Comprehensive Health Assessment Research Articles

Targeting Aging and Longevity with Exogenous Nucleotides (TALENTs): Rationale, Design, and Baseline Characteristics from a Randomized Controlled Trial in Older Adults.

Nucleotides (NTs), important biomolecules involved in numerous cellular processes, have been proposed as potential candidates for anti-aging interventions. However, whether nucleotides can act as an anti-aging supplement in older adults remains unclear. TALENTs is a randomized, double-blinded, placebo-controlled trial that evaluates the efficacy and safety of NTs as an anti-aging supplement in older adults by exploring the effects of NTs on multiple dimensions of aging in a rigorous scientific setting. Eligible community-dwelling adults aged 60-70 years were randomly assigned equally to two groups: nucleotides intervention group and placebo control group. Comprehensive geriatric health assessments were performed at baseline, 2-months, and 4-months of the intervention. Biological specimens were collected and stored for age-related biomarker testing and multi-omics sequencing. The primary outcome was the change from baseline to 4 months on leukocyte telomere length and DNA methylation age. The secondary aims were the changes in possible mechanisms underlying aging processes (immunity, inflammatory profile, oxidative stress, gene stability, endocrine, metabolism, and cardiovascular function). Other outcomes were changes in physical function, body composition and geriatric health assessment (including sleep quality, cognitive function, fatigue, frailty, and psychology). In the RCT, 301 participants were assessed for eligibility and 122 were enrolled. Participants averaged 65.65 years of age, and were predominately female (67.21%). All baseline characteristics were well-balanced between groups, as expected due to randomization. The majority of participants were pre-frailty and had at least one chronic condition. The mean scores for physical activity, psychological, fatigue and quality of life were within the normal range. However, nearly half of the participants still had room for improvement in cognitive level and sleep quality. This TALENTs trial will represent one of the most comprehensive experimental clinical trials in which supplements are administered to elderly participants. The findings of this study will contribute to our understanding of the anti-aging effects of NTs and provide insights into their potential applications in geriatric healthcare.

Design and implementation of the Our Health Counts (OHC) methodology for First Nations, Inuit, and Metis (FNIM) health assessment and response in urban and related homelands.

Methods for enumeration and population-based health assessment for First Nations, Inuit, and Metis (FNIM) living in Canadian cities are underdeveloped, with resultant gaps in essential demographic, health, and health service access information. Our Health Counts (OHC) was designed to engage FNIM peoples in urban centres in "by community, for community" population health assessment and response. The OHC methodology was designed to advance Indigenous self-determination and FNIM data sovereignty in urban contexts through deliberate application of Indigenous principles and linked implementation strategies. Three interwoven principles (good relationships are foundational; research as gift exchange; and research as a vehicle for Indigenous community resurgence) provide the framework for linked implementation strategies which include actively building and maintaining relationships; meaningful Indigenous community guidance, leadership, and participation in all aspects of the project; transparent and equitable sharing of project resources and benefits; and technical innovations, including respondent-driven sampling, customized comprehensive health assessment surveys, and linkage to ICES data holdings to generate measures of health service use. OHC has succeeded across six urban areas in Ontario to advance Indigenous data sovereignty and health assessment capacity; recruit and engage large population-representative cohorts of FNIM living in urban and related homelands; customize comprehensive health surveys and data linkages; generate previously unavailable population-based FNIM demographic, health, and social information; and translate results into enhanced policy, programming, and practice. The OHC methodology has been demonstrated as effective, culturally relevant, and scalable across diverse Ontario cities.

Examining the Changes in Problem Behaviours and Communication of Persons with Intellectual and Developmental Disabilities after Transitioning from an Institutional Setting to the Community

Worldwide, the community transition process away from institutions has increased in the past 30–50 years among persons with severe intellectual and developmental disabilities. This process, also known as “deinstitutionalization”, could potentially impact problem behaviors and communication. This study examined the impacts of community transitions on behavioural and communication outcomes in Canadians with intellectual and developmental disabilities. Data were collected using the Comprehensive Health Assessment Program and medical chart reviews. Descriptive, aggregate-level, and individual-level analyses were conducted for 32 adults who transitioned to community living. Descriptive analyses and the McNemar Chi-Square Test were conducted. Following community transitions, the study group experienced a significant decrease in problem behaviours and changes in communication. The study findings suggest that deinstitutionalization could provide effective strategies for addressing problem behaviors and fostering improvements in communication, promoting the well-being and quality of life of persons with intellectual and developmental disabilities.

IJCM_33A: Comprehensive Women’s Wellness and Family Welfare Clinic: A Promising Approach for Holistic Healthcare in PGIMER Satellite Sangrur, Punjab

Background: Women’s health disparities, often rooted in sociocultural discrimination, prompted the establishment of the ‘Women’s Wellness and Family Welfare Clinic.’ Objective: The objective of this clinic was to address the adolescents and women-related issues, screening, counselling, mental health, diet and nutrition and, family planning services under one roof. Methodology: The initiative was launched in September 2023 with collaborative efforts between the Department of Community Medicine & SPH and the Department of Gynaecology and Obstetrics at the PGIMER satellite center in Sangrur, Punjab. The clinic comprehensively, recorded socio-demographic profiles, clinical histories and various health dimensions, including physical parameters, mental well-being, social factors, NCD risks, and family planning. Positive screening results prompted referrals for further evaluation. Results: A total of 252 participants underwent screening, of whom 98 (38.9%) were aged 30-39, 32 (12.7%) were planning pregnancy, and 146 (57.6%) were using contraception, with tubal ligation being a prevalent choice 64 (43.4%). Beyond gynaecological concerns, participants reported chronic lower backache (59; 23.4%) and numbness of hands or feet (56; 22.2%) as common symptoms. More than one-third, 96 (39.09%), were found to be at risk for non-communicable diseases (NCDs), with 19 (7.5%) having hypertension, 10 (3.9%) with pre- diabetes/diabetes, and 5 (2%) presenting with breast lumps. Visual Inspection with Acetic Acid (VIA) revealed a 1.2% positivity rate among 117 participants. However, 161 (63%) participants had a BMI over 25, and 121 (48%) consumed fried snacks daily. Domestic abuse was reported by a mere 2 (0.4%) participants, shedding light on the clinic’s potential role in uncovering hidden health issues. Conclusion: The success of this initiative underscores the feasibility of the model wellness clinic in an evolving phase of satellite centre. By offering comprehensive health assessments and facilitating timely referrals, the clinic stands as a promising approach to enhance early detection and treatment, contributing to the holistic well-being of women.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study.

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. DERR1-10.2196/51298.

Irritable bowel syndrome and erectile dysfunction in medical students at a Peruvian university: an analytical cross-sectional analysis.

There is inconclusive evidence regarding the role of irritable bowel syndrome (IBS) in the development of erectile dysfunction (ED), especially among medical students due to high academic stress. To determine the association between IBS and ED in medical students from a Peruvian university in 2022. An analytical cross-sectional study was conducted with secondary data analysis on 133 medical students from a university in northern Peru during the 2021-II academic semester. The dependent variable was ED as measured with the 5-item International Index of Erectile Function, and the exposure variable was IBS as assessed with the Rome IV-Bristol questionnaire. The results were the prevalence rates of IBS and ED and the association of these variables. Of the 133 medical students surveyed, the median age was 22years (IQR, 19-24). The median score on the 5-item International Index of Erectile Function was 21 (IQR, 10-24). The prevalence of ED was 38.4% (95% CI, 30.05%-47.17%). Among the medical students 3% and 9% displayed moderate and severe ED, respectively, and 24.8%, 13.5%, and 24.1% showed moderate depressive, anxious, and severe symptoms. An overall 10.5% had IBS. Medical students with IBS had a 108% higher prevalence of ED than those without the syndrome (prevalence ratio, 2.08; 95% CI, 1.06-4.06). Other confounding variables were not significantly associated (P > .05). The results underline the importance of comprehensive sexual and mental health assessment, with an emphasis on the relationship between IBS and ED in medical students. Strengths include the use of validated and reliable instruments and rigorous biostatistical methods, and this is the first Peruvian investigation to explain the association between IBS and ED in medical students. Limitations include the cross-sectional design and nonprobability sampling, and there may be bias in applying the instruments. This study reveals a significant association between IBS and a higher prevalence of ED in these students.

A STUDY ON INTERDISCIPLINARY COOPERATIVE TEACHING OF PHYSICAL EDUCATION TEACHERS IN THE CONTEXT OF PHYSICAL EDUCATION AND HEALTH CURRICULUM INTEGRATION

Integrating physical education and health curriculum has become a prevalent trend, aiming to promote students overall well-being. This research investigates the interdisciplinary cooperative teaching practices of physical education teachers in this integrated curriculum context, exploring the application of health assessment tools and methods and the formulation of individualized exercise plans. Utilizing a mixed-methods approach, the study combines qualitative and quantitative data collection and analysis techniques involving physical education teachers, health professionals, and students from selected schools. The findings reveal the current status of curriculum integration, highlighting challenges and opportunities, and delve into the utilization of health assessment tools for physical fitness, physiological health, and psychological well-being evaluations. Case studies and best practices elucidate the process of developing individualized exercise plans based on these comprehensive health assessments. The research proposes strategies for effective interdisciplinary cooperative teaching, offers recommendations for the appropriate selection and application of health assessment tools and personalized exercise plans, and discusses limitations and future research directions. This study contributes to the growing knowledge of curriculum integration and interdisciplinary collaboration in physical and health education, informing educational policymakers, curriculum designers, and practitioners in promoting holistic student development. KEYWORDS: Sports and Health Curriculu, Integration, Physical Education Teachers, Interdisciplinary

The Burden of Tungiasis (Jiggers’ Infestation) and Its Impact on Rural Vulnerable Populations in Kenya: A Comprehensive Health Assessment on Muranga County, Kenya

Tungiasis, commonly known as jiggers’ infestation, poses significant health challenges within the vulnerable rural population in Kenya. This parasitic skin disease is caused by the female sand flea Tunga penetrans and primarily affects individuals living in impoverished and overcrowded conditions. The infestation leads to severe discomfort, pain, inflammation, and secondary infections, impacting the physical and mental well-being of those affected. This abstract aims to assess the health challenges brought by tungiasis in rural Kenya and especially in Muranga County, highlighting the need for effective prevention strategies, treatment interventions, and public health education to combat this neglected tropical disease. It will also aim at providing an overview of a study conducted to assess the health challenges associated with tungiasis in Muranga County, Kenya. It will also explore the significant health challenges and effects of tungiasis which is also known as jigger’s infestation on rural population in Kenya and provide recommendations on means and measures that should be taken by the department of public health within the ministry of health of Kenya and other stakeholders in improving healthcare conditions for the focus population and transform the plea of this rural population and other rural populations affected within Kenya.

Using big data to analyze the vaccination status of children with congenital heart disease in Yinzhou District, China

ABSTRACT Congenital heart disease (CHD) represents a significant population warranting particular attention concerning vaccination coverage. To comprehend the vaccination status of CHD within Yinzhou District, Ningbo City, China, and to facilitate the formulation of preventive, control, and immunization strategies against vaccine-preventable diseases in children with congenital heart conditions. Using the China Yinzhou Electronic Health Record Study (CHERRY) database, we analyzed the vaccination coverage of children with CHD born between January 1, 2016 and September 20, 2021, and analyzed the influencing factors associated with the level of vaccination coverage. This study involved 762 children diagnosed with CHD at the age of 12 months, revealing that 86.74% of these children had received at least one dose of the National Immunization Program (NIP) vaccines. The coverage for non-NIP vaccines, such as the rotavirus vaccine, influenza vaccine, Influenza Haemophilus influenzae Type b (Hib) Conjugate Vaccine, 13-valent pneumococcal conjugate vaccine (PCV13), and inactivated enterovirus type 71 vaccine (EV71), stood at 27.30%, 7.74%, 63.25%, 33.76%, and 34.51%, respectively. The completion coverage for the entire vaccination schedule were 27.30%, 5.51%, 55.77%, 34.25%, and 25.59%, respectively. There was a statistically significant correlation between vaccination coverage in classification of diagnostic medical institutions and the types of diagnosed diseases. Compared to their typically developing counterparts, 12-month-old children afflicted with CHD exhibit a slightly diminished vaccination coverage, alongside a discernible inclination toward delayed vaccination. Notably, the determination to undergo vaccinations seems predominantly influenced by the classification of diagnostic medical institutions. In practical terms, proactive measures involving early diagnosis, comprehensive health assessments, and timely interventions ought to be implemented to enhance vaccination rates while prioritizing safety.

Medical Sensors and their Integration in Wireless Body area Networking for Pervasive Healthcare Delivery

Wireless Body Area Networks (WBANs) integrate diverse sensors like heart rate monitors, electrocardiograms, pulse oximeters, respiration rate sensors, gyroscopes, and skin conductance sensors into a network for pervasive healthcare delivery. This interconnected system enables real-time monitoring and data fusion, ensuring accurate and comprehensive health assessments. Efficient communication protocols, cloud integration, and power management enhance the reliability and longevity of wearable devices. Security measures and user-friendly interfaces prioritize the protection of sensitive health data and ease of access. Machine learning algorithms contribute to predictive analytics for early detection of health issues. WBANs offer a holistic approach to personalized healthcare, allowing for continuous and remote monitoring of physiological parameters. The seamless integration of these sensors establishes a foundation for timely intervention and improved patient outcomes.

Estimating the direct effects of the genetic liabilities to bipolar disorder, schizophrenia, and behavioral traits on suicide attempt using a multivariable Mendelian randomization approach.

Bipolar disorder (BD) and schizophrenia (SZ) are associated with higher odds of suicide attempt (SA). In this study, we aimed to explore the effect of BD and SZ genetic liabilities on SA, also considering the contribution of behavioral traits, socioeconomic factors, and substance use disorders. Leveraging large-scale genome-wide association data from the Psychiatric Genomics Consortium (PGC) and the UK Biobank (UKB), we conducted a two-sample Mendelian randomization (MR) analysis to evaluate the putative causal effect of BD (41,917 cases, 371,549 controls) and SZ (53,386 cases, 77,258 controls) on SA (26,590 cases, 492,022 controls). Then, we assessed the putative causal effect of BD and SZ on behavioral traits, socioeconomic factors, and substance use disorders. Considering the associations identified, we evaluated the direct causal effect of behavioral traits, socioeconomic factors, and substance use disorders on SA using a multivariable MR approach. The genetic liabilities to BD and SZ were associated with higher odds of SA (BD odds ratio (OR) = 1.24, p = 3.88 × 10-12; SZ OR = 1.09, p = 2.44 × 10-20). However, while the effect of mental distress (OR = 1.17, p = 1.02 × 10-4) and risk-taking (OR = 1.52, p = 0.028) on SA was independent of SZ genetic liability, the BD-SA relationship appeared to account for the effect of these risk factors. Similarly, the association with loneliness on SA was null after accounting for the effect of SZ genetic liability. These findings highlight the complex interplay between genetic risk of psychiatric disorders and behavioral traits in the context of SA, suggesting the need for a comprehensive mental health assessment for high-risk individuals.

Subjective memory complaints and medication adherence among hypertensive Korean older adults with multimorbidity: mediating effect of depression and social support

Background & Aim(s)Medication adherence (MA) is a key factor in maintaining adequate blood pressure and preventing complications. However, some older adults experience difficulties in taking medicine properly due to declines in cognitive function. Although subjective memory complaints (SMC) are recognized as early markers of cognitive impairment, previous studies concerning the relationship between MA and cognitive function have focused only on objective cognitive function. Furthermore, while depression has a high correlation with SMC, low MA, and social support, there is limited evidence on their relationship. This study aims to understand the effect of SMC on MA and the mediating effect of depression and social support.Method(s)This study is a descriptive cross-sectional investigation. A sample of 195 community-dwelling hypertensive older adults with multimorbidity from 3 community senior centers in Gwangju, South Korea were recruited through convenience sampling. Data was collected through face-to-face survey from January to March 2018. The PROCESS macro v4.2 program [Model 6] was used to analyze the mediating effect of depression and social support in the relationship between SMC and MA. Data analysis was performed using SPSS/WIN 26.0 and STATA MP 17.0.ResultsThe average MA was 6.74. There were significant differences in MA according to awareness of prescribed drugs, awareness of side effects, insomnia, and healthcare accessibility. SMC was positively correlated with depression, while social support and MA were negatively correlated. While depression was a significant mediator of the effect of SMC on MA, the mediating effect of social support was not significant. The multiple mediation effect of depression and social support was not significant.ConclusionThe results suggest that medication management of older adults in community settings should be accompanied by a comprehensive health assessment of associated factors. Health professionals should explore strategies to improve memory as well as prevent and alleviate depression to increase MA among hypertensive older adults with multimorbidity.

(349) Shining a Light on Women's Sexual Health: Insights from Patients Presenting with Sexual Dysfunction

Abstract Introduction Sexual health is an essential component of overall health and wellbeing, and its importance in women's lives has often been neglected in clinical practice due to cultural, social, and educational barriers. Fortunately, in recent years, there has been a growing awareness and emphasis on women's sexual health, with increasing research attention dedicated to addressing this issue. Objective In this context, this study aims to contribute to the growing body of knowledge on women's sexual health by examining the characteristics of women who present for treatment of sexual dysfunction. Methods Women who presented with sexual dysfunction to our clinic from July 2022 to June 2023 were enrolled in this study and administered the PHQ-9 and FSFI surveys. In addition, hormone levels, demographic data, and pertinent medical history were collected at this time. Descriptive statistics and logistic regression analyses were used to identify factors associated with presentation for treatment. Results A total of 26 women with a mean age of 52 (SD=2.4) participated in this study. 10 (38.5%) women presented with low estradiol levels, and 4 (15.4%) women with low testosterone, although mean levels thereof were 53.7 (SD=18.9) and 72 (SD=16.8), respectively. Most women (15, 57.7%) reported mild to moderate depressive symptoms on PHQ-9 with a mean score of 7.53 (SD=1.08), but only 2 reported a formal diagnosis of depression. Somewhat expectedly, 24 (92.3%) women report an FSFI score less than 26 (mean=17.9, SD=1.63), corroborating their subjective experience. Additionally, logistic regression demonstrates that depressive symptoms have a strong relationship (R=0.63) with increased pain during intercourse (p=0.014) and decreased sexual satisfaction (p=0.002). Conclusions These results provide valuable insights into the characteristics of women who present for treatment of sexual dysfunction. The findings suggest that low hormone levels, particularly estradiol, may be a contributing factor to sexual dysfunction in some women. The high prevalence of depressive symptoms reported in our study highlights the need for clinicians to recognize and address the mental health concerns of these patients as well. It also underscores the importance of comprehensive sexual health assessments, including hormone level evaluations and mental health screenings, in the management thereof, though our findings are limited by a small sample size and lack of follow up and further studies are still needed. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast.

Frequency of Physical Activity in Acute or Chronic Smoker among General Population of Karachi - A Cross-Sectional Study

Background: This research aims to evaluate the frequency of physical activity among acute or chronic smokers in Karachi's general population, recognizing the reciprocal influence between smoking and physical activity on overall health. Assessing exercise frequency among smokers is crucial, considering the commonly observed association between smoking and declining bodily functions, making it pivotal for comprehensive health assessment. Methods: In this study, a cross-sectional survey involved 316 healthy adults aged 15-69 years, utilizing convenience sampling is used for diverse demographic representation. Data on demographic details, smoking status, and physical activity levels were collected through the International Physical Activity Questionnaire (IPAQ). The subsequent analysis, conducted using SPSS version 0.22, aimed to scrutinize the impact of smoking on participants' physical activity. Results: Among the participants, a majority (76.9%) held jobs with varying physical activity levels. For transportation, nearly all employed modes showed varying physical activity intensities, with 59.8% reporting low, 25.3% moderate, and 14.9% vigorous activity levels. Engagement in household chores and family care displayed diverse physical activity levels: 66.5% reported low, 24.1% moderate, and 9.1% vigorous activities. Similar trends were observed for house maintenance and family care, with 69.0% reporting low, 14.6% moderate, and 16.5% vigorous activities. Conclusion: The study indicates that smokers participate in physical activity less frequently, underscoring the need for heightened attention to their exercise habits. These findings underscore the importance of tailoring health strategies for smokers and examining lifestyle factors influencing their physical well-being. Keywords: Physical Activity, METs, Smoking, Well-being.

Monitoring of Sweat Ions and Physiological Parameters via a Reconfigurable Modular System.

In recent years, wearable sensors have revolutionized health monitoring by enabling continuous, real-time tracking of human health and performance. These noninvasive devices are usually designed to monitor human physical state and biochemical markers. However, enhancing their functionalities often demands intricate customization by designers and additional expenses for users. Here, we present a strategy using assembled modular circuits to customize health monitoring wearables. The modular circuits can be effortlessly reconfigured to meet various specific requirements, facilitating the incorporation of diverse functions at a lower cost. To validate this approach, modular circuits were employed to develop four distinct systems for in vitro evaluations. These systems enabled the detection of sweat biomarkers and physical signals under various scenarios, including sedentary state, exercise, and daily activities with or without incorporating iontophoresis to induce sweat. Four key sweat markers (K+, Ca2+, Na+, and pH) and three essential physical indicators (heart rate, blood oxygen levels, and skin temperature) are selected as the detection targets. Commercial methods were also used to evaluate the potential for effective health monitoring with our technique. This reconfigurable modular wearable (ReModuWear) system promises to provide more easy-to-use and comprehensive health assessments. Additionally, it may contribute to environmental sustainability by reusing modules.

“Great day! But now what?” Adolescents’ and foster carers’ experiences of a comprehensive health assessment for children in out-of-home care

Children in out-of-home care have extensive mental and physical health care needs. Best practice guidelines recommend comprehensive health assessments to all children entering out-of-home care, as their needs are often unidentified and unmet. The aim of this study was to explore adolescents’ and foster carers’ experiences and expectations after participating in a comprehensive multi-disciplinary health assessment. Within two weeks of the assessment day, nine adolescents (aged 11–17 years), and 12 foster carers were interviewed, and asked to share what they thought about the encounters and the tasks from the assessment day. Based on these experiences, further conversations explored relevant issues from contemporary life, and prospects for the future. Through Interpretative Phenomenological Analyses, three major themes were identified as the main findings. First, the participants felt seen and involved, taken care of and taken seriously throughout the assessment day. Adolescents and carers had concordant views on what made the environment feel safe, despite the potentially demanding comprehensiveness and topics of the assessment. Second, the assessment was perceived as relevant, and gave access to enhanced understanding, although the adolescents and the carers expressed divergent views on the perceived importance of the assessment and how it related to their daily lives. The third theme referred to feeling hopeful, but powerless facing the future, and the uncertainty regarding what would happen with the identified needs and recommendations for services. Our results suggest that the assessment day was manageable, understandable and acceptable, but the engagement and involvement from the assessment day did not transfer to the expectations for follow-up.

The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing.

This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response. This study used a descriptive, qualitative exploratory design and was informed by Systems Theory. The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed. The Standards for Reporting Qualitative Research (SRQR) guidelines were used. Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation. This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents. Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system. The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises. No patient or public contribution.

Risk factors of reattempt among suicide attempters in South Korea: A nationwide retrospective cohort study.

This study aimed to identify underlying demographic and clinical characteristics among individuals who had previously attempted suicide, utilizing the comprehensive Health Insurance Review and Assessment Service (HIRA) database. Data of patients aged 18 and above who had attempted suicide between January 1 and December 31, 2014, recorded in HIRA, were extracted. The index date was identified when a suicide attempt was made within the year 2014. The medical history of the three years before the index date and seven years of follow-up data after the index date were analyzed. Kaplan-Meier estimate was used to infer reattempt of the suicide attempters, and Cox-proportional hazard analysis was used to investigate risk factors associated with suicide reattempts. A total of 17,026 suicide attempters were identified, of which 1,853 (10.9%) reattempted suicide; 4,925 (28.9%) patients had been diagnosed with depressive disorder. Of the reattempters, 391 (21.1%) demonstrated a history of suicide attempts in the three years before the index date, and the mean number of prior attempts was higher compared to that of the non-reattempters (1.7 vs.1.3, p-value < 0.01). Prior psychiatric medication, polypharmacy, and an increase in the number of psychotropics were associated with suicide reattempt in overall suicide attempters. (Hazard ratio (HR) = 3.20, 95% confidence interval [CI] = 2.56-4.00; HR = 2.42, 95% CI = 1.87-3.14; HR = 19.66, 95% CI = 15.22-25.39 respectively). The risk of reattempt decreased in individuals receiving antidepressant prescriptions compared to those unmedicated, showing a reduction of 78% when prescribed by non-psychiatrists and 89% when prescribed by psychiatrists. Similar risk factors for suicide reattempts were observed in the depressive disorder subgroup, but the median time to reattempt was shorter (556.5 days) for this group compared to that for the overall attempters (578 days). Various risk factors including demographics, clinical characteristics, and medications should be considered to prevent suicide reattempts among suicide attempters, and patients with depressive disorder should be monitored more closely.

Digital child health: opportunities and obstacles. A joint statement of European Academy of Paediatrics and European Confederation of Primary Care Paediatricians.

The advancement of technology and the increasing digitisation of healthcare systems have opened new opportunities to transform the delivery of child health services. The importance of interoperable electronic health data in enhancing healthcare systems and improving child health care is evident. Interoperability ensures seamless data exchange and communication among healthcare entities, providers, institutions, household and systems. Using standardised data formats, coding systems, and terminologies is crucial in achieving interoperability and overcoming the barriers of different systems, formats, and locations. Paediatricians and other child health stakeholders can effectively address data structure, coding, and terminology inconsistencies by promoting interoperability and improving data quality and accuracy of children and youth, according to guidelines of the World Health Organisation. Thus, ensure comprehensive health assessments and screenings for children, including timely follow-up and communication of results. And implement effective vaccination schedules and strategies, ensuring timely administration of vaccines and prompt response to any concerns or adverse events. Developmental milestones can be continuously monitored. This can improve care coordination, enhance decision-making, and optimise health outcomes for children. In conclusion, using interoperable electronic child health data holds great promise in advancing international child healthcare systems and enhancing the child's care and well-being. By promoting standardised data exchange, interoperability enables timely health assessments, accurate vaccination schedules, continuous monitoring of developmental milestones, coordination of care, and collaboration among child healthcare professionals and the individual or their caregiver. Embracing interoperability is essential for creating a person-centric and data-driven healthcare ecosystem where the potential of digitalisation and innovation can be fully realized.

Exploring Adolescent Pregnancy Expectations in Continuity of Midwifery Care: A Qualitative Study in Indonesia

Introduction: Adolescent pregnancy presents a significant challenge to global reproductive health, including in Indonesia. The unique obstacles that young pregnant women encounter when seeking appropriate and supportive healthcare services call for a deeper understanding to improve maternal care. Purpose: This study aims to explore the expectations of young pregnant women regarding continuous midwifery care in Indonesia. Method: This research employed an exploratory qualitative approach, conducting 13 face-to-face interviews between January and June 2022. Participants included midwives, young mothers, a coordinating midwife, and Mother and Child Health (MCH) program holders. Interviews, lasting 1-1.5 hours, were conducted, and the interview data were rigorously analyzed thematically by the research team, strengthening data reliability through triangulation. Results: Continuity management emphasizes friendly service, privacy, clear communication, and comprehensive health assessments. Informational continuity involves comprehensive information, direct communication, attractive aids, and health education evaluation. Relational continuity highlights comprehensive maternal care, family tradition approval, reminders, and efficient care. The study underscores the importance of tailored, holistic, and culturally sensitive midwifery care for young pregnant women's overall well-being. Conclusion: This study highlights adolescent pregnant women's unique needs, focusing on continuity management, informational continuity, and relational continuity. Proposed strategies include tailored health services, comprehensive maternal education, cultural sensitivity training for healthcare providers, policy integration, and diverse research. Successfully implementing these measures can significantly enhance maternal care outcomes for Indonesian adolescents.