiences to stimuli potentially modify the beliefs that mode-related attitudes consist of, further highlighting the importance of considering within-trip experiences to individual stimuli for understanding travel behaviour and mode choice. The consideration of within-trip experiences highlights the individuality of peoples' responses to stimuli. Understanding and addressing this individuality and the unique needs of all potential user groups may assist in achieving mass modal shift towards cycling and active travel. [ABSTRACT FROM AUTHOR]

• A framework is presented to explore the influence of friendships in a social network on drivers' route choice. • This paper simulates the evolution of drivers' route choice in a hypothetical transportation network under different assumptions. • This research offers insight into the route choice process when drivers can access information about other drivers' travel experience in a social network. • The simulation results show that the information types mainly affect the change rate, and the memory length mainly affects the time for convergence. Route choice is a decision that drivers face daily under varying traffic conditions. Although many studies have focused on route choice, the actual behavior considering real-world networks and the mechanisms that govern it have eluded complete characterization. Part of the difficulty has been in accounting for the growing availability of information sources that may influence drivers' route choices, precluding collection of adequate observational data. In addition, with the continuing emergence of new forms and sources of information, such as social media with varying degrees of interactivity, engagement, and immediacy, existing frameworks and models for representing these choices and the influence of new information sources have been lacking. This study uses an agent-based modeling approach to investigate the effects of social influence on drivers' route choices. In the model, all drivers communicate with each other in the same social network, and this information is combined with their previous experiences. The first aim of this study is to investigate the impact of social network connectivity and information exchange on route choice. The second is to characterize situations in which all drivers in the social network are satisfied with their route choices. The simulation results show that an equilibrium is achieved when all drivers in the given social network are satisfied with their current route choices. [ABSTRACT FROM AUTHOR]

[Display omitted] • A structural equation model for understanding how negative encounters influence the satisfaction of shared auto-rickshaw usage as public transport. • Availability is the most significant factor in predicting the adoption of shared auto-rickshaws. • Negative encounters in shared auto-rickshaws substantially negatively influence users' satisfaction. • Provide interventions and policy proposals on transparent fare structures and digital payment options to address concerns about unapproved fares. Emerging research has highlighted the significant role auto-rickshaws play in travel services, and yet, compared to other transport modes, they have received relatively less attention in research. No study has investigated travel behaviour and negative encounters in shared auto-rickshaws. The assumption that negative encounters deter users from utilising shared auto-rickshaws has not yet been validated. Moreover, previous studies have focused on adopting auto-rickshaws and travel behaviour, neglecting the specific dynamics of shared services within the public transport landscape. Here, we investigate the determinants influencing shared auto-rickshaw usage as a distinct mode in Ghana. We also identify negative attributes by drawing the link between negative user encounters and their impact on satisfaction, loyalty, and openness to policy propositions. The study deployed structural equation modelling, which is generally preferred in transport research. We discovered that 'Availability' is the most significant factor in predicting the adoption of shared auto-rickshaws. The estimated model established that negative encounters substantially impact users' satisfaction, and users' satisfaction was impacted by discomfort with seating arrangement, driver conduct, fleecing of users, and long travel time, among others. Older commuters reported higher levels of satisfaction than younger commuters, whereas commuters with higher levels of education tend to report lower levels of satisfaction. This research expands the limited understanding of shared auto-rickshaw usage by advancing our theoretical grasp of how negative encounters influence satisfaction and loyalty from a user-centric perspective. These insights can aid policymakers, service providers, and transport authorities in crafting legislation that prioritises user needs, enhances service quality, and creates a positive commuting experience. Furthermore, this study discusses managerial implications for transport authorities and policymakers. [ABSTRACT FROM AUTHOR]

The metacarpophalangeal joint blocking orthosis (MCPJ-BO) is one of the first-line orthotic treatment for patients with trigger finger (TF). Relative motion extension orthosis (RME-O) has recently emerged as a treatment option for various hand disorders involving TF. The primary objective of this study was to compare the effectiveness of 6 weeks of orthotic treatment with the MCPJ-BO and the RME-O for pain relief. Function and satisfaction with the orthosis were assessed as secondary objectives. Randomized clinical study. Thirty patients with an average age of 50 years with Froimson stage 1-3 A1 pulley triggering participated in the study. They were randomly assigned to either the MCPJ-BO (n = 15; 10 females, five males) or the RME-O group (n = 15; 12 females, three males). The orthoses were worn full time for 6 weeks. All patients received patient education, activity modification, and flexor tendon gliding exercises as part of the rehabilitation program. Pre- and post-assessments included Numeric Pain Rating Scale, Disability of the Arm, Shoulder, and Hand questionnaire, and Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire. The Mann-Whitney U test was conducted to analyze the difference between the two groups. There were no significant differences between the two groups in pain and function before treatment (p < 0.05). Within-group comparisons indicated that both orthoses relieved pain, but the MCPJ-BO group achieved greater pain relief (p = 0.001). There was a significant improvement in function in the MCPJ-BO group, with a mean change of 12.7 (p = 0.0001). The overall success rates for the MCPJ-BO group and RME-O group were 60% and 27%, respectively. Patients in both groups had high satisfaction with the orthosis. MCPJ-BO and RME-O could be used for pain relief in the treatment of TF. The MCPJ-BO appears to be more effective than the RME-O in improving function. • A high level of satisfaction is reported with the orthoses. • Both orthoses are effective in relieving pain. • Metacarpophalangeal joint blocking orthosis resulted in better functional status. • The overall success rate for the MCPJ-BO was 60%, and for the RME-O, it was 27%. • RME-O is not recommended for acute and subacute trigger finger management. [ABSTRACT FROM AUTHOR]

How does physiotherapy delivered by real-time, video-based telerehabilitation compare with in-person delivery for the outcomes of attendance, adherence and satisfaction? Systematic review of randomised control trials indexed in PubMed, CINAHL, Embase, Cochrane and PEDro on 12 March 2024. Adults aged > 18 years. Physiotherapy delivered via real-time video telerehabilitation. Attendance, adherence and satisfaction. Eight studies were included for attendance (n = 1,110), nine studies for adherence (n = 1,190) and 12 studies for satisfaction (n = 1,247). Telerehabilitation resulted in attendance at treatment sessions that was 8% higher (95% CI −1 to 18) and adherence to exercise programs that was 9% higher (95% CI 2 to 16) when compared with in-person physiotherapy. Satisfaction was similar with both modes of delivery (SMD 0.03 in favour of telerehabilitation, 95% CI −0.23 to 0.28). The level of certainty assessed by GRADE ranged from very low to low, primarily due to inconsistency and high risk of bias. Attendance at appointments among participants assigned to telerehabilitation was somewhere between similar to and considerably higher than among control participants. Adherence to self-management with telerehabilitation was better than with in-person delivery, although with some uncertainty about the magnitude of the effect. Reported satisfaction levels were similar between the two modes of treatment delivery. Given the significance of attendance, adherence and satisfaction for successful outcomes, telerehabilitation offers a valuable alternative mode for physiotherapy delivery. Real-time telerehabilitation has potentially favourable effects on attendance at treatment appointments and adherence to exercise programs, with similar satisfaction when compared with traditional in-person physiotherapy. PROSPERO CRD42022329906 [ABSTRACT FROM AUTHOR]

The interaction between the recipient area and the graft is one of the key factors in the success of periodontal plastic surgery. This randomized controlled, split-mouth, double-blinded clinical trial aimed to compare the clinical and aesthetic outcomes of epithelialized palatal graft (EPG) and gingival unit graft (GUG) in achieving root coverage in localized (Recession Type 1) RT1 recession defects. Twenty participants with forty bilateral recession defects randomly received EPG or GUG surgical treatment modalities for each of the recession defects. Clinical measurements recorded at baseline and after six months included recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), and the average width of mesial and distal interdental papilla (aWIDP). There was a statistically significant greater mean root coverage (MRC) percentage at GUG sites (80.68 ± 16.12%) in comparison to EPG sites (71.05 ± 17.23%) (p = 0.01). The treatment satisfaction (p = 0.009) and aesthetic satisfaction (p < 0.001) experienced were significantly better for GUG as compared to EPG. The regression model (R 2 = 0.56) significantly predicted MRC percentage in GUG sites with baseline RD (β = −12.49; p = 0.02) and aWIDP (β = −9.31; p = 0.02). GUG showed a better MRC, aesthetics and increased KTW. Root coverage procedures often need to suffice the dual objective of coverage and aesthetics at the same time. GUG is a simple modification of the conventional EPG that can provide better clinical and aesthetic outcomes. [ABSTRACT FROM AUTHOR]

High mobile glandular ptotic breasts present the greatest challenge for implant breast augmentation with suboptimal outcomes occurring frequently. Here, we describe and evaluate an innovative approach for breast augmentation in this breast type. By widely disrupting and redefining the parenchyma-muscle interface, this technique offers opportunities to restore the takeoff point of the breast and improve the fullness of the upper pole, thus producing a "perkier" breast appearance. A retrospective review was performed, and 68 patients who underwent breast augmentation with either type III dual-plane or the new approach between January 2015 and January 2021 were included. The patients were divided into two groups. The aesthetic outcome and patient satisfaction were evaluated using different 10-point rating forms. Data on demographic information, surgical details, and relative complication rates were recorded and compared. Upon comparing the aesthetic outcomes and satisfaction, the test group demonstrated better breast shape, nipple-areola position, upper pole contour outcome, and upper pole satisfaction. No post-operative hematoma, seroma, or infection occurred in either groups. No double-bubble deformity occurred in the test group, whereas it occurred in two patients in the control group. The rates of capsular contracture were 1.4% and 1.6%, in the test and control groups, respectively. The new approach is a safe surgical method with good aesthetic outcome, high patient satisfaction, and long-lasting result. This approach is a supplement to the dual-plane techniques, to realize the benefits of mastopexy and type III dual-plane breast augmentation. [ABSTRACT FROM AUTHOR]

• Autonomy satisfaction is linked both directly and indirectly to vaccine acceptance. • Institutional trust mediates the effect of autonomy on vaccine acceptance. • Competence satisfaction is linked both directly and indirectly to vaccine hesitancy. • Science mistrust mediates the effect of competence on vaccine hesitancy. • We did not find any effect of relatedness satisfaction. Autonomous motivation is considered a powerful driver of health behaviour, but less is known about the specific roles played by basic needs. Drawing on the context of the COVID-19 pandemic, this research examined basic needs as a motivational determinant of vaccination. We hypothesized that satisfaction of basic needs (autonomy, competence, relatedness) has both a direct and an indirect effect (through trust in science and government) on vaccine hesitancy. Two studies (Study 1: N = 968 French and British; Study 2, pre-registered: N = 716 Americans) tested our hypotheses and compared vaccinated and non-vaccinated individuals using multigroup structural equation models. We found positive direct (in both studies) and indirect (in Study 1) effects of autonomy satisfaction on vaccine acceptance. In contrast, competence satisfaction was directly and indirectly, via science mistrust, related to vaccine hesitancy, particularly among non-vaccinated people. Competence satisfaction also indirectly reduced the intention to vaccinate in both studies. We found no impact of relatedness. Complementing previous work on self-determination theory, our research demonstrates the importance of considering the distinct roles of basic needs. Moreover, we highlight that increasing autonomy and science trust may be an efficient strategy to improve vaccine acceptance and vaccination, even among reluctant individuals. [ABSTRACT FROM AUTHOR]

The current bleep communication system between nurses and interns on-call in most Irish hospitals has been linked with interruption in patient care, disruption to workflow, inefficiency, increased burden and stress to the on-call health staff. A new electronic system was introduced in a University Hospital to replace and eliminate bleep usage during on-call hours. An Intern on-call task electronic template was generated using Microsoft Excel Spreadsheet. This electronic system enabled users to review and respond to requests placed by nursing healthcare staff. This project initially underwent a trial process in three wards for a period of two weeks in June 2023. Interns and nurses were asked to fill a survey before and after introduction of the system. The project was implemented across all wards in August 2023 and a secondary survey was obtained. In addition, the spreadsheets were analysed retrospectively. During the trial, twenty-six interns and twenty nurses were surveyed before and after implementation of the electronic system. Interns satisfaction rate was 73% and stress was reported to be reduced by 65%. Notably, 57% of interns reported a reduction in workload and the number of bleeps was reported to be as <10 by 42%. Nurses reported a decrease in the number of bleeps they needed to send overall by 65% and by 55% for repeated jobs. Workload was reported to be increased by 15% by nurses. However, exactly half of the nurses were unhappy with the new system and stress levels were unchanged. This project has shown promising results, efficient and clear communication was noted with an overall positive feedback and satisfaction rate by doctors. However, as evident, from a nursing perspective further work is needed to further progress into a system that can benefit both parties involved. • Using an electronic system to replace bleeps showed promising results. • Positive feedback and satisfaction rate were reflected by on-call doctors. • Moderate reduction in workload and stress was reported by on-call doctors. • The electronic system is simple, cost-effect and sustainable. [ABSTRACT FROM AUTHOR]

This retrospective study aimed to determine the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) cutoff scores for assessing patient satisfaction postlateral lumbar interbody fusion (LLIF) in degenerative lumbar spinal stenosis (DLSS) patients. Analyzing 136 DLSS patients (83 males, 53 females), the study evaluated demographics, pain (Numeric Rating Scale), and JOABPEQ outcomes (low back pain, lumbar function, walking ability, social life, mental health). Patient satisfaction was surveyed, and based on their responses, patients were categorized into "Beneficial" and "Nonbeneficial" groups. Statistical analysis encompassed the Kolmogorov–Smirnov test, t-tests, Mann–Whitney U test, and Receiver Operating Characteristic (ROC) curve analysis for JOABPEQ cutoff determination. Postoperative improvements in JOABPEQ scores, especially in walking ability, social life function, and mental health, were significant. Pain intensity, assessed using the Numeric Rating Scale, also showed notable reductions. The Δ walking ability cutoff was set at 25.00, indicating substantial mobility improvement. This domain's area under the curve (AUC) was 0.815 (95% CI: 0.726–0.903), demonstrating high effectiveness in assessing patient satisfaction postsurgery. The study also found no significant differences in complication rates between groups for conditions like transient motor weakness, thigh pain/numbness, and revision surgery. This study underscores the value of patient-centered outcomes in evaluating LLIF surgery success for DLSS. The identified JOABPEQ cutoff values provide a quantitative tool for assessing patient satisfaction, emphasizing the necessity of comprehensive postoperative evaluations beyond traditional clinical metrics for improved patient care and life quality. [ABSTRACT FROM AUTHOR]

Smartphone apps may help to prevent the transition from minor to severe mental health problems. We compared a free self-help smartphone app (COGITO; www.uke.de/cogito%5fapp) against a wait-list condition for the improvement of self-esteem and depression. The Rosenberg Self-Esteem Scale represented the primary outcome in this controlled trial. The final sample (n = 213) was randomly assigned to either the app or to the control condition. The app condition significantly improved the primary outcome relative to controls for all analyses. Satisfaction of completers was high. The present results warrant independent replication; the retention rate needs to be increased to allow solid inferences about acceptance. The present study demonstrates that the COGITO app may represent an effective self-help tool for psychological problems. [ABSTRACT FROM AUTHOR]

Clozapine is a gold standard treatment for treatment-resistant schizophrenia. However, the patients' and caregivers' perception and their experience with clozapine has remained much less explored. To review the available literature on the patients' and caregivers' attitudes, perceptions, and experiences with clozapine. 27 original research and review articles published in PubMed-indexed journals till March 2023 in the English language, exploring the patient and/or caregiver/family member's experience with using clozapine, were included. 30–80 %of patients and 92–100 % of caregivers were found to have a positive attitude towards clozapine in terms of its impact on psychopathology, cognitive and social functioning of the patient, and caregiving needs. Most patients and caregivers also found that the positive effects of clozapine outweighed the side effects and distress related to repeated blood testing. However, a lack of satisfaction was noted among both patients and caregivers regarding the knowledge provided to them regarding clozapine, especially regarding its common adverse effects. Discontinuation of clozapine was found to be more commonly done by the patients' accord rather than clinicians, and the perceived side effects like hypersalivation and excessive sedation emerge as important factors that lead to discontinuation rather than the need for repeated blood testing. Overall, patients and their caregivers share a positive attitude towards clozapine and perceive it to be an effective and beneficial drug, but more effort needs to be directed by the clinical teams to educate the users of clozapine regarding its complete side effect profile and provide continuous guidance about dealing with the emerging side effects throughout treatment. [ABSTRACT FROM AUTHOR]

Despite the potential negative impact of preoperative obesity on total hip arthroplasty (THA) outcomes, the association between preoperative and postoperative weight change and outcomes is much less understood. Therefore, this study aimed to determine the impact of preoperative and postoperative weight change and preoperative body mass index (BMI) on health care utilization, satisfaction, and achievement of minimal clinically important difference (MCID) for Hip Disability and Osteoarthritis Outcome Score Physical Function Short-Form (HOOS PS) and HOOS Pain. Patients who underwent primary elective unilateral THA between January 2016 and December 2019 were included (N = 2,868). Multivariable logistic regression assessed the association between BMI and preoperative and postoperative weight change on outcomes while controlling for demographic characteristics. There was no association between preoperative weight change and prolonged length of stay (> 3 days), 90-day readmission, nonhome discharge, patient dissatisfaction at 1 year, or achievement of HOOS Pain or HOOS PS MCID. Postoperative weight loss was an independent risk factor for patient dissatisfaction at 1 year but was not associated with achievement of either HOOS Pain or HOOS PS MCID at 1-year postoperative. Preoperative obesity classes I to III were independent risk factors for nonhome discharge. Nevertheless, preoperative obesity class I and class II were associated with an increased probability of reaching HOOS Pain MCID. Preoperative BMI was not associated with an increased risk of patient dissatisfaction. Preoperative weight change does not appear to influence health care utilization, satisfaction, or achievement of MCID in pain and function following THA. Postoperative weight loss may play a role as a risk factor for dissatisfaction following THA. Additionally, patients who had a higher baseline BMI may be more likely to see improvement in pain following THA. Therefore, when counseling obese patients for THA, surgeons must balance the risk of perioperative complications with the expectation of greater improvements in pain. [ABSTRACT FROM AUTHOR]

The patient acceptable symptom state (PASS) refers to a cutoff value on any patient-reported outcome measures (PROMs) scale, beyond which patients consider themselves as having achieved an acceptable outcome. This study aimed to identify PASS thresholds for knee-specific and generic PROMs at 10 years post-unicompartmental knee arthroplasty (UKA). There were 269 patients who underwent UKA for medial osteoarthritis from 2004 to 2007 at a single institution and were surveyed preoperatively and 10 years postoperatively using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), Oxford Knee Score (OKS), 36-Item Short Form Survey (SF-36) Mental Component Score (MCS), and SF-36 Physical Component Score (PCS). Treatment outcomes and expectations were assessed using an anchor question, and PASS attainment was determined using the Youden index on a receiver operating characteristic (ROC) curve. Also, a similar study that identified 2-year long-term PROM PASS thresholds for UKA was referenced and compared. Overall, 91.1% reported acceptable outcomes. The area under the curve for ROCs of KSKS, OKS, and PCS were 0.80, 0.75, and 0.71, respectively. The area under the curve for ROCs of KSFS and MCS were both 0.64. The PASS thresholds were 67.5 for KSFS, 70.5 for KSKS, 39.5 for OKS, 44.6 for PCS, and 43.8 for MCS. Patients who achieved a PASS were at least 3 times more likely to have satisfactory outcomes. To our knowledge, this is the first study that identified 10-year long-term PROM PASS thresholds for UKA. Accounting for our finding that a decade-long follow-up yielded lower PASS thresholds, time-specific UKA PROM PASS thresholds should be considered. III. [ABSTRACT FROM AUTHOR]

This study aims to determine the differences in satisfaction levels after septorhinoplasty between patients who are healthcare workers and those who are not. The study includes patients who underwent primary septorhinoplasty surgery, divided into two groups: healthcare workers and non-healthcare workers. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients at the 6th postoperative month. Among the 37 patients, 18 were healthcare workers, and 19 were non-healthcare workers. The mean Rhinoplasty Outcome Evaluation score for healthcare workers at the 6th postoperative month was 75.69 ± 16.06, while in the non-healthcare worker group, the ROE scores were 60.31 ± 27.69. The findings from our study indicated that individuals in the healthcare profession exhibited significantly greater satisfaction rates following septorhinoplasty in comparison to those in the non-healthcare worker group, with a statistically significant difference noted (p: 0.046). Having more knowledge about septorhinoplasty surgery and its complications among healthcare workers may allow for more realistic expectations regarding the surgical intervention. Simultaneously, it may facilitate better communication with the surgeon and the expression of expectations. Clinicians should pay attention not only to the patient's intellectual level but also to their health literacy in communication with the patient. [ABSTRACT FROM AUTHOR]

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Patients undergoing stoma reversal may experience surgical site infections and poor scarring. A purse-string closure approach may lower the incidence of surgical site infections due to its inherent ability to drain wound exudates. This study compared the frequency of surgical site infections and the cosmetic outlook of the scar among patients undergoing stoma reversal with linear and purse-string skin closure techniques. Department of Pediatric Surgery, University of Child Health Sciences Lahore with a duration of one year (June 2021 to June 2022). This randomized controlled trial (TCTR20210417001) was conducted with IRB approval. A total of 124 patients undergoing stoma reversal were randomly assigned to two groups (62 in each): Group A received conventional linear skin closure, while Group B received purse-string wound closure. The study evaluated surgical site infection, cosmetic outcome, and length of stay. Both groups had similar age, gender ratio, indication for surgery, and length of stay. The purse-string group had a significantly lower incidence of SSI (38.7 % vs. 14.5 %; p = 0.002) and better scar quality (Manchester scar scale showed 'good' scar quality in 63 % of patients vs. 22.6 % in the linear closure group, p-value <0.0001). The purse-string technique for skin closure resulted in fewer surgical site infections and improved scar appearance. [ABSTRACT FROM AUTHOR]

• Prolapse, bleeding and pain are the main manifestations of hemorrhoidal disease. • Acceptance of a hemorrhoidal surgical procedure is limited by the fear of postoperative consequences despite better effectiveness than medico-instrumental treatments and ultimately better satisfaction. • Apart from the classic prolapse score (cut-off at 2), age (> 44 years), the presence of hypertrophic anal skin tags, the Bristol score (cut-off at 5), the bleeding score (cut-off to 5), severe impact on quality of life, active smoking, and reading during bowel movements were significantly associated with surgical decision-making. • An application, available via this link (https://risk-chirurgical.streamlit.app/) or via the QR-Code below, has been developed based on the previously identified factors making it possible to calculate the level of risk of hemorrhoidal surgery for each patient and which will be validated in a second study ▪. There are very few French studies on hemorrhoidal disease and its management. Prospective single-center study from July to December 2021 including 472 patients. Bleeding, prolapse and pain were the main reasons for consultation. Treatment modalities were medical (44%), ± instrumental (72%), and surgical (17%). After treatment, the bleeding score and prolapse score decreased significantly (P = 0.002 and P ≤ 0.0001, respectively), but improvement was more marked in the surgery group with a better rate of "very good satisfaction" (73% vs. 54%, P = 0.003). Factors associated with likelihood of surgical treatment were: age > 44 years, hypertrophic perianal skin tags, high scores (Bristol > 5, bleeding > 5, prolapse > 2), severe impact on quality of life, smoking and reading during bowel movements. We have developed an online application, which aims to assess the risk of requiring hemorrhoidal surgery. Less than 20% of patients who present with hemorrhoidal disease require surgical treatment, but it is associated with better effectiveness despite more complex postoperative consequences that sometimes motivate patient refusal. We have highlighted factors associated with surgical management, which can guide the practitioner in their therapeutic choices. [ABSTRACT FROM AUTHOR]

Acute hepatic porphyrias (AHP) are rare genetic disorders associated with acute neurovisceral attacks and chronic symptoms. This analysis was conducted to examine the long-term efficacy and safety of givosiran in Taiwanese participants in the ENVISION study (NCT03338816). Patients (age ≥12 years) with AHP and recurrent attacks were randomized to receive givosiran 2.5 mg/kg or placebo for 6 months during the double-blind period. Patients then switched from placebo to givosiran (placebo crossover group) or continued taking givosiran (continuous givosiran group) during a 30-month open-label extension period. The total study duration was 36 months. An analysis was conducted that included patients enrolled in Taiwan (N = 7). During the double-blind period and open-label extension period, the median annualized attack rates were 0.0 and 0.0, respectively, in the continuous givosiran group (n = 5) and 15.1 and 4.6, respectively, in the placebo crossover group (n = 2; 70 % decrease). Median annualized days of hemin use in the double-blind period and open-label extension period were 0.0 and 0.0, respectively, in the continuous givosiran group, and 23.8 and 5.0, respectively, in the placebo crossover group (79 % decrease). EQ-5D VAS scores remained relatively stable in both groups, and PPEQ responses indicated improved functioning and satisfaction in both groups. Delta-aminolevulinic acid and porphobilinogen levels remained low with long-term givosiran treatment. Serious adverse events were reported by 3 patients (43 %). Long-term efficacy and safety results in the Taiwan cohort are consistent with those in the global cohort. [ABSTRACT FROM AUTHOR]

This paper introduces research aimed at developing and implementing an intelligent passenger counting system in public transportation. The goal is to enhance fare evasion control and reduce financial losses for transit operators by automatically monitoring the entering and exiting of passengers. Utilizing the advanced capabilities of YOLO and DeepSORT algorithms, the system demonstrates high accuracy in detecting and tracking passengers, even in congested scenarios. Practical experiments have highlighted several challenges, including real-time frame processing rates, single-board computer performance, and the accuracy of passenger counts. It was discovered that the selection and positioning of USB cameras significantly influence system efficiency. Notably, changing the IP cameras to USB cameras significantly improves the processing speeds. A dataset containing images was created to improve the YOLO model's accuracy in detecting passengers. This dataset was particularly relevant considering the winter season, where identifying passengers could be challenging due to their bulky outerwear. To upgrade the performance of the DeepSORT system, the YOLO model was also improved with the pre-designed dataset to focus solely on the heads. This trained model achieved a recognition accuracy of 91% during peak hours. During periods of lighter traffic, when there were fewer passengers, the accuracy increased further due to reduced interference and higher precision. To enhance real-time processing efficiency, this research incorporates the status of public transport doors as a key parameter. By optimizing the number of frames forwarded to the YOLO algorithm for processing, we ensure that the system maintains accuracy without compromising on speed. Future development will focus on incorporating depth-sensing cameras and developing advanced data analysis algorithms for real-time processing on single-board computers. This will further enhance the precision of passenger counts during high-traffic periods. Expected benefits of this project include more efficient transport route planning, better management of passenger flows, improved rider satisfaction, and more effective measures against fare evasion. [ABSTRACT FROM AUTHOR]

• Evaluated two versions of parent-led CBT for anxiety in autistic youth. • Compared low with standard therapist contact. • No differences were found in primary or secondary outcomes. • 69% of completers were responders at posttreatment. • Low-contact CBT saved an average of $1,222.64 per family. Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders, though to date it has been minimally tested. In this study, 87 autistic youth (7 to 13 years old) with anxiety disorders and their parents were randomized to two forms of parent-led CBT in which parents led their child through a guided CBT workbook across 12 weeks: one with low therapist contact (four 30-minute telehealth calls), and one with standard therapist contact (ten 60-minute telehealth calls). Anxiety, functional impairment, and autism features significantly declined across therapy, without differences between groups. High satisfaction was reported in both groups, though significantly higher satisfaction ratings were reported in standard-contact CBT. Responder rates were 69% of completers at posttreatment (70% in standard contact, 68% in low contact) and 86% at 3-month follow-up (86% in standard contact, 87% in low contact). Low-contact CBT was estimated to incur an average cost of $755.70 per family compared with $1,978.34 in standard-contact CBT. Parent-led CBT with minimal or standard therapist contact both appear to be effective CBT delivery formats for autistic youth with anxiety disorders, with significant cost savings for low-contact CBT. [ABSTRACT FROM AUTHOR]

• Five baseline profiles among low-income couples presenting for relationship help. • Four distinct satisfaction trajectories among low-income help-seeking couples. • Baseline profiles predicted satisfaction trajectories but not intervention effects. • The odds of satisfaction gains increased for intervention couples in all profiles. • The odds of satisfaction declines reduced for intervention couples in all profiles. Using a couple-centered approach, the current study seeks to understand (a) the specific ways in which help-seeking couples vary in how their relationship satisfaction changes over time, (b) whether there are important differences in relationship characteristics at the beginning of the interventions, and (c) whether couples with distinct relationship characteristics benefit equally from effective online relationship programs. Mixed-gender low-income couples (N couple = 659) seeking help for their relationship were randomly assigned to one of two online relationship programs (n = 432) or the wait-list control group (n = 227). Latent profile analyses were conducted to identify (a) trajectory profiles with both partners' relationship satisfaction assessed at baseline, during, and postprogram, and at 2- and 4-month follow-ups; and (b) baseline couple profiles with indicators of baseline communication, commitment, emotional support, and sexual satisfaction reported by both partners. Four unique satisfaction trajectories were identified: women-small–men-medium improvement (39%), men-only decline (25%), large improvement (19%), and women-only improvement (17%). Five unique baseline couple profiles were identified: conflictual passionate (30%), companionate (22%), men-committed languishing (22%), satisfied (16%), and languishing (10%). Compared to control couples, intervention couples' odds of following the large improvement trajectory increased and their odds of following the men-only decline trajectory decreased; the odds of following the other two intermediate trajectories did not differ by intervention status. Moreover, couples with more distressed baseline profiles were more likely to follow trajectories characterized by greater satisfaction gains regardless of their intervention status. However, program effects did not differ based on baseline couple profiles, suggesting that a universal approach may be sufficient for delivering online relationship programs to improve relationship satisfaction in this population. [ABSTRACT FROM AUTHOR]

Given the high-stakes nature of their work, neurosurgery residents face constant pressure and require high-quality training to succeed. We aim to investigate the satisfaction levels of residents with their Saudi Neurosurgery Residency Training Program (SNRTP) and its influential factors. This is a nationwide, cross-sectional study that employed a questionnaire, structured based on the relevant literature, which was disseminated to neurosurgery residents, commencing from December 2021 and culminating in September 2022. A total of 70 out of 143 neurosurgery residents were included, giving a response rate of 48.9%. Most participants (62.9%) aged 24–28 years old, 55.7% were males, and 40.0% were from the Central region of Saudi Arabia. The residents were further divided into juniors (R1-R3; 64.3%) and seniors (R4-R6; 35.7%). Approximately 13.3% of the juniors were satisfied with the SNRTP, whereas only 8.0% of the seniors were satisfied. Dissatisfaction rates over the SNRTP were significantly higher in the seniors (68.0%) compared to the juniors (28.9%; P = 0.006). The frequency of operating room sessions per week and presence of protected research time were the only 2 factors significantly associated with the junior and senior residents' satisfaction, respectively. The SNRTP has a vision to provide the society with elite competent neurosurgeons. However, we found a degree of dissatisfaction among the residents, indicating a need for improving the SNRTP's policies. We recommend incorporating more hands-on training opportunities, implementing a mentorship model, setting tailored teaching sessions, and establishing resident wellness programs. We hope this study initiate dialogue on promoting residents' satisfaction and overall well-being. [ABSTRACT FROM AUTHOR]

Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the country. An electronic survey was distributed to all consultant neurosurgeons and neurosurgery residents in Nigeria. Demographic information and questions relating to the content, process, strengths, and challenges of neurosurgical training were explored as part of a broader survey assessing neurosurgical capacity. Descriptive statistics were used for analysis. Respondents identified 15 neurosurgical training centers in Nigeria. All 15 are accredited by the West African College of Surgeons, and 6 by the National Postgraduate Medical College of Nigeria. The average duration of core neurosurgical training was 5 years. Some identified strengths of Nigerian neurosurgical training included learning opportunities provided to residents, recent growth in the neurosurgical training capacity, and satisfaction with training. Challenges included a continued low number of training programs compared to the population density, lack of subspecialty training programs, and inadequate training infrastructure. Despite the high number of neurosurgery training centers in Nigeria, compared to other West African countries, the programs are still limited in number and capacity. Although this study shows apparent trainee satisfaction with the training process and contents, multiple challenges exist. Efforts at improving training capacity should focus on continuing the development and expansion of current programs, commencing subspecialty training, driving health insurance to improve funding, and increasing available infrastructure for training. [ABSTRACT FROM AUTHOR]

To examine the associations between food insecurity and health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic and examine whether the associations were less pronounced among adults with safety nets. We conducted a retrospective longitudinal cohort study using the 2020–2021 Medical Expenditure Panel Survey. Linear probability models were used to assess the associations between food insecurity in one year and the outcomes of interest in the following year while adjusting for baseline characteristics. We performed the analyses for the entire population and then conducted stratified analyses for adults with and without Supplemental Nutrition Assistance Program (SNAP) benefits or Medicaid coverage. Compared with food-secure adults, food-insecure adults were 9.1 percentage points less likely to report life satisfaction and 9.9, 10.2, and 13.2 percentage points more likely to experience delays in getting medical care, postpone or forgo medical care because of cost, and struggle with paying medical bills. Food-insecure adults were 30.4, 27.2, and 23.5 percentage points more likely to face challenges in affording necessities, paying utility bills, and meeting rent or mortgage payments on time than food-secure adults. Notably, the strengths of these associations were attenuated among adults with SNAP benefits or Medicaid coverage. Food insecurity was associated with poor health, limited access to and affordability of care, and a greater financial burden of care among US adults during the pandemic. Nevertheless, safety net programs can play a critical role in alleviating adverse consequences. [ABSTRACT FROM AUTHOR]