Health Characteristics Research Articles

Karakteristik Kesehatan Mental Remaja Dalam Perilaku Self Harm

Self-harm is known as self-harm is a mental health phenomenon in which a person uses physical pain to cope with emotional stress. The study aims to understand the characteristics of adolescent mental health with self-harm behavior, as well as to find out how adolescents can reduce self-harm behavior. This study applies a descriptive qualitative method. This study involved three informants with the initials DA, MAT, and FR. The informants in this study were adolescents aged 18-19 years who committed self-harm when facing problems. The determination of informants used a purposive sampling technique. Data collection techniques were obtained from observation, interviews, and documentation and were analyzed using the Miles and Huberman method. The characteristics of mental health possessed by adolescents with self-harm behavior in Village X tended more towards unhealthy mental characteristics. The results of the study showed adolescent behavior such as losing self-control in managing emotions, withdrawing from their environment, having feelings of shame and guilt, and difficulty concentrating in their social and school environments. In line with the opinions of experts regarding the characteristics of mental health which refer to an unhealthy mentality (ill mentality). However, even so, teenagers have tried to stop their self-harming behavior with other more positive activities such as exercising, writing and listening to music to please their hearts and minds.

Spectrum of COVID-19 cases in Arkhangelsk, Northwest Russia: Findings from a population-based study linking serosurvey, registry data, and self-reports of symptoms.

The spectrum of COVID-19 manifestations makes it challenging to estimate the exact proportion of people who had the infection in a population, with the proportion of asymptomatic cases likely being underestimated. We aimed to assess and describe the spectrum of COVID-19 cases in a sample of adult population aged 40-74 years in Arkhangelsk, Northwest Russia, a year after the start of the pandemic. A population-based survey conducted between February 24, 2021 and June 30, 2021 with an unvaccinated sample aged 40-74 years (N = 1089) combined a serological survey data, national COVID-19 case registry, and self-reported data on COVID-19 experience and symptoms. Based on the agreement between these sources, we classified the study participants as non-infected and previously infected (asymptomatic, non-hospitalized and hospitalized symptomatic) cases, and compared these groups regarding demographics, lifestyle and health characteristics. After a year of the pandemic in Arkhangelsk, 59.7% 95% confidence intervals (CI) (56.7; 62.6) of the surveyed population had had COVID-19. Among those who had been infected, symptomatic cases comprised 47.1% 95% CI (43.2; 51.0), with 8.6% 95% CI (6.6; 11.1) of them having been hospitalized. Of the asymptomatic cases, 96.2% were not captured by the healthcare system. Older age was positively associated, while smoking showed a negative association with symptomatic COVID-19. Individuals older than 65 years, and those with poor self-rated health were more likely to be hospitalized. More than half of the infected individuals were not captured by the healthcare-based registry, mainly those with asymptomatic infections. COVID-19 severity was positively associated with older age and poor self-rated health, and inversely associated with smoking. Combining different sources of surveillance data could reduce the number of unidentified asymptomatic cases and enhance surveillance for emerging infections.

What Characteristics Modify the Relation of Neighborhood Walkability and Walking Behavior in Older Adults?

Neighborhood walkability can influence walking behaviors in older adults. However, its associations of walkability with walking may differ by demographic, socioeconomic, health, social, and residential characteristics due to factors such as increased vulnerability to environmental factors or increased resilience. In a sample of older adults (n = 493, median age = 82 [range 78-89], 56% female, 31% Black), a walkability index was derived from audits of Google Street View images of participants' immediate neighborhoods. Walking was self-reported in the past week. Effect modifiers by demographic (age, race, gender, marital status), socioeconomic (education, income), health (gait speed, falls, knee pain, depressive symptoms, cognitive status, perceived energy), social (driving status, social engagement), and residential/neighborhood (residence type, neighborhood socioeconomic status [SES], population density) characteristics were assessed by interaction terms in logistic regression models, adjusted for gender, race, gait speed, prior falls, high depressive symptoms, currently driving, and cognitive status. When effect modification was suggested (p for interaction <.1), adjusted analyses of walkability with walking stratified on the effect modifier were conducted. In this sample, 59% walked in the past week and greater walkability was associated with greater odds of walking (odds ratio [OR] = 1.16, 95% confidence interval [CI]: 1.01-1.34). This association (p for interaction range 0.002-0.07) was present for those who were not currently married (OR = 1.35, 95% CI: 1.17-1.56), who reported knee pain (OR = 1.40, 95% CI: 1.14-1.72) or high depressive symptoms (OR = 1.30, 95% CI: 1.06-1.60), or who had declining cognitive function (OR = 1.30, 95% CI: 1.09-1.55). High walkability may influence physical activity, particularly for those with vulnerabilities related to social, pain, and brain health characteristics. These results should inform neighborhood planning and targeted interventions for vulnerable older adults.

Remaining useful life prediction of lithium-ion batteries based on DBO[sbnd]CNN-DSformer

In order to improve the accuracy of predicting RUL of lithium-ion batteries, a lithium-ion battery RUL prediction method based on the DBOCNN-DSformer model is proposed. Firstly, the health characteristics of the battery are extracted and the local information of health features is mined using CNN. DSformer is utilized for global information, local information, and variable correlation learning of battery aging characteristics. The DBO is used to optimize the super-parameters of the CNN-DSformer model and build the DBOCNN-DSformer model. Finally, the battery aging data set was used for verification. The results show that DBOCNN-DSformer, which sets different prediction starting points, can extract sequence information from input data and establish long-term dependencies between sequences. The maximum average MRE error in the NASA data set was 0.05, the maximum average MAE was 0.018, and the maximum average AE error was within 5. The maximum average MRE error of the CALCE data set was 0.37, the maximum average MAE was 0.014, and the maximum average AE prediction error was within 10. Compared with LSTM, RNN, and Transformer models, it was found that DBOCNN-DSformer showed high prediction accuracy and good robustness.

Impact of care coordination on service utilisation for children with medically complex cerebral palsy.

Complex care programmes for children with medically complex cerebral palsy (CP) exist; however, evidence for their impact is limited. This study (i) explored the impact of The Royal Children's Hospital Complex Care Hub (CCH) on hospital service utilisation rates over a 3-year period for children with medically complex CP compared with those eligible but received routine care, and (ii) compared health, disability and socio-demographic characteristics of children and their families in both groups. Electronic medical record data from 78 children (mean age 9.43 years, females n = 37) with medically complex CP who accessed CCH services, and 92 (mean age 10.86 years, females, n = 39) who received routine care were included. Multivariable regression was used to analyse service utilisation: number of emergency department (ED) presentations, length/number of inpatient and intensive care unit admissions and number/type of hospital appointments. Critical health-care needs, functioning/disability profile and child/family demographics for each group were compared. More children in the CCH group had a mixed motor type (73.1% vs. 15.2%), were classified within Gross Motor Function Classification System level V (76.9% vs. 34.8%), had respiratory, nutrition and social support needs and epilepsy. Children receiving CCH services had higher service utilisation rates; ED presentations (rate ratio (RR) = 1.81, 95% confidence interval (CI): 1.09-3.01), inpatient admissions (RR = 2.77, 95% CI: 2.01-3.83), outpatient encounters (RR = 1.69, 95% CI: 1.31-2.18) and telephone encounters (RR = 6.05, 95% CI: 4.56-8.02). Children with medically complex CP accessing a complex care service have higher service utilisation rates yet have more complex clinical presentations and higher support needs.

Food for Thought: Mental Health, Psychological Well-Being, Social Engagement and Campus Service Utilization of Students Experiencing Food Insecurity at a Large Atlantic Canadian University

ABSTRACT The aims of this study were to determine the prevalence and associated mental health characteristics of food insecure (FI) students at an Atlantic Canadian University. Based on data from the National College Health Assessment-third revision (NCHA-III, 2023) (N = 1694; mean age = 26.6; 63.2% female), FI prevalence was 46.6%, with higher rates for male, international, and undergraduate students, and those from low-income families. Food Insecure students were more likely to report “serious” psychological distress, a state of ’languishing,’ a greater frequency of all forms of suicidality, and use of the university’s food bank and mental health services. Concomitant social issues were also more likely for FI students in terms of lacking companionship, feeling left out and isolated from others, experiencing problems/challenges with family and peers, and indicating less agreement that they belonged at their university, and that their health/well-being was a priority on campus. Recommendations on how institutions can address the issue are considered.

Clinical, Diagnostic, and Metabolic Characteristics Associated with Nephrolithiasis in the Black Women's Health Study.

Background/Objectives: Nephrolithiasis (kidney stones) is a frequently occurring urologic condition resulting in significant patient morbidity and healthcare costs. Despite the higher prevalence of metabolic risk factors for nephrolithiasis among Black women, there have been few epidemiologic studies of kidney stones focusing on this group. Methods: We describe demographic and health characteristics, diagnostics, and metabolic profiles of US Black women with self-reported kidney stones. The women were participants in the Black Women's Health Study (BWHS), a large prospective cohort of US Black women (median age 38 years) begun in 1995. Results: Among the 2750 BWHS participants who completed an online supplemental questionnaire assessing urologic health, 201 women reported nephrolithiasis. Of this number, 62% had completed ≥ 16 years of education, and 82% reported access to health care. Overall, 39% reported experiencing ≥ 2 stones in their lifetime, and 29% required surgery to treat the condition. Thirty-two percent reported having completed a metabolic evaluation, while 70% had undergone a CT scan to diagnose nephrolithiasis. The frequency of metabolic evaluation increased with the number of metabolic components reported: 3% (0 components) to 43% (3-4 components). Conclusions: Our findings are consistent with reports of lower rates of metabolic evaluation among Black patients despite their having multiple risk factors for nephrolithiasis. Further study is needed to identify the barriers and facilitators of metabolic and diagnostic workup of nephrolithiasis in Black women.

Sociodemographic, mental health, education, employment and income characteristics of adults with obsessive–compulsive disorder who accessed secondary health services in Aotearoa | New Zealand

ABSTRACT Little is known about New Zealanders who experience obsessive–compulsive disorder (OCD). Using population-level data for people aged 18–64 years, we identified a cohort of 5559 people who accessed secondary health services and had a diagnosis of OCD. We explored their characteristics in comparison to people without OCD. The rate of OCD per 10,000 people differed by ethnicity (European, 24.7; Māori, 13.4; Pacific Peoples, 5.6; Asian, 5.9). We observed variation in OCD rates by the geographic divisions of the public healthcare provider Health NZ which persisted following standardisation for age, sex, ethnicity and urban vs rural residence (Northern, 14.5; 95% confidence interval (CI) 13.7–15.2; Te Manawa Taki, 10.9; CI 10.0–11.8; Central, 19.7, CI 18.5–20.8; Te Waipounamu, 27.4, CI 26.2–28.7). These disparities suggest inequity of access to healthcare. Individuals in this cohort typically had at least one co-occurring mental health or related condition (78.8%) and were less likely to have at least level 4 educational qualifications (equivalent to first year of an undergraduate degree) (adjusted rate ratio (ARR) 0.94; CI 0.90–0.97), to be employed (ARR 0.69; CI 0.66–0.72) and to belong to a higher income bracket ($40,000 or higher, ARR 0.57; CI 0.53–0.62). These findings suggest wider support needs. What we already know Obsessive–compulsive disorder (OCD) is a mental health condition that is characterised by repetitive intrusive thoughts and compulsive behaviours and has a twelve-month prevalence of around 1–2% in adults. In clinic-based studies, most individuals with OCD have other mental health and related conditions and, to a lesser degree, this is also observed in community surveys. OCD is typically first experienced as a child, adolescent or young adult and can severely impact an individual’s ability to engage in education and employment. What this article adds Using the Integrated Data Infrastructure (IDI), a national collection of linked health and non-health data, we explored the characteristics of working-age adults with OCD who had accessed public secondary health services in Aotearoa | New Zealand (NZ). There were marked differences in the rates of OCD for geographic areas corresponding to the regional divisions of Health NZ | Te Whatu Ora, and, as previously described, by ethnicity. These findings suggest inequity of access to healthcare and merit further investigation. In comparison to other working-age adults, people in the study cohort were moderately less likely to have achieved higher level educational qualifications, and they were markedly less likely to be employed and to belong to a higher income bracket. Accessing public secondary health services is likely to be a proxy for more severe and/or complex psychological disability and many people in this cohort had other mental health and related conditions. Therefore, the characteristics of this cohort cannot be generalised to the entire group of people who experience OCD in NZ.

Nationwide Availability of and Enrollment in Medicare and Medicaid Dual-Eligible Special Needs Plans With Exclusively Aligned Enrollment

In 2021, the Centers for Medicare & Medicaid Services designated a new category of dual-eligible special needs plans (D-SNPs) with exclusively aligned enrollment (receive Medicare and Medicaid benefits through the same plan or affiliated plans within the same organization). To assess the availability of and enrollment in D-SNPs with exclusively aligned enrollment and to compare the characteristics of beneficiaries enrolled in D-SNPs with exclusively aligned enrollment available vs beneficiaries without such enrollment available. Full-benefit beneficiaries enrolled in D-SNPs for 6 months or longer in 2021 or 2022. Availability of and beneficiary enrollment in D-SNPs were assessed by year and county for D-SNPs with exclusively aligned enrollment available vs D-SNPs without exclusively aligned enrollment available. The D-SNP enrollees residing in counties with aligned plans available were compared based on demographic, social, health, and area characteristics vs D-SNP enrollees in counties without such plans available. Comparisons were also made based on beneficiaries who enrolled in the aligned D-SNPs vs those who did not enroll (were enrolled in unaligned D-SNPs). The data analyses were conducted from October 1, 2023, to August 2, 2024. Availability of aligned D-SNPs and beneficiary residence by county; enrollment in exclusively aligned D-SNPs vs unaligned D-SNPs; and beneficiary demographic, social, health, and area characteristics. Of 2 197 732 beneficiaries enrolled in D-SNPs in 2021, 881 736 (40.1%) were living in counties with aligned enrollment available and 251 305 (11.4%) enrolled. Of 2 689 045 beneficiaries enrolled in D-SNPs in 2022, 1 047 223 (38.9%) were living in counties with aligned enrollment available and 318 906 (11.9%) enrolled. Beneficiaries enrolled in D-SNPs residing in counties without aligned enrollment available were more likely to live in rural or micropolitan areas (21.9%) vs beneficiaries in counties with aligned enrollment available (8.1%) (standardized mean difference [SMD], 0.38 [95% CI, 0.38-0.38]), be entitled to disability (44.4% vs 27.3%, respectively; SMD, 0.36 [95% CI, 0.36-0.36]), or be Black individuals (27.4% vs 21.4%; SMD, 0.14 [95% CI, 0.14-0.14]); were less likely to be Hispanic individuals (15.4% vs 33.7%; SMD, 0.45 [95% CI, 0.45-0.45]) or Asian or Pacific Islander individuals (6.1% vs 12.2%; SMD, 0.22 [95% CI, 0.22-0.22]); and lived in zip codes with a higher area deprivation index (mean, 66.8 [SD, 26.4] vs mean, 43.2 [SD, 29.0]; SMD, 0.86 [95% CI, 0.86-0.86]). Beneficiaries enrolled in aligned D-SNPs were more likely to be receiving long-term institutionalized care vs beneficiaries in nonaligned D-SNPs (4.3% vs 1.0%, respectively; SMD, 0.24 [95% CI, 0.24-0.25]) or have dementia or Alzheimer disease (9.2% vs 5.9%; SMD, 0.13 [95% CI, 0.13-0.13]). This study found that availability of and enrollment in D-SNPs with exclusively aligned enrollment are increasing, but the overall proportion enrolled remains low. Further reforms are needed to promote aligned enrollment.

Health Care Utilization and Perceived Quality of Care in a Colombian Indigenous Health Organization.

Indigenous governance of health care has increasingly been advocated among Indigenous peoples in many countries. However, there is limited research that has empirically examined its benefits. In 2020/21, we conducted a survey of 2113 Indigenous Wayuu individuals in Colombia who received services from the Indigenous Wayuu led health care insurance organization Anas Wayuu and its network of service providers, and Wayuu individuals who received services from non-Indigenous health insurance organizations. We compared their health care utilization and perception of quality of care. A main finding of the study was that Anas Wayuu enrollees were more than twice as likely to access health care than enrollees from non-Indigenous health insurance organizations, even when controlling for the demographic and health characteristics. The study provided compelling evidence suggesting that Anas Wayuu, being an Indigenous led health organization improves access to, and quality of care, among Indigenous health service recipients.

Health enhancement through activity travel participation and physical activity intensity

IntroductionPast studies investigate the impact of health parameters on activity and transport options. However, limited research has been done on how activity-travel participation influences health outcomes. Physical activity has the potential to improve health characteristics; however, its intensity (duration and frequency) and optimal mode are yet to be determined. Therefore, the current study aims to use physical activity intensity (PAI) as an intermediate variable to study the correlation among daily activities, transport mode choice, and health parameters to pursue sustainable transportation and improve health parameters. MethodsIn September 2013, a multidimensional three-week household survey was used to collect the data containing 191 households and 732 individuals representing 0.029% of the total population of Bandung, Indonesia. SPSS was used for the data normalization and descriptive analysis, whereas R was used for the multilevel regression and structural equation modeling (SEM). Four models were developed between endogenous, mediator, and exogenous variables. ResultsA significant correlation was found between daily activities, transport mode choice, and health parameters with exceptionally acceptable R2 and p-values. The appraised results indicate that strenuous PAI is 2.1% and 0.3% positively correlates with physical health (PH) and social health (SH), showing that it mediates the correlation among transport-related daily activities and health parameters. High-income households are dependent on motorized transport which is 0.1% and 0.2% negatively associated with PH and SH. Whereas, active transport is 2.0% and 0.2% and public transport is 0.2% and 1.5% positively associated with PH and SH. Replacing short car trips with a sustainable transportation system enhances health parameters and reduces GHG emissions from the transportation sector. ConclusionThe current study concluded that the association was mediated by transport-related PAI which enhances health parameters. Policymakers and practitioners promote transport-related physical activity which may help to enhance health parameters and provide a sustainable transportation system.

The associations between self-rated autistic traits, social camouflaging, and mental health outcomes in Taiwanese anime, comics and games (ACG) doujin creators: an exploratory study

BackgroundDoujin (どうじん) is a Japanese term referring to a circle where people share the same interests, usually something that belongs to the Anime, Comics, and Games (ACG) subculture. Individuals who belong to it and create related works, known as ACG doujin creators, are usually described as socially awkward and at potential risk of isolation. In such a context, they may theoretically exhibit higher autistic traits and manifest camouflaging tendencies, which may consequently be associated with their mental health. Nonetheless, the impact of autistic traits and camouflaging on mental health in this subculture remains significantly underexplored.MethodsWe recruited 183 Taiwanese ACG doujin creators (age ranges from 18 to 41, 146 female and 37 male) via social networking platforms. Participants completed Chinese online surveys assessing socio-demographic information, doujin activities, past psychiatric history, the 35-item Version of Autism-Spectrum Quotient (AQ-35), Chinese version Camouflaging Autistic Traits Questionnaire (CAT-Q-Ch), the General Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Linear regression analysis was employed to examine the associations between the aforementioned scales.ResultsOur findings revealed that among ACG doujin creators, descriptively higher level of AQ-35 and CAT-Q-Ch than previous studies were found. Moreover, we observed a positive association between camouflaging behaviours and most AQ-35 subscales, with the exception of the mindreading subscale. Additionally, we identified that both camouflaging and autistic traits were significantly linked to higher PHQ-9 and GAD-7 scores.ConclusionsThrough this study, we gained insight into the distinctive characteristics of autistic traits, camouflaging behaviours, and mental health among Taiwanese ACG doujin creators, as the associations between the factors mentioned above are divergent compared to previous research. This topic demonstrated that camouflaging is also associated with adverse mental health in a subculture group.

The influence of sociodemographic, tobacco use, and mental health characteristics on treatment adherence among adults enrolled in a community-based tobacco cessation program

BackgroundWhile counseling and pharmacological interventions are known to facilitate smoking cessation, poor adherence can impact their effectiveness. Therefore, this study aimed to identify personal and clinical factors that influenced adherence to smoking cessation treatment among socioeconomically disadvantaged adult Oklahomans enrolled in a publicly available tobacco treatment program and observational research study. MethodsAdult participants (N = 442) were enrolled in a community-based tobacco treatment program. Logistic regression models identified sociodemographic, mental health, and substance use characteristics associated with treatment adherence. Adherence was measured by counseling session attendance and weeks of moderate/high medication adherence assessed via the Medication Adherence Questionnaire. Analyses were conducted using SAS 9.4 with p < 0.05. ResultsParticipants (mean age of 53, 55 % female, and 42.3 % racially minoritized, smoked 16 (SD = 10) cigarettes/day for 30 years on average (SD = 15), and 44.8 % reported depression (Center for Epidemiological Studies Depression Scale [CESD] score ≥ 10). Self-efficacy, White race, increasing age, and years of smoking were positively associated with counseling adherence, while menthol use, being uninsured, and depression predicted lower counseling adherence. Medication adherence was lower among individuals who used menthol cigarettes, lived with someone who smoked, and had higher levels of expired carbon monoxide. ConclusionsThis study highlights key factors that influenced adherence to smoking cessation treatment in a socioeconomically disadvantaged population. Tailored interventions are needed to address social, behavioral, and environmental factors, such as living situations and mental health, in smoking cessation interventions to enhance treatment outcomes for underserved populations. Future tobacco cessation programs should consider these factors to improve adherence and, ultimately, success rates.

Matched Comparison Examining the Effect of Obesity on Clinical, Economic, and Humanistic Outcomes in Patients with BipolarI Disorder.

BipolarI disorder (BD-I) is associated with an increased risk of obesity, but few studies have evaluated the real-world clinical, humanistic, and economic effects associated with obesity in people with BD-I. This was a retrospective, cross-sectional analysis of responses to the 2016 and 2020 National Health and Wellness surveys. Respondents (18-64years) with a self-reported physician diagnosis of BD-I were matched to controls without BD-I based on demographic and health characteristics. Respondents were categorized by body mass index as underweight/normal weight (< 25kg/m2), overweight (25 to < 30kg/m2), or obese (≥ 30kg/m2). Multivariable regression models were used to compare obesity-related comorbidities, healthcare resource utilization (HCRU), health-related quality of life (HRQoL), work productivity, and indirect and direct costs. Before matching, the BD-I cohort was younger than the non-BD-I cohort and included more female and white respondents and a greater proportion covered by Medicaid or Medicare. After matching, the BD-I and non-BD-I cohorts had similar characteristics. A total of 5418 respondents (BD-I, n = 1806; matched controls, n = 3612) were analyzed. Obese respondents with BD-I reported the highest adjusted prevalences of high blood pressure (50%), high cholesterol (35%), sleep apnea (27%), osteoarthritis (17%), type2 diabetes (12%), and liver disease (4%). Obesity in respondents with BD-I was associated with the lowest HRQoL scores. Measures of work impairment were highest in respondents with BD-I and obesity, as was HCRU. Respondents with BD-I and obesity had the highest associated total indirect and direct medical costs ($25,849 and $44,482, respectively). Obese respondents with BD-I had greater frequencies of obesity-related comorbidities, higher HCRU, lower HRQoL, greater work impairments, and higher indirect and direct medical costs. These findings highlight the real-world burden of obesity in people with BD-I and the importance of considering treatments that may reduce this burden.

Factors Associated With Sedentary Behavior Among Adult Women In A Medical Clinic

Background: Sedentary behavior (SB) refers to any behavior performed with low energy expenditure while seated, reclined, or lying down during waking hours. Considered a public health issue, SB has been associated with various adverse health outcomes. The objective of this study was to analyze factors associated with sedentary behavior in adult women attending a university medical clinic. Materials and Methods: This is a cross-sectional study with data collected from users at a medical clinic in the city of Aparecida de Goiânia. Information on sociodemographic, occupational, behavioral, and health characteristics was collected. Sedentary behavior was assessed using the short version of the International Physical Activity Questionnaire (IPAQ). Poisson multiple regression analysis with robust variance was performed. Results: The sample consisted of 223 women, and high CS was associated with an income of five or more minimum wages (p=0.021), incomplete secondary education (p=0.032), not working outside the home (p=0.047), not having children (p=0.003) and drinking alcohol twice/week (p=0.000). Conclusion: These findings indicate groups more susceptible to high sedentary behavior and can collaborate with the planning of specific interventions

ECO-MIND: enhancing pro-environmental behaviours and mental health through nature contact for urban youth – a research protocol for a multi-country study using geographic ecological momentary assessment and mental models

IntroductionUrban youth are experiencing increasing mental health problems due to diverse personal, social and environmental concerns. Youths’ detachment from natural environments, including green and blue spaces, may intensify such issues...

An exploratory data-driven approach to classify subgroups of patients with temporomandibular disorders based on pain mechanisms

Temporomandibular disorders (TMDs) are a common musculoskeletal condition, presenting treatment challenges due to their non-specific nature. Categorizing patients with TMDs into clusters based on neurobiological pain mechanisms could provide a promising approach to facilitate targeted treatments. This observational study (1) used a network analysis (NA) to explore the complexity of TMDs by investigating relationships among biopsychosocial variables, and (2) validated potential TMD subgroups based on mechanism-specific pain categories. One hundred and two patients with TMD were included. Biopsychosocial variables covered: general health, psychosocial features, TMD pain, and TMD characteristics. A NA evaluated the associations between variables and determined the role of each feature within the network. Hierarchical clustering was used to identify TMD subgroups. The NA revealed significant correlations primarily within the same feature domains, indicating a strong interplay between symptoms and psychological factors. Cluster analysis identified two subgroups driven by nociceptive and nociplastic pain mechanisms; the nociplastic group exhibited higher levels of anxiety, depression, pain catastrophization, central sensitization, pain duration, and more pain locations, along with poorer sleep quality, quality of life, and health status. In contrast, the nociceptive group exhibited restricted maximal mouth opening (MMO), heightened pain during TMJ palpation and mouth opening, and a greater positive response to manual therapy. Across all features, psychological factors, pain locations, and MMO primarily contributed to the separation of subgroups. By adopting a data-driven approach, these results support the significant role of considering the neurobiological basis of pain to improve patient classification. This knowledge may facilitate clinical reasoning and personalized treatments. PerspectiveThis study used a network analysis to explore the complex biopsychosocial interactions present in people with TMDs, identifying important variables such as the Central Sensitization Inventory and pain-free maximal mouth opening. The findings distinguish potential nociceptive and nociplastic pain subgroups, offering important insights for targeted therapeutic strategies.

S2031 Oral Health Characteristics in US Adults With and Without Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

S2031 Oral Health Characteristics in US Adults With and Without Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Menstrual health characteristics, knowledge, and perceived effects on performance in female athletes competing at the 2023 ICC Women’s T20 World Cup

Menstrual health characteristics, knowledge, and perceived effects on performance in female athletes competing at the 2023 ICC Women’s T20 World Cup

On the issue of the effectiveness of the civil law method in the regulation of health protection relations

The subject of the study is the rights of citizens to health protection, as well as the possibility of their transformation in the direction of strengthening the legal nature of these relations. In the context of the dominance of the sectoral approach in law, the author develops ideas about subjective law as an effective regulator of patient behavior. The opinion is expressed that the responsibility of the subject's independent choice can give a new impetus to improving the level of quality indicators of medical care, ensuring the timeliness, qualification and comprehensiveness of examinations. An attempt has been made to shift the focus in the process of streamlining relations from the subject of legal regulation to methods. New opportunities have been identified to increase the level of the legal nature of court decisions that can take into account the objective need to expand the scope of private law (civil) ways of influencing the patient on the medical process. The dialectical method has become the main research method. The conditions for improving medical care are revealed, taking into account the differences between public law and civil law regulatory methods in solving problems of law enforcement practice. The scientific novelty is that the examples of legal practice have provided new knowledge necessary for the development of existing doctrinal approaches in legal science. The limitations of the sectoral approach in law, due to the high degree of dynamism of society, are convincingly argued. It has been established that orientation to the subject of legal regulation, as an unconditionally dominant factor in choosing a strategy and tactics for streamlining relations, does not always ensure the completeness of the legal nature of judicial acts. The emphasis of legal regulation in health protection is focused on the priority use of public law (or "organizing") methods that guarantee the mass provision of medical care designed for everyone. The possibility of providing quality indicators of care to a specific patient with special health characteristics and conditions for receiving it is still secondary. It is necessary to actively apply civil law methods of protecting the right to health protection, while skillfully using the resource potential of the law.