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The authors examine work patterns in the United States from 1973 to 2018, with the novel focus on days per week, using intermittent CPS samples and one ATUS sample. Among full-time workers, the incidence of four-day workweeks tripled, adding 7 million four-day workers. Similar growth occurred in the Netherlands, Germany, and South Korea. The rise was not due to changes in demographics or industrial structure. Such schedules are more common among those who are 1) less educated, 2) younger, 3) white non-Hispanic, 4) men, 5) natives, 6) people with young children, 7) non-unionized, 8) police and firefighters, 9) health care workers, and 10) restaurant workers. Based on an equilibrium model, the authors show that the increase in four-day workweeks results more from workers' preferences and/or their daily fixed costs of working than production costs. The wage penalty for a four-day workweek is greater when such work is more prevalent, and the penalty has diminished over time. [ABSTRACT FROM AUTHOR]

Background: In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. Methods: This project adopted a realist perspective, aiming to understand "what works, in which circumstances, and for whom?" The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. Results: 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support—the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Conclusions: Our findings shed light on inequities across the UK's musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions. [ABSTRACT FROM AUTHOR]

Physical activity (PA) has a variety of well-established benefits for physical and mental health. However, there are PA disparities based on numerous sociodemographic characteristics, including sexual orientation. Mapping of PA interventions tailored to sexual minorities (ie, nonheterosexual) is currently absent from the literature. Purpose: The purpose of this scoping review was to summarize the existing interventions focused on promoting PA among sexual minority (SM) adults. Methods: A search strategy was developed in consultation with a research librarian for PubMed, Web of Science, SportDiscus, and CINAHL. The scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Randomized and nonrandomized interventions that focused on increasing PA among SM adults were included. Data on study design, sample demographics, purpose of research, methodology, intervention components, theory-based constructs used, PA measures, and outcomes of the intervention were extracted. Results: Our search yielded 7289 articles, with 26 articles requiring full-text review. Four interventions were identified that focused on increasing PA among SM adults, with 2 focusing on lesbian/bisexual women, 1 focusing on lesbian/gay cancer survivors, and 1 focusing on men who have sex with men. Two of the 4 studies were successful at increasing PA, with varying psychosocial theories (ie, social cognitive theory and theory of reasoned action) and intervention strategies (ie, PA counseling, group meetings, and pedometers). Conclusion: Findings of this review demonstrate a clear lack of PA interventions targeting SM adults, limiting the available knowledge required for preventionists, practitioners, and health care professionals to effectively promote PA through behavioral modification among this group. [ABSTRACT FROM AUTHOR]

This study proposed multiple revised variable neighborhood search (VNS) approaches applying the greedy concept to solve a nurse scheduling problem (NSP). In this paper, we developed three greedy-neighbourhood-swapping mechanisms (greedy-2-exchange, greedy-3-exchange, and greedy-4-exchange) to conduct local searches based on one-, two-, or three-neighbourhood structures that accounted for constraints imposed by government and hospital regulations. The greedy-neighbourhood-swapping mechanisms were used to identify medical staff members with the highest soft-constraint (e.g. nurses' preferences) violation weights on a given day who then swapped their shifts with others. To validate the proposed VNS approaches, we also conducted a case study. Based on the testing instances, all of the proposed VNS approaches generated optimal or near-optimal solutions, and the differences between them were small. The optimal number of the neighbourhood structures was determined to be two, confirming that a larger number of neighbourhoods in a neighbourhood structure would not necessarily be associated with more easily escaping local optima. Furthermore, the resulting outcomes supported the conclusion that the proposed modified VNS approaches generated better schedules for the medical staff members of hospitals than the compared meta-heuristic algorithms. [ABSTRACT FROM AUTHOR]

The sudden onset of the COVID-19 pandemic ushered in an unprecedented era of public admiration for healthcare workers. Indeed, the title "healthcare heroes" became a ubiquitous moniker for healthcare providers of all stripes during the pandemic, a sentiment reflected in countless advertisements and banners. Paradoxically, these same "healthcare heroes" who were being publicly celebrated for their work in the fight against a novel coronavirus also faced stigma for their work amid the virus and infected patients. Using grounded theory, we document how stigmatized members of an occupation experience and respond to mixed—and even conflicting—social evaluations. We contribute to the literature on stigma and social evaluations more broadly by showing how targets of stigma evaluate their evaluators through nuanced logical and emotional processing and, moreover, that such processing can lead recipients of mixed evaluations toward a number of outcomes not previously theorized. We explore the concept of "dirty heroes," where workers are celebrated and stigmatized along distinct dimensions of work traditionally studied in dirty work (i.e., physical, social, and moral). Our findings further illustrate how high-legitimacy occupations can be subject to "hero-washing," whereby workers are publicly celebrated yet privately neglected. [ABSTRACT FROM AUTHOR]

Author(s): M. Yogesh [1]; Roshni Vamja [1]; Vijay Vala [2]; Arya Ramachandran [1]; Bhumika Surati [1]; Jay Nagda (corresponding author) [1] INTRODUCTION Metabolic-associated fatty liver disease (MAFLD) has emerged as [...], Background: Female healthcare workers have unique occupational stressors and lifestyle factors that may increase their risk of metabolic disorders. This study aimed to investigate the utility of the fatty liver index (FLI) as a predictor of metabolic syndrome among female employees in the healthcare sector. Methods: This cross-sectional study included 450 female healthcare workers aged ≥18 years, employed in various roles at a tertiary healthcare facility in Gujarat. Clinical examination, anthropometric measurements, and biochemical tests were conducted. FLI was calculated, and metabolic syndrome was diagnosed using harmonized criteria. Logistic regression analysis evaluated predictors. Results: T he mean age was 44.2 ± 7.8 years, and the prevalence of metabolic syndrome was 61%. Increasing the FLI category was significantly associated with a worsening metabolic profile. The odds of hypertension, diabetes, metabolic syndrome, and cardiovascular disease progressively increased with higher FLI levels (P < 0.001), denoting a dose-response relationship. FLI demonstrated good diagnostic accuracy for metabolic syndrome with an area under the curve (AUC) of 0.86 (95% CI: 0.81 - 0.89). An FLI cutoff ≥30 provided an optimal balance of sensitivity (71%) and specificity (41%) for predicting metabolic syndrome. Conclusion: FLI demonstrates a strong association with metabolic syndrome and related comorbidities in a dose-dependent manner. FLI can be a simple, low-cost screening tool to identify high metabolic risk individuals in resource-limited settings. Keywords: Cardiovascular diseases, diabetes mellitus, fatty liver index, metabolic syndrome, nonalcoholic fatty liver disease

The historiography of the American effort in World War I describes an American unwillingness to learn from the Allies. However true that may be for the combat arms, it was untrue for the Army Medical Department (AMEDD). The AMEDD sought a wide range of information from the beginning of the war, and through multiple channels that expand substantially and systematically once the U.S. entered the war. The information was also disseminated through multiple channels and made significant impacts on medical care in the American Expeditionary Force (AEF) during the Great War. Historians should be more cautious about assuming that all parts of the AEF were resistant to foreign information. [ABSTRACT FROM AUTHOR]

Digital or CAD/CAM workflows and protocols are being increasingly utilized because of their improved efficiency and reproducibility. For the fabrication of complete dentures, digital workflows can reduce treatment time and clinical visits while enhancing the reliability and reproducibility of the laboratory phase and materials. However, establishing centric relation (CR) and vertical dimension of occlusion (VDO) in a reproducible way is still a challenging step for complete denture fabrication in both analog and digital workflows. This clinical report describes a digital workflow using an individualized gothic arch tracing device (GATD) with open-source software for the fabrication of complete dentures. With this workflow, clinicians can offer customized solutions according to patient rehabilitation, with good reproducibility using gothic arch tracing to be implemented in the digital workflow. [ABSTRACT FROM AUTHOR]

Coronary stent underexpansion is an important problem and limitation of percutaneous coronary intervention, adversely affecting both short- and long-term patient outcomes. Stent underexpansion occurs when a stent fails to expand adequately compared with the adjacent reference segment, resulting in inadequate luminal gain. Multiple studies suggest that stent underexpansion is associated with increased risks of in-stent restenosis, stent thrombosis, and myocardial infarction, resulting in recurrent symptoms, readmissions, repeat interventions, and increased mortality. Contributing factors for stent underexpansion include severe calcification, inadequate lesion preparation, suboptimal stent deployment, and preexisting in-stent restenosis. Calcific plaques, especially when present behind a previously implanted, underexpanded stent, pose a significant challenge for further stent optimization. These lesions are often resistant to high-pressure balloon dilatation and may require advanced techniques that carry increased risks of complications. Intravascular imaging modalities, such as intravascular ultrasound and optical coherence tomography, have emerged as essential tools in diagnosing and managing stent underexpansion. These techniques provide a more detailed evaluation of the vessel and previously implanted stent, enabling the clinician to understand the exact mechanism of stent failure, and assess plaque burden and morphology, which ultimately helps guide appropriate treatment strategies. Despite the clinical importance of stent underexpansion, there is currently no consensus on its optimal treatment, largely because of the absence of large prospective studies in this area. This comprehensive review aims to summarize the existing evidence, clinical experience, and treatment strategies for coronary stent underexpansion, with the goal of providing practical guidance to clinicians to help optimize percutaneous coronary intervention and patient outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

In 1960, Dr. William Dock, visiting professor at Yale, discussed the case of a young girl with an unknown liver disease. Dock recommended biopsy, invoking bank robber Willie Sutton's words "that's where the money is." Drs. Petersdorf and Beeson, in attendance that day, included the following in their 1961 publication on fever of unexplained origin, "We are indebted to Dr. William Dock for the term Sutton's Law. It recommends proceeding immediately to the diagnostic test most likely to provide a diagnosis, and deplores the tendency to carry out a battery of 'routine' examinations in conventional sequence." Thereafter, Sutton's Law became an acclaimed aphorism advocating pursuit of tissue, because of its specificity for achieving diagnostic certainty. However, its popularity was fleeting, as formal medical decision-analysis (FMDA) became the standard. In the 1940s and 1950s, pioneers in the field laid the groundwork, and by the 1980s, clinician researchers had introduced the science into everyday clinical practice. The original version of Sutton's Law neglected the reality that FMDA is more than specificity, tissue, and absolute certainty. The newer version encourages clinicians to employ and prioritize their "routine" interview questions, physical examination assessments, and laboratory tests that provide clarity to differentiate between disease and no disease, to influence favorably the patient's management, and to discard those evaluations more likely to provide misleading results. Dock, Petersdorf, and Beeson may not have spoken the language of FMDA, but they were adept at applying its principles. Without them, and the unknown medical student who made the diagnosis of schistosomiasis, there would be no Sutton's Law. For many, it is an obsolete and apocryphal aphorism valuable solely for touting the importance of specificity in tissue diagnosis. For others, it has evolved, remaining relevant as an authentic lesson in decision-analysis, past and present. [ABSTRACT FROM AUTHOR]

Since 2020, there has been a significant cultural and political backlash in the USA to growing acceptance of gender diversity and gender-affirming care. Legislative attacks, particularly targeting gender-affirming care access for transgender and gender diverse youth, have occurred in a media environment rife with misinformation and disinformation. Even in states where a ban is not enacted, we have seen significant harm caused by such misinformation and disinformation, to transgender and gender diverse patients, their families, and clinicians who provide this important and much needed care, in the form of clinic closures and disruption of services. In this hostile sociopolitical environment, we present strategies for health care organizations and workers to continue to provide this lifesaving care thoughtfully, to safeguard the protections currently in place, and to continue to advocate for patients, families, and health care staff. [ABSTRACT FROM AUTHOR]

Background: Medicare beneficiaries are increasingly enrolling in Medicare Advantage (MA), which employs a wide range of practices around restriction of the networks of providers that beneficiaries visit. Though Medicare beneficiaries highly value provider choice, it is unknown whether the MA contract quality metrics which beneficiaries use to inform their contract selection capture the restrictiveness of contracts' provider networks. Objective: We evaluated whether there are meaningful associations between provider network restrictiveness (across primary care, psychiatry, and endocrinology providers) and contracts' overall star quality rating, as well as between network restrictiveness and contracts' performance on access to care measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Participants: Medicare Advantage contracts with health maintenance organization (HMO), local preferred provider organization (PPO), and point of service (POS) plans with available data. Design: A cross-sectional analysis using multivariable linear regressions to assess the relationship between provider network restrictiveness and contract quality scores in 2013 through 2017. Measures: Statistical significance in the relationship between network restrictiveness and contract performance on quality measures. Results: Across all study years, we included 562 unique contracts and 2801 contract-years. We find no evidence of consistent relationships between MA physician network restrictiveness and contract star rating. For primary care, psychiatry, and endocrinology, respectively, a 10 percentage point increase in restrictiveness was associated with a 0.02 (95% confidence interval [CI] −0.01 to 0.04), 0.0008 (95% CI, −0.01 to 0.02), and −0.01 (95% CI, −0.01 to 0.001) difference in star rating (p-value > 0.05 for all). Similarly, we find no evidence of consistent relationships between network restrictiveness and access to care measures. Conclusions: Our findings suggest that existing MA contract quality measures are not useful for indicating differences in network restrictiveness. Given the importance of provider choice to beneficiaries, more specific metrics may be needed to facilitate informed decisions about MA coverage. [ABSTRACT FROM AUTHOR]

Importance: Many social need screening to advance population health and reduce health disparities, but barriers to screening remain. Improved knowledge of patient populations at risk for social needs based on administrative data could facilitate more targeted practices, and by extension, feasible social need screening and referral efforts. Objective: To illustrate the use of cluster analysis to identify patient population segments at risk for social needs. Design: We used clustering analysis to identify population segments among Veterans (N=2010) who participated in a survey assessing nine social needs (food, housing, utility, financial, employment, social disconnection, legal, transportation, and neighborhood safety). Clusters were based on eight variables (age, race, gender, comorbidity, region, no-show rate, rurality, and VA priority group). We used weighted logistic regression to assess association of clusters with the risk of experiencing social needs. Participants: National random sample of Veterans with and at risk for cardiovascular disease who responded to a mail survey (N=2010). Main Outcomes and Measures: Self-reported social needs defined as the risk of endorsing (1) each individual social need, (2) one or more needs, and (3) a higher total count of needs. Key Results: From the clustering analysis process with sensitivity analysis, we identified a consistent population segment of Veterans. From regression modeling, we found that this cluster, with lower average age and higher proportions of women and racial minorities, was at higher risk of experiencing ≥ 1 unmet need (OR 1.74, CI 1.17–2.56). This cluster was also at a higher risk for several individual needs, especially utility needs (OR 3.78, CI 2.11–6.78). Conclusions: The identification of characteristics associated with increased unmet social needs may provide opportunities for targeted screenings. As this cluster was also younger and had fewer comorbidities, they may be less likely to be identified as experiencing need through interactions with healthcare providers. [ABSTRACT FROM AUTHOR]

The prevalence of breast cancer as a major global cancer has underscored the importance of postoperative recovery for breast cancer patients. Among the issues, postoperative patients are prone to spinal deformities, including scoliosis, which has drawn significant attention from healthcare professionals. The primary aim of this study is to design a postoperative recovery platform for breast cancer patients that can effectively detect posture changes, provide feedback and support to medical staff, assist doctors in formulating recovery plans, and prevent spinal deformities. The feasibility of the recovery platform is also validated through experiments. The development and validation of the experimental recovery platform. The recovery platform includes instrument design, patient data collection, model training and fine-tuning, and postoperative body posture evaluation by comparing preoperative and postoperative conditions. The evaluation results are provided to doctors to facilitate the formulation of personalized postoperative recovery plans. This paper comprehensively designs and implements the recovery platform and verifies its feasibility through simulation experiments. Statistical methods were employed for the validation of the rehabilitation platform in simulated experiments, with a significance level of p < 0.05. In comparison to static assessments like CT scans, this paper introduces a dynamic detection method that provides a more insightful analysis of body posture. The experiments also demonstrate the preventive capability of this method against post-operative spinal deformities, ultimately enhancing patients' self-image, restoring their confidence, and enabling them to lead more fulfilling lives. [ABSTRACT FROM AUTHOR]

Exposure to stressful life events is associated with a high risk of developing psychiatric disorders with a wide variety of symptoms. Cognitive symptoms in stress-related psychiatric disorders can be particularly challenging to understand, both for those experiencing them and for health care providers. To gain insights, it is important to capture stress-induced structural, epigenomic, transcriptomic, and proteomic changes in relevant brain regions such as the amygdala, hippocampus, locus coeruleus, and prefrontal cortex that result in long-lasting alterations in brain function. In this review, we will emphasize a subset of stress molecular mechanisms that alter neuroplasticity, neurogenesis, and balance between excitatory and inhibitory neurons. Then, we discuss how to identify genetic risk factors that may accelerate stress-driven or stress-induced cognitive impairment. Despite the development of new technologies such as single-cell resolution sequencing, our understanding of the molecular effects of stress in the brain remains to be deepened. A better understanding of the diversity of stress effects in different brain regions and cell types is a prerequisite to open new avenues for mechanism-informed prevention and treatment of stress-related cognitive symptoms. [ABSTRACT FROM AUTHOR]

Tamoxifen (TAM), a selective estrogen receptor (ER) modulator, has received approval for use in patients with breast cancer (BC) exhibiting positive ER expression. Given the widespread clinical use of TAM, a comprehensive real‐world study of its adverse events (AEs) is warranted. The database for analysis, sourced from the Food and Drug Administration Adverse Event Reporting System (FAERS), covers the period from the first quarter of 2014 to the third quarter of 2023. A disproportionality analysis was conducted to quantify the correlation between TAM and AEs. Subgroup analyses were performed to identify differences between BC AEs in males and females receiving TAM, aiming to assess the risk factors of male BC AEs. Total 4890 reports indicated BC, with 91 and 4190 specifically linked to AEs in male and female patients with BC, respectively. Male‐specific AE was libido decreased (reporting odds ratio [ROR]: 43.33), and female‐specific AE was uterine disease, including sarcoma uterus (ROR: 519.51), endometrial cancer (ROR: 131.26), uterine polyp (ROR: 40.83), endometriosis (ROR: 11.39), among others. A notably higher risk of AEs in male patients with BC was observed in individuals aged >65 years (χ2 = 20.83, p <.001). Male patients with BC had a relatively higher risk of hospitalization (χ2 = 4.83, p =.03) and a lower risk of deaths (χ2 = 5.32, p =.02). Theses finding may assist healthcare professionals in recognizing the TAM‐associated AEs and understanding gender differences, potentially improving safety in clinical applications. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATION:The objective of the study was to perform the translation and adaptation of the Spanish version of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS), and evaluate the psychometric properties.The original scale was translated from English to Spanish in accordance with international guidelines. Exploratory factor analysis was conducted to examine factor structure, while internal consistency was evaluated using Cronbach’s alpha. The intraclass correlation coefficient (ICC) was calculated to examine test–retest reliability. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were estimated. Criterion validity was assessed using the Spearman correlation coefficient.The Spanish SCI-FCS was administered to 81 manual wheelchair users with chronic SCI from a Spinal Cord Unit. Exploratory factor analysis revealed a two-factor structure. Internal consistency was high (α = 0.94) and test-retest reliability was excellent (ICC 2.1 = 0.99). SEM was 1.20 and MDC with 95% confidence interval was 3.31. The SCI-FCS score showed a positive correlation with fear of falling (r = 0.602, p < 0.001), Fatigue Severity Scale, r = 0.197 (p = 0.03), and the age of participants (r = 0.19, p = 0.04).The Spanish version of the SCI-FCS is a valid and reliable tool for assessing fall-related concerns in wheelchair users with chronic SCI.The Spinal Cord Injury-Falls Concern Scale (SCI-FCS) is a self-report scale designed to evaluate the level of concern about falls during daily activities in individuals with spinal cord injuries who are dependent on manual wheelchairs.The SCI-FCS can help identify specific areas that require intervention, aiming to reduce concerns about falling among individuals with SCI in the Spanish-speaking population.The availability of a transculturally validated Spanish version of the SCI-FCS will enhance the accuracy and quality of assessments conducted by Spanish healthcare professionals and researchers, ultimately improving patient care and rehabilitation outcomes.The Spinal Cord Injury-Falls Concern Scale (SCI-FCS) is a self-report scale designed to evaluate the level of concern about falls during daily activities in individuals with spinal cord injuries who are dependent on manual wheelchairs.The SCI-FCS can help identify specific areas that require intervention, aiming to reduce concerns about falling among individuals with SCI in the Spanish-speaking population.The availability of a transculturally validated Spanish version of the SCI-FCS will enhance the accuracy and quality of assessments conducted by Spanish healthcare professionals and researchers, ultimately improving patient care and rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) serve as the cornerstone of health services, which are among the primary needs during disasters. The chaotic environment caused by disasters can lead to mental health disorders in HCWs, similar to those experienced by disaster victims. Experiencing mental health disorders can hinder HCW’s professional approach to intervention. HCWs should not be overlooked for the possibility of experiencing mental health disorders while providing healthcare services during disasters. Therefore, this study aims to examine the impact of psychological resilience and trauma exposure on PTSD, depression, and sleep disorders among HCWs involved in the Kahramanmaraş Earthquakes, which were Turkey’s most devastating earthquakes. In this quantitative research, a survey technique was employed, reaching 642 hCWs involved in the Kahramanmaraş Earthquakes. Structural Equation Modeling (SEM) was used to test the impact of variables on each other. According to the SEM results, trauma exposure in the HCWs had a significant and positive effect on PTSD (β=+0.899, p = 0.000), depression (β=+0.685, p = 0.000), and sleep disorders (β=+0.603, p = 0.000). Psychological resilience had a significant and negative effect on PTSD (β=−0.278, p = 0.004) and depression (β=−0.322, p = 0.008). Surprisingly, psychological resilience had a significant and positive effect on sleep disorders (β=+0.692, p = 0.000). In conclusion, while trauma exposure led to PTSD, depression, and sleep disorders in the HCWs, psychological resilience mitigated PTSD and depression. Unexpectedly, psychological resilience increased sleep disorders. For this reason, it is recommended that future studies investigate in detail the reasons why HCWs experience sleep disorders and examine them in depth. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate whether there are differences in terms of cognitive disengagement syndrome (CDS) symptoms and some psychiatric symptoms between obese children and healthy controls. Participants were 60 cases diagnosed with obesity and 60 healthy children who were not obese/overweight aged 6–12 years. The obese group had significantly higher CDS symptom scores comparing to the control group. In the obese group, there were statistically significant associations found between the symptoms of CDS and attention, conduct issues, emotional instability, and excessive daytime sleepiness. Clinicians who work with obese children should also be aware of CDS symptoms. [ABSTRACT FROM AUTHOR]

Rape victims often face secondary victimization when interacting with the legal and healthcare systems, a risk that is exacerbated by the attitudes and practices of the professionals they encounter. This study, drawing on responses (N = 237) from police employees, prosecutors, and healthcare personnel, aimed to investigate rape victim treatment from the perspective of these professionals. Our investigation was two-fold: through a web survey, we first examined how professionals’ beliefs in a just world, acceptance of rape myths, and demographic factors influence their estimations of false reporting and trust in the justice system. We then used open-ended questions to identify perceived barriers, problematic practices, and areas for improvement within their professional roles and the overall system handling rape cases, providing both quantitative and qualitative data. Prosecutors and healthcare professionals reported significantly lower levels of estimations of false reports than police, with no significant difference between the two; additionally, prosecutors displayed the highest trust in the legal system, significantly greater than both police and healthcare professionals, whereas no significant difference was found between healthcare professionals and police. Overall, the professionals requested more specific knowledge on how to treat victims of rape and identified several perceived barriers (e.g. lack of resources, deprioritizing, and legislation) and problematic practices (e.g. interview practices and medical examination practices) that may cause secondary victimization. Practical implications for meeting and treating rape victims are discussed. [ABSTRACT FROM AUTHOR]

This study identifies and analyzes X (formerly Twitter) posts related to 14 e-cigarette use prevention campaigns from 2014 to 2020, assessing message volume, content, sources, potential reach and engagement. Using supervised machine learning, we classified 618,965 tweets, finding 43% contained opposition messaging. Two regional campaigns received the highest levels of opposition, with over 99% of related tweets classified as opposition. However, prevention/neutral messages exhibited 92% higher potential reach than opposition messages. Geolocation analysis suggested that regional campaigns may have struggled to focus their impact within targeted jurisdictions. These findings illustrate the dual role of social media as both an amplifier of prevention messages and a platform for oppositional narratives, underscoring the need for public health practitioners to develop adaptive strategies to address misinformation and enhance the impact of digital campaigns. [ABSTRACT FROM AUTHOR]

The article discusses the advancements in clinical reasoning expertise in Asia through the lens of the 3M framework. It highlights the importance of improving diagnosis, reducing diagnostic errors, and engaging patients in the diagnostic process. The Japan Diagnostic Excellence Team has launched a new initiative to enhance diagnosis, focusing on clinical reasoning education and conferences. The article also reflects on the recent "Diagnosis Insight 2024 Asia" conference, which attracted participants from various countries and emphasized the critical role of human factor engineering in diagnosis. [Extracted from the article]

Background: The aim of this study was to evaluate the knowledge, attitudes, and practices of migrant Syrian mothers regarding the neonatal screening programs (NSP) using in-depth interviews. Methods: Women were selected from the Migrant Health Center (MHC), which is the primary health care institution in Istanbul. A translator who spoke Arabic, the native language of participants, used an open-ended, semi-structed interview form to guide face-to-face interviews with participants. Questions were about sociodemographic information, opinions about NSP's heel prick testing, diseases the test screens for, reasons for agreeing to the heel prick test, and challenges faced accessing health care services. The interviews were audio recorded. The translator then transcribed the audio recordings in Arabic and translated them into Turkish. The framework method for analysis of qualitative data was used to analyze transcripts of the interviews. Results: Forty-one migrant women were interviewed. Four themes were identified from analysis of transcripts of the interviews, regarding (1) knowledge of the NSP, (2) attitudes about the NSP, (3) practices that create barriers to accessing health care services, (4) practices to overcome barriers to accessing health care services. Most participants had no knowledge of the diseases the NSP tests for. A few participants had heard of congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and spinal muscular atrophy (SMA), but they were not aware of the symptoms and effects of these diseases. Some participants thought the heel prick test benefited their child's health as it enables early diagnosis and treatment of diseases. All participants agree to heal prick testing after the birth of their most recent child. Participants noted the information and recommendations health care professionals provided influenced their decision to agree to the heel prick test. Most participants experienced language barriers when accessing health care services. Conclusions: Migrant women expressed a positive attitude toward the NSP. Future health care interventions regarding migrants should aim to reduce the negative experiences they encounter accessing health care, such as language barriers. [ABSTRACT FROM AUTHOR]

Background: Longitudinal healthcare worker (HCW) cohorts throughout the COVID-19 pandemic provide a unique opportunity to study the relative contributions of various exposures to infection risk over time. This study aimed to examine how demographic, health, occupational, household and community factors influenced the SARS-CoV-2 infection risk in a cohort of HCWs in Southeastern Ontario, Canada, during the early pandemic and the Omicron waves. We compared the contribution of these factors to infection risk and explored the implications for future epidemic preparedness and the protection of HCWs. Methods: We conducted a longitudinal analysis using data from a cohort of HCWs recruited from one acute care hospital and four long-term care homes. The analysis was divided into two periods: the initial phase of the pandemic (period #1) and the first three Omicron waves (period #2). We employed Poisson regression for period #1 and Cox regression for period #2 to examine associations of demographic factors (age, sex, ethnicity, migration status, income insufficiency), health factors (chronic conditions, smoking history, SARS-CoV-2 vaccination status), household factors (exposure to COVID-19), occupational factors (work role, exposure to COVID-19 patients, personal protective equipment access, aerosol-generating procedures) and community exposures (use of masks, distance, hand-washing) with SARS-CoV-2 infection. Results: At period #1, 17/208 (8.2%) HCWs reported having had SARS-CoV-2 infection. At period #2, 65/167 (38.3%) reported at least one SARS-CoV-2 infection. In period #1, factors associated with increased risk of infection included working in a long-term care home, exposure to more COVID-19-positive patients, working as a nurse or therapist, and inadequate use of personal protective equipment. In period #2, the hazard of infection was higher among HCWs who had COVID-19-infected children at home, whereas the use of protective measures in the community (maintaining social distance, mask-wearing) and receiving a vaccine booster were associated with reduced risk. Providing care to COVID-19 patients was not associated with the risk of acquiring SARS-CoV-2 infection at period #2. Conclusions: During the Omicron wave, community and household exposures, but not occupational exposure to COVID-19 cases, were the primary factors contributing to infection risk in HCWs. This contrasts with the early waves of the pandemic where occupational exposures played a significant role. These findings may be explained by the effectiveness of institutional interventions in reducing the risk of SARS-CoV-2 transmission in healthcare settings, alongside the failure of community-level interventions to mitigate risk during the Omicron period. [ABSTRACT FROM AUTHOR]