To examine preferences for human papillomavirus (HPV) specimen self-collection, and collection location, in a nationally representative sample of reproductive-aged women in the United States. This cross-sectional analysis used household population-based data from the National Survey of Family Growth (January 2022-December 2023) and was limited to women aged 21-49 years without a history of hysterectomy or cervical cancer (sample n=4,465). Survey weights and design variables were applied to generate nationally representative population frequencies and percentages of preference for HPV self-collection compared with clinician collection, and preference for collection location (ie, at home or in office). Among eligible U.S. women, 42.9% preferred HPV self-collection, 28.5% preferred clinician collection, and 28.6% expressed no preference. An estimated 41.7 million (71.5%) U.S. women aged 21-49 years were open to HPV self-collection (either preferring it or having no preference), including 9.7 million women who were underscreened or never screened. Among women who were open to HPV self-collection, more than half (52.1%) preferred self-collection at home, 14.7% preferred to do self-collection in a doctor's office, and 33.2% had no preference for location. More underscreened or never-screened women preferred HPV self-collection (54.0%) and at-home collection (59.3%) compared with those who were up to date with screening (40.3% and 50.2%, respectively, P<.001). Preference for self-collection also varied by race and Hispanic origin, education, income, parity, sexual orientation, and prior experience of nonvoluntary vaginal intercourse. In this nationally representative study, more than 7 in 10 U.S. women aged 21-49 years were open to HPV self-collection for cervical cancer screening, with more than half favoring at-home collection. Preference was higher among women who were not up to date with screening. These findings provide timely evidence to inform future policy decisions and implementation strategies to improve access to cervical cancer screening.

Background/AimsThe existing literature indicates that clinical trial knowledge and participation is multifactorial, yet little is known about the association with digital health technology use and digital health engagement. To address this gap, we examined the multivariate association between clinical trial knowledge and participation with past-year health technology use and digital health engagement with medical providers using data from a federal surveillance system in the United States.MethodsA total of 3865 US adult respondents from the Health Information National Trends Survey 5, Cycle 4 provided data in 2020. The two outcomes were clinical trial knowledge (no knowledge, a little knowledge, a lot of knowledge) and participation (never invited, invited did not participate, invited and participated). There were four binary indicators of health technology use for the following purposes in the past year: searching for health or medical information, communicating with a doctor's office, looking up medical test results, and making medical appointments. There were four binary indicators of digital health engagement in the past year: sharing health information on social media, participating in a health forum or support group, watching health-related videos on YouTube, and awareness of ClinicalTrials.gov.ResultsSurvey-weighted multivariate regression models demonstrated that awareness of ClinicalTrials.gov had the greatest associations with clinical trial knowledge (adjusted risk ratio = 7.60, 95% confidence interval: 4.82-12.00) and participation (adjusted risk ratio = 2.60, 95% confidence interval: 1.23-5.54). Using digital technology to look for health information (adjusted risk ratio = 1.35, 95% confidence interval: 1.06-1.71) and communicate with doctor's offices were significantly associated with higher clinical trial knowledge (adjusted risk ratio = 1.64, 95% confidence interval: 1.25-2.14). Involvement in an online forum or support group was significantly associated with an increased likelihood of being invited but not participating in a clinical trial (adjusted risk ratio = 2.32, 95% confidence interval: 1.22-4.39), while using digital technology to make medical appointments was significantly associated with an increased likelihood of clinical trial participation (adjusted risk ratio = 1.79, 95% confidence interval: 1.07-2.99).ConclusionsFindings from this study can inform the design of large-scale digital health campaigns and quality improvement programs focused on increasing clinical trial participation.

Acceptance of artificial intelligence tools for medical history-taking: Findings of a population survey in Germany

"To reach the new generation… TikTok:" Applying behavioral economics to adolescent and young adult HIV pre-exposure prophylaxis education.

Abstract Background and Aims Arterial hypertension (AH) represents the main cause of cardiovascular (CV) morbidity and mortality in the period after kidney transplantation (KT). It is an independent risk factor for atherosclerosis and related CV complications including concentric left ventricular hypertrophy, heart failure, coronary artery disease and overall CV mortality. Inadequate hypertension control in the grafts leads to glomerulosclerosis, intraglomerular hypertension, proteinuria and it is a non-immunological cause of progressive graft dysfunction. KT recipients exhibit varying blood pressure (BP) measured at home, in the doctor's office and through systematic BP monitoring methods including ambulatory BP monitoring (ABPM). Method We present prospective study of CV risk factors and ABPM in cohort of patients (n = 50) transplanted from deceased (80%) and living donors (20%) during the period from January 2022 to February 2024. Follow up was 12 months after KT. Results Prior to KT 92% of patients were hypertensive, which decreased to 86% within the 1. year post-KT. Positive trends were noted in the prevalence of abnormal AH phenotypes with non-dippers and reverse dippers reduced by 8% and 4%, respectively, and normal dipping pattern restored in 12% of patients by the end of the 1. year. There was a marked decrease (35%) in the number of AH medications required, particularly in patients on triple and more AH regimens. The incidence of acute coronary syndrome within the 1. year post-KT was 8%, including STEMI, NSTEMI and unstable angina pectoris, CV events such as paroxysmal atrial fibrillation (6%), hypertensive emergencies (6%) and strokes (4%) were recorded. Graft loss occurred in 6% of patients, mortality was 6% (COVID-19, stroke, MODS). Additional findings included improvements in eGF (P = 0.022) and proteinuria (P = 0.304) comparing results from 3rd month post-KT and 12th month post-KT, and improvements in anaemia (P = 0.00000001), hyperuricemia (P = 0.024) and hyperparathyroidism (P = 0.00002) comparing results prior to KT and from 12th month post-KT. Conclusion KT significantly improves BP control, metabolic profiles and echocardiographic findings in the 1. year. Long-term strategies to minimize CV risk should include maintaining BP ˂140 mmHg, early intervention for dyslipidaemia and glucose metabolism disorders, obesity prevention and individualized immunosuppressive therapy.

Formal and informal substance use treatment utilization amongst Asian Americans.

Hypertension remains the leading cardiovascular risk worldwide. The most recent World Health Organization (WHO) Global Report on Hypertension indicated that the number of hypertensive patients has almost doubled in the last three decades, with an annual increase in deaths, disability and related costs. It is also important to note that an increasing number of hypertensive patients, despite the use of three or more drugs, do not achieve normalization of blood pressure, thus defining the clinical scenario of resistant hypertension. To confirm the presence of resistant hypertension, various causes of pseudo-resistant hypertension and secondary hypertension must be excluded. Inadequate blood pressure control should be confirmed by measuring blood pressure outside the doctor's office. Resistant hypertension affects approximately 5% of the hypertensive population and is associated with increased cardiovascular morbidity and mortality. Management includes lifestyle interventions and optimization of current drug therapy. Additional drugs should be introduced sequentially if BP remains uncontrolled, and renal denervation may be considered as an additional treatment option. However, achieving optimal blood pressure control remains a challenge in this setting. The data presented are part of the literature review/ results obtained within the institutional project with the acronym DIAFEREZIS.

BackgroundAdverse childhood experiences (ACEs) are known to predict adverse outcomes related to physical and mental health, including anxiety and depression. How ACEs predict the outcomes of interpersonal sensitivity, paranoid ideation, and hostility, which are known to be associated with impaired interpersonal relationships, interpersonal conflict and violence, is less well researched. Consequently, this study aimed to determine the extent to which the number and types of ACEs that individuals experienced were associated with these outcomes, and whether these relationships were moderated by the sociodemographic variables of age, sex, educational level, and relationship status.MethodThe study used data from a survey of 1,633 adult Jamaicans who constituted a non-probability sample. They were recruited via flyers that were placed on social media, at doctor's offices, in supermarkets, at places of work, and at educational institutions. The survey consisted of sociodemographic items, as well as the Adverse Childhood Experiences International Questionnaire (ACE-IQ) and the Symptom Checklist-90-Revised (SCL-90-R). A correlational design, using Pearson's correlation analyses, was used to assess the association between overall past ACEs and specific current interpersonal psychopathological vulnerabilities, namely interpersonal sensitivity, paranoid ideation, and hostility. Regression analyses were also used to determine which specific childhood adversities were associated with these vulnerabilities.ResultsMost participants (70.5%) reported having experienced at least four of the 13 categories of ACEs explored in the ACE-IQ. There were positive correlations among the ACE-IQ and SCL-90-R subscales of interest (interpersonal sensitivity, paranoid ideation, and hostility), with correlation coefficients ranging from 0.249 to 0.770 (p < 0.001). Emotional abuse was the most commonly reported ACE (70.5%), followed by violence in the home (69.3%), and community violence (66.9%). Seven of the 13 ACEs from the ACE-IQ were associated with all three mental health outcomes. Physical abuse had an inverse relationship with paranoid ideation, as did household alcohol or drug misuse with interpersonal sensitivity and hostility. The relationships between ACEs and the interpersonal psychopathological vulnerabilities were not moderated by the sociodemographic variables.ConclusionsThe number of ACEs (ACE-IQ score) was positively correlated with all three psychopathological outcomes. Many ACEs were associated with one or more of these outcomes. A few ACES exhibited an inverse relationship with either paranoid ideation or hostility and interpersonal sensitivity. These findings add new knowledge to an under-explored area and are discussed in relation to prior research, theory, and practice.

To quantify preferences for sexually transmitted and blood-borne infections (STBBI) testing in the general adult population in Canada. We developed an online discrete choice experiment survey and administered it to a sample of the general Canadian population aged 19 and up recruited using an online market research panel. We included six attributes based on the literature and a qualitative study: location of test administration; requisition and personal information requirement; specimen collection method; test accuracy (false-negative rate); time to result and out-of-pocket costs. The final design consisted of six blocks of 10 choice tasks, plus three choice tasks that were used for consistency checks. Data were analysed using conditional logit, mixed logit and latent class models. Analyses were based on 5113 respondents. There were positive preferences for STBBI testing using less invasive methods of testing, missing fewer infections, having a shorter time to result and lower costs. Latent class analysis identified four classes: non-testers, accuracy-driven testers, doctor's office testers and multiattribute testers. Regardless of class, accuracy and costs remained the two most important attributes. These classes had different preferences for the location of testing and requisition and personal information requirements. Compared with non-testers, multiattribute testers were more likely to be African, Caribbean and/or black; under 25 years; indicate sexual activities that would place people at high risk for acquiring HIV; and use injection drugs. Adults in the general population in Canada indicated strong preferences for low-cost and accurate tests. A variety of testing locations may be needed to reach diverse populations.

This cross-sectional retrospective survey study modeled on previous research explored the prevalence of period poverty in 1 urban setting to inform future targeted interventions toward improving menstrual equity. An 8-item questionnaire was developed by a menstrual health equity work group led by the Allentown Health Bureau, Pennsylvania. Data collection occurred for 1.5 years, using an anonymous online survey tool and convenience sampling. Study participants were recruited with an informational flier (with QR code and web address pointing to the questionnaire) posted in various public locations. A total of 353 people who menstruate, aged 13 to 54, representing 5 of Allentown's 7 ZIP code regions responded. The majority were impacted by period poverty, either by missing a life event (77.9%) or engaging in an at-risk menstrual hygiene behavior (79.0%). Most (91.5%) had been educated in menstrual health. Doctor's offices (40.3%) and social media (27.8%) were the most frequently cited sources for learning about the survey. ZIP codes were significantly associated with engaging in at-risk behaviors (P < .001), missing a life event (P < .001), no menstrual health education (P = .03), and preference for period underwear (P = .04). Age was significantly associated with preferring pads (P = .007) and tampons (P = .03). Period poverty was found to impact a substantial number of people in Allentown, Pennsylvania. Interventions will need to be tailored to ZIP code and age-group. Future study should aim for a larger sample size and additional questions, about menstrual education.

Where do children get vaccinated in the U.S.? Parental experiences, attitudes, and beliefs about place of vaccination with a focus on pharmacies and schools.

Endometriosis is a chronic and often debilitating condition affecting millions of individuals worldwide, yet it remains largely overlooked in workplace policies and practices. This study explores the systemic discrimination faced by employees with endometriosis, examining the barriers to equitable employment, career advancement, and workplace accommodations. Despite increasing recognition of menstrual health in corporate diversity and inclusion efforts, endometriosis is still not adequately addressed, leaving affected individuals vulnerable to stigma, job insecurity, and workplace exclusion. The study proposes the Endo-Inclusive Workplace Model (EIWM) as a structured framework to promote workplace inclusivity for individuals with endometriosis. EIWM consists of four key components: policy reform, flexible work arrangements, education and training, and support systems. By embedding chronic illness protections into corporate policies, offering flexible work options, educating managers on endometriosis-related challenges, and establishing employee support networks, organizations can create a more inclusive and equitable work environment. Findings highlight that workplaces adhering to the traditional “ideal worker” norm often fail to accommodate employees with chronic illnesses, leading to reduced productivity, absenteeism, and job loss. Implementing EIWM not only benefits employees with endometriosis but also enhances overall workplace morale, job satisfaction, and retention rates. This study underscores the urgent need for systemic change in workplace structures to ensure individuals with endometriosis can participate fully and fairly in the workforce. Future research should focus on evaluating the effectiveness of EIWM and expanding discussions on chronic illness inclusion in workplace diversity initiatives. “I remember the day vividly, as if it had etched itself into my mind. I was sitting in a doctor's office, overwhelmed by pain, anxiously waiting for answers. My thoughts were scattered, consumed by the uncertainty of what was happening to my body. Then, my phone buzzed. It was work, demanding a sick note before I even knew what was wrong with me. Later, instead of offering any support, she told me to write a work think piece' about my condition, mocking my struggle as if it were an inconvenience rather than a legitimate health issue. That moment was a stark realization: endometriosis is invisible in the workplace, and It's not just the physical pain that weighs on individuals. It's the stigma, the scepticism, and the lack of accommodations that turn an already difficult battle into a career-defining obstacle” FZ Juqu Keywords: (MESH terms) Endometriosis, Employment Discrimination, Social Inclusion, Chronic Disease, Health Policy, Flexible Work Arrangements, Sex Factors, Health Equity

Introduction: lung cancer is a common malignant neoplasm in adults, with a multifactorial etiology, characterized by the uncontrolled proliferation of cells from the lower respiratory tract, particularly the lung parenchyma.Objective: to characterize the level of information about lung cancer among patients belonging to Family Doctor's Office 1 in the municipality of Palma Soriano, Santiago de Cuba province.Methods: an observational, descriptive, cross-sectional study was conducted from January to April 2025. The study population consisted of 691 patients, selected through non-probabilistic intentional sampling. Descriptive statistics were used. Absolute and relative frequencies (percentage) were employed as summary measures.Results: 51.81% of the patients were female, and 29.09% belonged to the 20-34 age group. The most frequent educational level was completed secondary education (25.33%). Smoking as a risk factor was present in 20.55% of patients, and 60.35% showed an informed level about lung cancer.Conclusions: a predominance of informed patients was identified, although exposure to multiple risk factors persists, notably the smoking habit and passive smoke exposure.

Older adult fall injuries and the usage of fall screener tools.

Omental torsion is considered an uncommon cause of acute abdominal pain in patients. It is a medical condition in which the omentum pedicle, which is a tissue structure in the abdomen, rotates around its own axis. This twisting can negatively affect its blood supply, compromising its proper vascularization and can lead to complications in the patient's health. In the vast majority of clinical situations, cases tend to manifest in the right hemiabdomen. This is largely due to the fact that the omentum in this area is larger and more mobile than in other abdominal regions. As a consequence of these characteristics, it is possible for it to be confused with a frequent acute abdominal pathology, such as appendicitis. However, the presence of infarction in the omentum located on the left side of the body has also been documented, affecting either a specific portion of the omentum or even encompassing its entire extent. This phenomenon may have an origin that is considered primary or, on the contrary, it may be a secondary result of other medical conditions. A 30-year-old male patient presents at the doctor's office. He reports that he has been feeling acute abdominal pain, which has recently begun to manifest itself.

OP0372-PARE Beyond the Doctor's Office: The School and Workplace Needs of Young People Living with Rheumatic Disease

Forgone care, defined as not using health care despite needing it, leads to adverse outcomes such as increased emergency care use. Our study uses data from German representative surveys (2016, 2021, 2022) to examine the frequency, demographics, and reasons for forgone care. Multiple logistic regression models of individual cohorts and pooled data were used to assess the likelihood of forgoing a doctor's visit. Reasons for forgone care were analyzed descriptively and further clustered in different types of barriers. Of 10,122 participants, 21 % reported forgone care in the past year: 22 % in 2016, 18 % in 2021, and 20 % in 2022. The likelihood of forgone care is highest among women (OR: 1.22 [1.09; 1.37]) and younger adults aged 18-44 years (OR: 1.19 [1.05; 1.34]), whereas participants in partnerships were less likely to forgo care (OR: 0.77 [0.69; 0.87]). Barriers were categorized as systemic (e.g. waiting time; 39 %), psychological (e.g. fear of diagnosis; 22 %), and physical (e.g. difficulty reaching the doctor; 19 %). Younger adults and members of the workforce cited systemic barriers most often, whereas older adults (65+) cited psychological and physical barriers. Targeted interventions for vulnerable groups are needed that reduce barriers for forgone care. Recommendations include more accessible doctor's offices, improved appointment systems, expanded telemedicine, and flexible hours.

Introduction: Achieving an adequate nutritional status in older adults is a primary goal in the socio-health care of this population. Objective: To determine the relationship between nutritional habits and lifestyle variables, and morbidity, in older adults from Doctor's Office number 15 from June 2020 to June 2023. Method: An analytical correlational study was conducted. The universe consisted of all elderly individuals (198), and a sample of 130 elderly individuals who met the inclusion criteria was selected using a simple random sampling method. The information used was collected through the application of a questionnaire. The data obtained were arranged to search for association between variables according to the objectives set. For data processing, the absolute and relative frequency were determined, and for the association between qualitative variables, the Chi-square test was determined. Results: There is a strong association between inadequate nutritional habits, obesity, and associated morbidity, with hypertension (HTA) being the most common. When the level of physical activity was inadequate, dietary practices were also inadequate. There was a relationship between toxic and nutritional habits, with a high prevalence of smokers. Conclusions: Inadequate nutrition is among the main causes of multimorbidity in the elderly.

Introduction: Geriatric syndromes are a collection of conditions typically caused by the combination of diseases with a high prevalence in the elderly, and are a frequent source of functional or social disability. Objective: To characterize elderly individuals with Geriatric Syndromes, belonging to FDO 32 in San Cristobal. Method: An observational, descriptive, cross-sectional study was conducted in adults aged 60 years and older belonging to the population of said doctor's office of the "Camilo Cienfuegos" Polyclinic, in the period between October 2021 and April 2024. The population consisted of 410 patients over 60 years of age, and the sample consisted of 296 patients with one of the major geriatric syndromes (immobility, incontinence, instability or falls, cognitive impairment, and frailty or functional decline), who met the inclusion criteria. A questionnaire was applied to identify them, as well as instruments designed to evaluate sub-variables such as depression and mental status. The data were represented in tables and graphs, processed using descriptive statistical methods, such as percentage assessment. Results: Geriatric syndromes were more frequent in the 80 to 85-year-old age group and in females. The most prevalent syndromes were instability and frailty. Regarding functional capacity in basic activities of daily living, mild dependence was the most common, and in instrumental activities of daily living, moderate dependence.

Low birth weight is the most important predictive index of infant mortality and is an important public health problem. An investigation of cases and controls was carried out in women who gave birth to children with low birth weight, from the urban family doctor's offices belonging to the Camilo Cienfuegos Gorrieran health area of San Cristóbal, during the period 2020- 2022, with the objective of identifying the biological risk factors that were most frequently associated; 32 cases and 53 controls were studied from a universe of 521 live births. It was shown that maternal age up to 19 years and 35 years and older, insufficient weight gain during gestation, family history of prematurity, threat of preterm delivery and premature rupture of membranes, were risk factors present in the cases, and this coincides with what was reported by some authors in reviewed research. The identification of maternal factors associated with LBW will serve to strengthen promotion and prevention strategies aimed at the population at risk. Future population-based studies to extrapolate these results should be carried out in the rest of Artemisa province.