Background: Non-communicable diseases (NCDs) present a significant public health challenge, particularly among India’s tribal populations. This study aims to implement community-based screening to assess the current risk factors for NCDs in a tribal population, estimate the proportion at high risk using a Community-Based Assessment Checklist (CBAC), evaluate the program’s acceptability and fidelity, identify determinants of high-risk groups, and explore reasons for non-attendance at health centers by high-risk individuals.Methods: A mixed-methods cross-sectional study was conducted among 238 urbanized tribal individuals aged 30-60. Data were collected using a pre-designed, structured, and validated questionnaire in the local language and analyzed with SPSS version 26. Qualitative data were subjected to thematic analysis to provide a comprehensive understanding of the findings.Results: Of the participants, 88 (37%) were identified as high-risk, while 129 (54.2%) exhibited inadequate awareness of NCDs. The program demonstrated high acceptability (90.5%) but moderate fidelity (45.46%). Among the 88 high-risk individuals, 48 (54.54%) did not visit the primary health center (PHC). In-depth interviews with 10 randomly selected defaulters revealed key barriers, including financial and time constraints, inaccessibility of facilities, and a lack of seriousness and awareness regarding NCDs.Conclusion: The findings underscore an urgent need for multifaceted awareness-raising initiatives to improve NCD prevention and management in tribal populations. Enhanced education and accessibility to healthcare services are crucial for reducing the burden of NCDs in these communities.

Background: Critical thinking has emerged as a vital competency for effective decision-making in healthcare management, yet its conceptualization and application within culturally specific contexts remain insufficiently explored. In this qualitative study, we seek to conceptualize critical thinking within the context of Iranian healthcare management.Methods: In 2023, through conventional content analysis of semi-structured individual interviews with 17 healthcare managers from diverse roles and institutions in Sanandaj, Iran, we tried to identify key components of critical thinking within the Iranian healthcare context. The interviews lasted from 45 to 60 minutes. MAXQDA 2020 was used to manage the data.Results: From the viewpoints of our participants, the concept of critical thinking in healthcare settings means Strategic organizational awareness, Adaptive leadership & staff-centered management, Structured decision-making, Operational oversight and collaboration, and Learning and professional development.Conclusion: Our study provided a contextually grounded understanding of critical thinking among Iranian healthcare managers. Findings may be contributed to both theoretical and practical discourse on managerial competence in healthcare, potentially offering transferable insights for comparable global contexts. The findings can inform policy formulation, enhance professional training programs, and shape leadership strategies specific to Iran’s healthcare system.

Background: A decline in sexual intimacy within marital relationships can significantly impact the overall dynamics of the partnership, potentially leading to a progressive deterioration of emotional and physical closeness between couples. This study sought to examine married individuals’ perceptions of the factors contributing to diminished sexual intimacy, as well as the barriers impeding its sustenance. By elucidating these dimensions, the research aims to provide a nuanced understanding of the psychosocial and interpersonal mechanisms underlying this phenomenon.Methods: Employing a qualitative design, the study utilized a conventional content analysis approach to investigate these phenomena. A purposive sample of 26 married men and women participated in the study, with data collected through individual semi-structured interviews. Concurrent analysis was performed during data collection, with MAXQDA 2020 software used for textual data management and organization.Results: Thematic analysis yielded five principal themes (with fourteen sub-themes) characterizing factors contributing to diminished sexual intimacy. These comprised: (1) sex drive mismatch, (2) lack of perceived emotional intimacy, (3) sexual dissatisfaction, (4) restrictive sexual stereotypes, and (5) sexual nostalgia. The findings indicate that diminished sexual intimacy arises from interacting intrapersonal, interpersonal, and sociocultural factors, which cumulatively affect sexual relationship quality and, by extension, marital intimacy.Conclusion: In light of these findings, it is recommended that sexual health delivery systems prioritize implement targeted couple consultations addressing multidimensional barriers to intimacy (psychological, relational, and societal). Such evidence-based interventions could enhance sexual and marital satisfaction by providing comprehensive support tailored to couples’ needs.

Background: In recent years, global commitments to achieving universal health coverage (UHC) have emphasized the critical importance of public health funding. This study aims to explore the relationship between public health expenditure (PHE) and UHC.Methods: The study is based on Grossman’s health production model, which posits that health is a commodity requiring investment. Data for this analysis was sourced from the World Bank’s World Development Indicators and the World Health Organization’s Global Health Expenditure Database, covering 169 countries over a 22-year period from 2000 to 2022. Both fixed and random effect panel regressions were conducted using STATA for the analysis.Results: The findings indicate that per capita domestic health expenditure significantly impacts health outcomes (0.068, 95% CI: 0.0336,0.1038), especially in combating infectious diseases (0.2543, 95% CI: 0.1552,0.3533). Additionally, higher education completion rates are linked to better health outcomes (0.0020, 95% CI: 0.0008,0.0032). The results also suggest that an aging population may require increased resources for managing non-communicable diseases (0.0184%, 95% CI: 0.0121,0.0246) and Service Capacity an access (0.0140, 95% CI: 0.0022,0.0259). Furthermore, higher life expectancy at birth strongly correlates with improved health outcomes across various sectors, marking it as a robust indicator of overall health (0.0339, 95% CI: 0.0226,0.0453). The findings indicate that per capita domestic health expenditure significantly impacts health outcomes, especially in combating infectious diseases. Additionally, higher education completion rates are linked to better health outcomes. The results also suggest that an aging population may require increased resources for managing non-communicable diseases and service capacity an access. Furthermore, higher life expectancy at birth strongly correlates with improved health outcomes across various sectors, marking it as a robust indicator of overall health.Conclusion: Our analysis using fixed effect models revealed significant factors affecting health outcomes in reproductive, maternal, newborn, and child health (RMNCH); infectious diseases (ID); non-communicable diseases (NCD); and service capacity and access (SC). Strategic health investments and policies in areas like infectious diseases, where funding directly improves health outcomes, could greatly enhance these results. Our data strongly supports increasing and strategically allocating health expenditure to maximize impact.

Background: The global challenge of tobacco usage poses significant hurdles in policy implementation. Local governments’ smoke-free policies have struggled with optimal enforcement, hampering effective smoking control. This study evaluates smoke-free zone implementation in healthcare services within Muaro Jambi, Indonesia.Methods: This convergent mixed-methods study collected data from June to December 2023. The quantitative phase entailed a spatial survey across 74 healthcare facilities (hospitals, community health centers, and clinics), facilitated by the KoboToolbox application. Data were analyzed using SPSS 16.0 for descriptive statistics and QGIS 3.30.2 for spatial mapping. The qualitative component employed content analysis of in-depth interviews with 31 purposively selected informants representing healthcare facilities and policymakers. Interviews were conducted by trained enumerators, transcribed verbatim, and analyzed using conventional content analysis techniques following Bengtsson’s methodology.Results: Most healthcare facilities (74.3%, 95% CI: 62.8-83.8%) failed to implement smoke-free areas effectively, with hospitals and community health centers showing 100% non-compliance and clinics at 61.2%. Key barriers included inconsistent policy socialization, inadequate leadership enforcement, absence of sanctions, and cultural acceptance of smoking in outdoor areas. Effective implementation correlated with strong leadership commitment and consistent rule enforcement.Conclusion: The effectiveness of smoke-free policies in Indonesian healthcare facilities hinges on robust regulatory measures and consistent oversight from local governments. Leaders and staff serve as role models, ensuring compliance through their actions. While regional regulations are critical for tobacco control, their success depends on unwavering support from local and organizational leaders, emphasizing the need for active involvement from decision-makers and stakeholders.

Background: There are many risk factors that heighten severity and susceptibility of concussion which have come into heightened awareness attributed to more revelations across the concussions landscape in recent years in light of news media, cinema, landmark legal cases, and continued research findings.Methods: This review specifically focused on identifying concussion-related information accessed by different audiences on a range of social media platforms. The goals of this review were to synthesize the existing state of concussion coverage across social media platforms from all published studies to date as the basis to inform directions for patient and family education, clinical practice and future research on improving concussion care and treatment.Results: Findings revealed a wide range of consumer and professional sources publishing content on concussions. News stories and testimonials were the most widely accessed formats across two studies. YouTube, Twitter, Facebook, Instagram, TikTok, Pinterest, and Flickr were the social media platforms examined across these studies. Post-concussive symptoms and concussion treatment approaches were widely covered across two studies followed by prevention in three studies. Focus on situational and contextual factors of concussions (e.g. setting, surface and trauma-related considerations) were missing from findings in the studies across this review.Conclusion: Clinical and educational implications and recommendations for future ways to harness the potential of social media in improving concussion care and treatment are also presented. Increased content on concussion prevention could yield value in addressing modifiable risk factors for concussion as the basis to reduce the rates of this longstanding public health complexity.

Background: This systematic review and meta-analysis aimed to evaluate the prevalence of post-traumatic stress disorder (PTSD) among road traffic accident (RTA) survivors, a demographic impacted by over 50 million disabilities globally each year.Methods: An initial systematic search was conducted in November 2021, with an updated search performed in October 2024. Relevant databases were comprehensively searched using keywords related to "traffic accidents," "road accidents," "motor vehicle accidents," "PTSD," and "Post-Traumatic Stress Disorder." This systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines and the PICO framework established by Cochrane. The review included studies that involved RTA survivors diagnosed with PTSD, focusing on time frames from one to six months post-accident and utilizing DSM criteria. Eligible studies were reviewed for quality using the standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Checklist, by two independent reviewers. Meta-analysis was performed using Comprehensive Meta-Analysis statistical software and STATA16 to estimate overall prevalence rates and subgroup analyses to explore variations.Results: A comprehensive search across multiple databases identified 11,142 articles, of which 92 were reviewed, and 82 were included in the meta-analysis. The findings revealed an overall PTSD prevalence of 20.3% (95% confidence interval [CI]: 18.1%-22.8%; I2: 93.86%); 18.7% (95% CI: 16.0%-21.8%; I2: 93.47%) based on clinician-administered assessments and 22.8% (95% CI: 18.8%-27.3%; I2: 93.92%) from self-reported questionnaires. After removing outliers, the total prevalence was decreased to 18.1% (95% CI: 15.4%-21.0%; I2: 93.09%), in clinician-administered and 20.8% (95% CI: 17.5%-24.4%; I2: 91.51%) in self-reported questionnaires. Notably, the prevalence was 29.4% (95% CI: 22.4%-37.5%) one-month post-RTA, decreasing to 18.8% (95% CI: 14.8%-23.5%); P<0.001 at three months. Age did not significantly predict PTSD prevalence rates. The quality assessment of the studies included demonstrated moderate to high quality according to the Joanna Briggs Institute standards, ensuring the reliability of the findings. Geographic variability in PTSD prevalence was observed, with lower rates reported in Switzerland, Australia, Germany, and Japan, while higher rates were found in Spain, China, and Iran.Conclusion: This review highlights a significant PTSD prevalence of 20.3% among traffic accident survivors, emphasizing the need for early intervention and targeted mental health support to mitigate long-term psychological impacts and improve recovery outcomes in this vulnerable population. Screening and public awareness of disease symptoms are recommended.

Background: Health promotion within higher education institutions is gaining increasing global attention, particularly in response to the growing health challenges faced by adolescents and young adults. This demographic often experiences a convergence of health-related issues, including poor dietary practices, substance use, mental health disorders, and obesity. These issues frequently interact in complex ways, influencing long-term health trajectories. This scoping review aimed to examine the breadth of strategies and research concerning health-promoting initiatives across universities worldwide, while identifying existing gaps in the literature.Methods: Following the PRISMA-ScR guidelines, a systematic search was conducted for peer-reviewed articles published between 2014 and 2024 using the SCOPUS and Web of Science databases. After screening and eligibility assessment, 272 articles were included in the final review.Results: Thematically, 19% of studies focused on health-related policies and frameworks, 19% on mental health and wellness, 16% on technology-assisted interventions, 14% on physical activity, 7% on nutrition, 6% on behavioral habits, and others addressed curriculum restructuring.Conclusion: Findings reveal that most interventions remain in preliminary stages of implementation, with limited follow-up studies evaluating their effectiveness or cost-efficiency. There is a pressing need for robust, longitudinal research to assess outcomes, particularly in low- and middle-income countries. Furthermore, regional disparities—especially the limited representation from Sub-Saharan Africa—underscore the necessity for inclusive, globally coordinated research networks to foster equitable health promotion across diverse educational settings.