Experienced Symptoms Research Articles

Hemoglobin level and common mental disorder among school adolescent girls in Central Ethiopia: Structural Equation Model.

The prevalence of common mental disorder (CMD) and anemia is observed to be on the rise over time, adversely affecting the health and overall quality of life among adolescents. Extensive literature corroborates the significant impact of anemia on cognitive development, intelligence and developmental milestones. Nevertheless, the linkage between hemoglobin level and CMD emerging during adolescence remains relatively unexplored. Thus, the objective of this study was to investigate the association between hemoglobin level and CMD as well as the mediating factor among school adolescent girls residing in Central Ethiopia. A cross-sectional study design was conducted among adolescent girls attending schools in Silti Woreda, Central Ethiopia, comprising a total sample size of 516 individuals during the period from October 2-20, 2023. Hemoglobin level was adjusted for altitude, while CMD was evaluated utilising the summation score of a 20-item Self-Reporting Questionnaire. Data were analysed through fitting Structural Equation Model and the maximum likelihood estimation method. Goodness of fit was assessed using the χ2The -test statistic, Comparative Fit Index, Root Mean Square Error of Approximation, Standardised Root Mean Square Residual, Non-Normed Fit Index, Pclose and coefficient of determination (R2). The prevalence of CMD was 22.3% (95% CI: 18.6%-25.8%). Hemoglobin level (UTE = -0.73, CI: -0.93, -0.53) and experience of morbidity symptoms (UTE = 1.05; CI: 0.74, 1.38) were significantly associated with CMD. Furthermore, hemoglobin level is significantly influenced by morbidity frequency symptoms (UDE = -0.63, CI = -0.77, -0.49) and animal source food (ASF) (UDE = 0.09, CI = 0.01, 0.17). Hemoglobin level has been identified as a significant mediator of the experience of morbidity symptoms and ASF on CMD. However, household food insecurity and wealth index had no significant association with CMD. A significant proportion of adolescent girls face CMD, often linked to a lower hemoglobin level. Having a significant association with CMD, the hemoglobin level is found to mediate a significant effect of morbidity symptom experience and ASF on CMD. Hence, addressing early infection prevention, promoting ASF and treating anemia are promptly needed.

Clinicopathological features of lacrimal gland biopsy lesions in 582 Chinese patients

Background This study was conducted to assess the clinicopathological characteristics of biopsy lesions in the lacrimal gland, in response to evolving pathological technologies and the emergence of new diseases. A retrospective review of case notes was conducted for 582 patients with biopsied lacrimal gland lesions at West China Hospital of Sichuan University in China. This study, spanning from January 1, 2010, to December 31, 2021, recorded demographics, clinical features, imaging findings, histopathological diagnoses, and recurrence rates. In a cohort of 582 patients, the mean age was 47.5 years, with 318 being female. Bilateral disease was present in 127 patients. Common signs and symptoms included a palpable mass, lid swelling, proptosis, and decreased ocular movements or diplopia. The predominant pathologies identified were inflammation, epithelial tumors, and lymphoproliferative lesions. Patients with inflammation (mean 32.8 months) experienced symptoms for a longer period compared to those with lymphoproliferative lesions (mean 22.2 months) (95% confidence interval [CI] 1.53–19.27, P = 0.022). Younger patients tended to have structural lesions (mean 42.5 years) (95%CI 4.74–21.59, P = 0.003), inflammation (mean 42.9 years) (95%CI 0.46–6.57, P<0.001), or epithelial tumors (mean 46.4 years) (95%CI 6.21–12.38, P<0.001), while older patients more frequently had lymphoproliferative lesions (mean 55.7 years). The period from 2016 to 2021 saw a higher diagnosis rate of biopsied lacrimal gland lesions than from 2010 to 2015. During this later period, there was an increase in cases of immunoglobulin G4-related ophthalmic disease (IgG4-ROD) and malignant epithelial tumors, while lymphoid hyperplasia cases declined. Adenoid cystic carcinoma showed the highest recurrence rate, with lesion extent and Ki-67 index identified as independent risk factors in our study. Inflammation, epithelial tumors, and lymphoproliferative lesions were the three primary causes of lacrimal gland lesions in our study group. Among the inflammatory conditions, IgG4-ROD was the most specific. The incidence of lacrimal gland lesions has risen, particularly for IgG4-ROD. Adenoid cystic carcinoma among the lacrimal gland lesions was prone to recurrence, with the extent of the lesion and Ki-67 index serving as independent risk factors.

Distal Mononeuropathy and Nerve Release After Open and Arthroscopic Shoulder Surgery: A Matched Cohort Analysis.

The purpose of this study was to determine if patients who have undergone prior open or arthroscopic shoulder surgery and develop distal mononeuropathy (DMN) achieve the same clinical benefit after nerve release compared with those who did not have a prior shoulder procedure. Patients were identified by Current Procedural Terminology code for shoulder arthroplasty, shoulder stabilization, and rotator cuff repair and if they had an ensuing nerve release (cubital or carpal tunnel) within 2 years of shoulder surgery. Another cohort that underwent nerve release surgery for DMN with no prior history of shoulder surgery was identified and subsequently matched to the first cohort by a 3:1 (control:case) ratio. Patients were included if they were over the age of 18 years. Chart reviews and surveys stored using REDCap were used to collect demographics, surgical history, EMG/nerve conduction velocity results, postoperative symptoms, and patient-reported outcomes with a minimum 2-year follow-up. In total, 120 patients were included in this analysis (28 cases, 92 controls). The most common nerve release for DMN across both cohorts was open carpal tunnel release. Following nerve release, the case group had more postoperative persistent numbness/tingling than the control group. Both groups were similar with regard to postoperative pain, weakness, or patient-reported outcome measures. Residual postoperative numbness following nerve release was more likely to occur in the forearm for the case group than the control group. Patients with a history of arthroscopic rotator cuff repair and reverse total shoulder replacement shoulder surgery before the presentation of DMN are more likely to experience persistent numbness or tingling after nerve release surgery as well as experience symptoms in the forearm than those without prior shoulder surgery. Symptom prevalence retrospective study III.

Protocol for a pilot study: Feasibility of a web-based platform to improve nutrition, mindfulness, and physical function in people living with Post COVID-19 condition (BLEND)

Individuals with Post COVID-19 condition (PCC), or long COVID, experience symptoms such as fatigue, muscle weakness, and psychological distress, including anxiety, depression, or sleep disorders that persist after recovery from COVID-19. These ongoing symptoms significantly compromise quality of life and diminish functional capacity and independence. Multimodal digital interventions targeting behavioural factors such as nutrition and mindfulness have shown promise in improving health outcomes of people with chronic health conditions and may be beneficial for those with PCC. The BLEND study (weB-based pLatform to improve nutrition, mindfulnEss, and physical function, in patients with loNg COVID) study is an 8-week pilot randomized controlled trial evaluating the feasibility of a digital wellness platform compared to usual care among individuals with PCC. The web-based wellness platform employed in this study, My Viva Plan (MVP)®, integrates a holistic, multicomponent approach to promote wellness. The intervention group receives access to the digital health platform for 8 weeks with encouragement for frequent interactions to improve dietary intake and mindfulness. The control group receives general content focusing on improvements in dietary intake and mindfulness. Assessments are conducted at baseline and week 8. The primary outcome is the feasibility of platform use. Secondary and exploratory outcomes include a between-group comparison of changes in body composition, nutritional status, quality of life, mindfulness, physical activity, and physical performance after 8 weeks. Findings of this study will inform the development of effective web-based wellness programs tailored for individuals with PCC to promote sustainable behavioural changes and improved health outcomes.

Adolescents smartphone screen time and its association with caries symptoms experience from the Korea youth risk behavior web-based survey 2020–2021

Adolescence is a time when important changes occur in behavioral development, and previous studies have confirmed the relationship between excessive Internet use and decreased oral health behavior. Our purpose is to identify the indirect effects and behavioral factors of smartphone screen time on the caries symptom experience of adolescents. Using data from the 16–17th Korea youth risk behavior web based survey (2020–2021), we investigated the smartphone screen time of 109,796 students in middle school 1st to high school 3rd. Adolescents who used smartphones more than 6 h per week were 28% more likely to experience caries symptoms than those who used smartphones less than 2 h (odds ratio = 1.28; 95% confidence interval, 1.22–1.35). Those who consumed cariogenic drinks more than once a day were 25% more likely to experience caries symptoms, and those who brushed their teeth less than once a day were 26% more likely to experience caries symptoms (odds ratio = 1.25, 1.26; 95% confidence interval, 1.07–1.46, 1.06–1.51). Excessive smartphone screen time is associated with addictive eating habits and reduced physical activity that increase cariogenic dietary behaviors, and decrease oral health behaviors. It suggests that excessive smartphone use indirectly related to the experience of caries symptoms.

P14 A case of worsening scleroderma-associated interstitial lung disease in pregnancy – treated with tocilizumab

Abstract Introduction Systemic sclerosis is a rare, multi-system connective tissue disorder, predominantly affecting women of reproductive age, with remarkable heterogeneity in organ involvement. Pulmonary involvement, such as interstitial lung disease (ILD) and pulmonary hypertension, remains the leading cause of death. There have been reports of disease progression during pregnancy and trials are ongoing to establish a safe treatment regimen for patients with exacerbation of ILD during pregnancy. We present an interesting case where interleukin-6 (IL-6) inhibitor, tocilizumab, was successfully used to control inflammation in the lung during pregnancy, resulting in a positive outcome for both the mother and the baby. Case description Our patient was diagnosed with diffuse cutaneous systemic sclerosis with overlapping facial dermatomyositis at the age of 25. She was found to have anti Scl-70 antibody, anti-Ro antibody and weakly positive anti Jo–1 antibody. On review, she was noted to have significant Raynaud’s disease, fixed flexion deformity at the proximal interphalangeal joints as a consequence of digital ulcers. At the age of 29, minor lung fibrosis was detected in the CT, with pulmonary function tests showing FEV1 at 87%, FVC at 87%, and TLCO at 73%. She was managed with mycophenolate mofetil, hydroxychloroquine, prednisolone, sildenafil, omeprazole, and vitamin D. During active disease phases with digital ulcerations, she received iloprost and bosentan. She had her first child aged 30 without complications while off mycophenolate mofetil. Planning for another pregnancy at 34, she was advised to stop mycophenolate mofetil. During her 21st week of pregnancy, she presented with palpitations, non-productive cough, and shortness of breath. A limited sequence CTPA revealed diffuse ground-glass opacity with mid and lower zone predominance, indicating progressive inflammatory changes compared to the previous imaging. Repeat lung function tests showed significant deterioration: FEV1 at 75%, FVC at 68%, and TLCO at 57%. Her echocardiogram was normal with no evidence of pulmonary hypertension. Despite the increase in her prednisolone to 10 mg and the initiation of azathioprine, she continued to experience dyspnoea at rest. After multidisciplinary discussions and review of guidelines and literature, the decision was made to use tocilizumab to stabilise her lung disease. She received two doses, one in the second and another in the third trimester. She safely delivered a healthy baby via planned C-section, and her symptoms significantly improved postpartum, allowing her to switch back to her usual mycophenolate mofetil. Discussion The incidence of ILD is highest within the first five years of a systemic sclerosis diagnosis. Patients with anti-topoisomerase antibodies are at a higher risk of developing ILD. Synthetic DMARDs, most commonly mycophenolate mofetil, are used to induce remission, but they have teratogenic side effects in pregnancy. The FDA approved tocilizumab, a humanised monoclonal antibody against the IL–6 receptor, for management of ILD associated with systemic sclerosis. Exacerbation of ILD during pregnancy is expected, with limited case reports on using non-teratogenic DMARDs and biological agents. For systemic sclerosis-ILD, the American College of Rheumatology conditionally recommends tocilizumab as a first-line treatment option. A meta-analysis suggests tocilizumab significantly prevents worsening of FVC, though it shows no significant improvement in skin disease control. The evidence regarding the teratogenicity of IL-6 inhibitors during pregnancy is limited. While it is advisable to discontinue IL-6 inhibitors at conception, exposure during pregnancy is unlikely to cause harm. If used in the third trimester, precautions such as avoiding live vaccines for the infant until six months of age are recommended. Maternal use of IL-6 inhibitors appears compatible with breastfeeding based on limited evidence. Pre-conception counselling should optimise disease control before pregnancy, including advice on timing, drug therapy, and contraception. Women planning pregnancy should avoid incompatible drugs, and the risks and benefits of treatment should be discussed. Contraindicated immunomodulatory drugs should be switched to pregnancy-compatible alternatives before conception. In severe maternal disease, controlling the disease takes priority over potential foetal outcomes, and biologic DMARDs may be continued if necessary. In this case, the patient experienced symptoms with significant deterioration in CT and lung function tests after stopping mycophenolate mofetil to conceive. After consulting with regional experts, tocilizumab was obtained through Trust funding, which helped to limit progression of disease. Key learning points • Early treatment is cruical for improving prognosis. The goal of treatment strategies is to achieve remission by halting disease progression and ideally reversing some disease-related changes. • There are studies supporting the efficacy of tocilizumab in improving lung function tests for patients with systemic sclerosis. In the above case, the off-label use of tocilizumab saved the life of this pregnant woman. This suggests that tocilizumab may help stabilise inflammatory lung disease during pregnancy, indicating its potential use in managing severe maternal disease if other pregnancy-compatible drugs are not suitable. The decision to use tocilizumab in pregnancy involves careful consideration of the risks and benefits, with input from a multidisciplinary team to ensure comprehensive patient care.

Transactional experiences of discrimination, depressive symptoms, and ethnoracial socialization in Mexican-origin families.

Racial-ethnic discrimination is a prevalent stressor for Mexican-origin individuals that potentiates health inequities in depressive symptoms. However, existing research has primarily focused on individual-level associations between discrimination and depressive symptoms, neglecting the interdependent nature within family systems. Little is known about how one family member's discriminatory experiences relate to the depressive symptoms of others. Although ethnoracial socialization may disrupt the link from discrimination to depressive symptoms, how different ethnoracial socialization practices operate and influence parents themselves have not been examined. This study examines the associations among discriminatory experiences, depressive symptoms, and ethnoracial socialization among 604 Mexican-origin adolescents and their parents from low-income families. The findings revealed intraindividual and interindividual discrimination-depressive symptoms associations. Parental ethnoracial socialization's role in the link varied over time, individuals, and practices. Mental health research and services should consider shared and nonshared experiences among family members and adopt personalized approaches to support different family members. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Symptom perception and coping in patients with primary biliary cholangitis: a qualitative study in the context of SOMA.LIV

Patients with primary biliary cholangitis (PBC) suffer from a variety of physical complaints such as fatigue, itching or joint pain. Since little is known about the experience of symptoms and the corresponding coping strategies in this patient group, a qualitative study was conducted in which 15 patients with PBC were interviewed. The patients reported being burdened by numerous physical complaints, some of which require extensive coping and adaptation processes. By means of thematic analysis, two overarching themes could be generated from the data material: "Accepting limitations and shifting boundaries" describes the patients' challenge of redefining their own stress limits and adapting demands and expectations to their own capabilities. "Maintaining normality and reorienting" describes the tension between the desire to maintain normality and the challenge of integrating the symptoms as perceptible signs of their illness into their own self-image. The results illustrate the central role of physical symptoms in the everyday lives of many patients with PBC, the complexity of the experience of symptoms and the challenges of dealing with these symptoms. They also emphasize the supportive and mediating function of healthcare practitioners in individual symptom management.

Comparison of oral disease symptoms according to eating habits of adolescents from Korean families and adolescents from multicultural families

Objectives: This study used the 18th Youth Online Health Behavior Data to compare oral disease symptoms according to the eating habits of adolescents from Korean families and adolescents from multicultural families. The total number of subjects was 40,913. Methods: The Rao-Scott chi-square test was used to compare general characteristics, eating habits, and experience with oral disease symptoms. In the final multiple logistic regression analysis, general characteristics and eating habits-related characteristics were used as correction variables to investigate eating habits related to oral disease symptoms in Korean adolescents and adolescents from multicultural families. Results: In Korean family the experience of oral disease symptoms was found to be lower when sweet drink 5-6 times a week 0.89 times, 3-4 times a week 0.77 times, 1-2 times a week 0.65 times, and 0.56 times when not consuming them than when consuming them daily. In multicultural families, the incidence of experiencing oral disease symptoms was 0.47 times lower in those who sweet drink daily than in those who consumed them 1-2 times a week, and 0.32 times lower in those who did not consume them. Conclusions: Based on the above research results, it is thought that customized nutrition education and oral health education programs should be continuously developed and utilized to promote oral health among adolescents from Korean families and multicultural families and to change their eating habits.

Gender Nonconformity, Minority Stress, and Psychological Distress Among Sexual Minority Adolescents.

Purpose: Sexual minority adolescents (SMAs) have disproportionate experiences of mental health symptoms during adolescence, and minority stress contributes to mental health inequities among SMAs. Gender nonconformity (GNC) could place SMAs at higher risk for minority stress and subsequent mental health symptoms. The current study was designed to examine associations between GNC, minority stress, and psychological distress among SMAs. Method: SMAs ages 12-17 years (n = 455; mean age = 15.52 years) in the United States completed a cross-sectional online survey from February to July 2022, including measures of GNC, peer victimization, family rejection, negative expectations, negative disclosure experiences, internalized homonegativity, and psychological distress. We conducted path analysis to examine associations between GNC, minority stressors, and psychological distress, including indirect effects of GNC on psychological distress via minority stress. Results: In multivariable path analysis adjusted for demographic characteristics, GNC was associated with higher levels of peer victimization and negative expectations and lower internalized homonegativity among SMAs. Higher levels of peer victimization and negative expectations were associated with higher psychological distress. GNC was indirectly related to higher levels of psychological distress via higher peer victimization. Conclusions: The current study is the first to document associations between GNC and multiple minority stress experiences among SMAs, and GNC was indirectly related to psychological distress among SMAs via peer victimization. Although all SMAs would benefit from interventions designed to reduce peer victimization and increase their capacity to cope with minority stress, such interventions may be particularly beneficial for SMAs who are gender nonconforming.

Supplemental Material for Transactional Experiences of Discrimination, Depressive Symptoms, and Ethnoracial Socialization in Mexican-Origin Families

Supplemental Material for Transactional Experiences of Discrimination, Depressive Symptoms, and Ethnoracial Socialization in Mexican-Origin Families

Prevalence of Mental health and Receipt of Services in Latino Immigrants Living in Philadelphia

Abstract Background and Purpose Research shows that Latino populations are less likely to seek formal mental health services, these attitudes combined with difficulty finding affordable services impact the ability to receive a mental health diagnosis. This project examines mental health symptoms, utilization of mental health services, and socio-ecological barriers to receive mental health services among Latino immigrants, including region of origin, health insurance, immigration status, and English proficiency. Methods Data was collected between 2021-2022 by Drexel University’s CRISOL lab using a cross-sectional respondent-driven sample survey of Latinos born outside the U.S. mainland and residing in Philadelphia. The final sample included 420 Latino/a/e immigrants. Descriptive statistics and bivariate associations using Chi-square analyses were computed. Outcomes The findings revealed that 29.1% of the surveyed individuals exhibited signs of Depression, 36.1% experienced symptoms of Anxiety, 8.7% showed signs of PTSD, and 43.4% possessed one or more mental health conditions. The findings show that country of origin (p&amp;lt;.01), health insurance (p&amp;lt;.05), immigration status (p&amp;lt;.01), and language proficiency (p&amp;lt;.001) are significantly associated with whether an individual has received mental health services in the past year or in their lifetime. Of the survey population, only 39.5% of individuals with one or more mental issues had received mental health services in their lifetime. Conclusions Interventions to increase access to mental health services for Latino communities are needed. Solutions addressing disparities in access to mental health services must address systemic, cultural, and language barriers. Key messages • Region of origin, health insurance, immigration status, and English proficiency impact the utilization of mental health services. • Immigrant populations face stressors that increase the risk for mental health disease and experience multiple barriers to access mental health services.

Complete extraction of main pancreatic duct residual and microstones using an 8-wire basket catheter

Extracorporeal shock wave lithotripsy (ESWL), pancreatoscopy-guided electrohydraulic lithotripsy (EHL), and endoscopic retrograde cholangiopancreatography (ERCP) are primary treatments for symptomatic main pancreatic duct (MPD) stones. However, incomplete clearance of residual/microstones post-treatment may cause symptom recurrence. We hypothesized that the 8-wire biliary basket catheter could be suitable for MPD stone extraction and aimed to analyze its ability to achieve more complete clearance of MPD residual/microstones. Patients suspected to have MPD residual/microstones ≤5 mm because of abdominal symptoms, computed-tomography examination results, and pancreatography results after previous therapy, including ERCP, EHL, and ESWL, were retrospectively enrolled. Patients with severe MPD stenosis/biliary obstruction requiring ERCP drainage were excluded. Extraction of residual/microstones was attempted using an 8-wire basket that is widely expandable in the narrow pancreatic duct and can capture and sweep stones in the narrow pancreatic duct. Technical success was defined as the extraction of residual/microstones. The primary outcome was the technical success rate. Secondary outcomes were therapeutic details of stone extraction using the 8-wire basket catheter, including symptom improvements. The technical success rate was 100% for seven patients; 1–8 residual/microstones were extracted. An improvement was observed in five patients with symptoms after the previous therapy. Three patients underwent residual stone extraction after extraction using a dedicated basket. No patient experienced symptom recurrence during the 270-day follow-up period. The 8-wire basket resulted in successful MPD residual/microstone extraction and pancreatic symptom improvement. This method may prevent symptom recurrence caused by incomplete residual/microstone clearance.

Factors associated with sleeping difficulties in patients with heart failure

Abstract Background Sleeping difficulties is prevalent in heart failure (HF) and a predictor of cardiac events in patients with HF. Purpose To describes the prevalence of sleeping difficulties in patients with HF and factors associated. Method This study used data of a multicentre RCT entitled Tele-Yoga study (clincialtrials.gov:NCT03703609). Patients were included in the analysis when they were diagnosed with HF and completed a questionnaire on sleeping difficulties. Sleeping difficulties were measured with the Minimal Insomnia Symptom Scale (MISS), patients with a score a 6 or higher patients were characterised as having sleeping difficulties. Through a literature search we identified factors that could be associated with sleeping difficulties. Demographic and clinical background variables (age, sex, BMI, marital status, working status, having atrial fibrillation and/or diabetes), anxiety and depressive symptoms (Hospital Anxiety and Depression scale) and Health related Quality of Life (EQ-5D index score) were considered. Logistic regression was performed with backwards elimination of the factors considered associated with having or not having sleeping difficulties. Results In total 244 patients were included (mean age 67±10, 28% women), whereas 27% had sleeping difficulties (n = 68, a score a 6 or higher on the MISS); 28% had moderate till very severe difficulties initiating sleep (n=77), 53% had moderate till very severe problems by waking up at night (n=130), 38% had moderate till very severe problems by not feeling refreshed by sleep (n=92). The logistic regression showed that patients with sleeping difficulties were significantly more often single (27% vs. 18%, OR 0.336 P-value=0.023), more often not working (72% vs. 69%, OR 2.524, P-value=0.047) more often experienced symptoms of anxiety (45% vs. 10%, OR 4.882, P-value&amp;lt;001) and had a lower quality of life, (0.637±0.261 vs. 0.786±0.203, OR 0.042 P-Value=0.001) compared to patients with no sleeping difficulties. Conclusion Patients having symptom of anxiety were at five times greater risk of experiencing sleeping difficulties. Being in a relationship and being employed were associated with less sleeping difficulties. Additionally, patients with sleeping problems reported lower quality of life.

Factors Associated with Dental Care Utilization for Oral Disease Prevention Among Adolescents in Multicultural Families in Republic of Korea

Objectives: This study utilized data from the 2022 Korea Youth Risk Behavior Survey to examine the utilization of preventive dental care among adolescents from multicultural families and analyze the associated factors. Methods: The number of adolescents from multicultural families, based on parental nationality, was 1361. The dependent variables were asymptomatic dental visits, sealant experience, and scaling experience. The independent variables included health perception factors (subjective health status, subjective oral health status), health behaviors (fruit consumption frequency, vegetable consumption frequency, sugary drink consumption frequency, drinking experience, smoking experience), and oral health behaviors (daily tooth-brushing frequency, tooth brushing after lunch, use of oral care products, oral symptom experience). Confounding variables included demographic variables (age, grade) and socioeconomic variables (academic performance, economic level, parental education level, mother’s nationality). Statistical analyses were conducted using a complex samples cross-tabulation and complex samples logistic regression. Results: Asymptomatic dental visits were significantly associated with subjective oral health status and sugary drink consumption. Those who perceived their oral health as “Healthy” had an odds ratio (OR) of 3.34 (CI = 1.76–6.32; p &lt; 0.001), and those who perceived themselves “Normal” had an OR of 2.03 (CI = 1.08–3.82; p = 0.029). A sugary drink consumption of less than three times per week was linked with an OR of 1.68 (CI = 1.05–2.70; p = 0.031). Sealant experience was associated with brushing before bedtime (OR = 2.27, CI = 1.18–4.35; p = 0.014) and using more than one oral care product (OR = 1.97, CI = 1.27–3.07; p = 0.003). Scaling experience associated with oral symptoms (OR = 1.94, CI = 1.21–3.11; p = 0.006). Conclusions: To enhance access to preventive dental care utilization for adolescents from multicultural families, efforts are needed to raise subjective oral health awareness, improve oral health behaviors, and develop strategies that ensure timely preventive dental care.

Effectiveness of Cross Friction Massage, Manual Therapy, Gastro Soleus Complex Stretch on Foot for Heel Pain in Menopause Women

Plantar fasciitis is a common musculoskeletal problem and is a frequent source of heel discomfort. Plantar fasciitis is a widespread ailment, but its exact mechanism and aetiology are yet unknown. Most people agree that it is related to recurrent micro-trauma. However, because of the hormonal changes that follow menopause, it is more common in postmenopausal women. Because estrogen maintains the suppleness and length of the plantar fascia, the decrease in oestrogen levels is important. The inferior heel area, especially in the vicinity of the medial plantar process, as well as the medial, lateral, and lower posterior parts of the calcaneus are frequently affected by heel pain. Weight-bearing activities are usually when the patient experiences the most severe pain, and the majority of the time, a shift in the quantity or intensity of physical activity occurs before the patient experiences symptoms. This study aims to show the effectiveness of three treatment protocols for plantar fasciitis: foot and ankle manipulation combined with cross-friction massage and gastrocsoleus complex stretching.

Impact of Academic Progress on the Mental Health of Young People in Nigeria: A Case Study of Undergraduate Students in South-Western Nigeria

Background: Education is important in forging a pathway to economic opportunity and social mobility. It is widely regarded as a fundamental human right and a cornerstone of personal and social development. Method: This descriptive cross-sectional study employs a quantitative data collection approach. Four hundred individuals were interviewed using semi-structured, interviewer-administered questions through a multi-stage sampling technique. After data analysis with SPSS version 26, a chi-square test statistic was employed to determine whether there was a significant relationship between the categorical variables, with a p-value of less than 0.05. Results: Out of 400 respondents, 211 (52.8%) male and 189 (47.2%) female were questioned. Nearly half of the respondents (49.0%) were between the ages of 19 and 21 years old. According to the survey, most of the respondents (70.0%) asserted that their current academic workload is heavy, while (18.0%) and (9.0%) described their workload as moderate and light, respectively. Additionally, (60.0%) of the respondents rated their overall academic performance as good. However, only (13.0%) acknowledged that academic pressure contributes to stress and anxiety in life and (79.0%) occasionally expressed stress related to academic demands. About (11.8%) and (8.8%) of the respondents reported having been diagnosed with a mental health disorder before and experienced symptoms of depression in the past month respectively. An additional (20.0%) of respondents reported having experienced depression, while (24.5%) and (23.5%) claimed to have experienced anxiety and stress, respectively. Moreover, (11.8%) reported experiencing panic attacks, and (5.3%) mentioned having had suicidal thoughts. More than half of the respondents used to exercise (59.0%) and engaged in hobbies or interests (56.5%) as coping mechanisms for academic stress. Additionally, (45.5%) practiced mindfulness or relaxation techniques, and (25.5%) sought social support to manage their academic stress. About (32.5%) of respondents claimed they were aware of mental health support services available at their institutions, compared to (67.5%) who were unaware of these services. Of those aware, (33.1%) had utilized mental health support services. Additionally, (44.2%) of respondents were satisfied with the mental health support services on campus, while (39.5%) were very satisfied. The study also reveals that there’s no statistically significant association between the age, gender, monthly upkeep of the respondents and utilization of mental health support services. Conclusion: There is a complex connection between academic performance, psychological well-being, and the use of coping strategies and mental health support services among university students. This underscores the importance of addressing students' mental health needs alongside providing academic assistance. Keywords: Mental health, Academic performance, Mental health support services, Stress, Anxiety, Depression, Mental health coping mechanisms

Patient Experience of Living With Hemophilia A: A Conceptual Model of Humanistic and Symptomatic Experience in Adolescents, Adults, and Children

Background: People living with hemophilia A face challenges impacting their daily lives despite treatment innovations. Previous studies have explored perceptions and treatment experiences; however, there is a lack of an evidence-based, comprehensive model to identify concepts (clinical, physical, and psychological functioning) relevant for people with hemophilia A (PwHA). Objectives: The aim of this qualitative study was to address the question: What is the humanistic and symptomatic experience of adolescents, adults, and children living with hemophilia A and what is the impact of hemophilia A on their quality of life? Methods: Participants, identified through patient associations in the UK, were male PwHA and caregivers of male PwHA receiving prophylactic treatment. Qualitative research was conducted involving semistructured telephone interviews with PwHA and caregivers between April 2020 and September 2020 in the UK. Standard analytical techniques of conceptual model development were used. Results: Of 30 participants, 23 were PwHA and 7 were caregivers. A conceptual model was produced describing patient experience of symptoms, physical functioning, treatment experiences, and the impact of symptoms and treatment on daily lives. Participants reported hemophilia-related symptoms, including bleeding, pain, and joint stiffness, as well as difficulties engaging with social and leisure activities. They also reported protection from bleeds provided by their treatment, relief from symptoms, and the resultant sense of normality. Concepts were broadly relevant across all age groups; however, psychological impacts were reported only by adult PwHA, and caregivers reported impacts related to outdoor activities, play, and education. Participants indicated that their ideal treatment would be delivered orally. Discussion: This study highlights the range of symptoms experienced by PwHA across a broad range of age groups, thus enabling the evaluation of relevant concepts across different stages of life. The research supports development of a conceptual model documenting symptoms, impacts, and treatment experience relevant to PwHA. Conclusion: Insights gathered through the interviews and resulting conceptual model support development of new therapies to address the physical and social challenges identified by PwHA and highlight a need for novel hemophilia A treatments that can ease treatment administration, provide adequate level of protection, and enable life to be lived normally.

Patient Experience of Living With Hemophilia A: A Conceptual Model of Humanistic and Symptomatic Experience in Adolescents, Adults, and Children.

Background: People living with hemophilia A face challenges impacting their daily lives despite treatment innovations. Previous studies have explored perceptions and treatment experiences; however, there is a lack of an evidence-based, comprehensive model to identify concepts (clinical, physical, and psychological functioning) relevant for people with hemophilia A (PwHA). Objectives: The aim of this qualitative study was to address the question: What is the humanistic and symptomatic experience of adolescents, adults, and children living with hemophilia A and what is the impact of hemophilia A on their quality of life? Methods: Participants, identified through patient associations in the UK, were male PwHA and caregivers of male PwHA receiving prophylactic treatment. Qualitative research was conducted involving semistructured telephone interviews with PwHA and caregivers between April 2020 and September 2020 in the UK. Standard analytical techniques of conceptual model development were used. Results: Of 30 participants, 23 were PwHA and 7 were caregivers. A conceptual model was produced describing patient experience of symptoms, physical functioning, treatment experiences, and the impact of symptoms and treatment on daily lives. Participants reported hemophilia-related symptoms, including bleeding, pain, and joint stiffness, as well as difficulties engaging with social and leisure activities. They also reported protection from bleeds provided by their treatment, relief from symptoms, and the resultant sense of normality. Concepts were broadly relevant across all age groups; however, psychological impacts were reported only by adult PwHA, and caregivers reported impacts related to outdoor activities, play, and education. Participants indicated that their ideal treatment would be delivered orally. Discussion: This study highlights the range of symptoms experienced by PwHA across a broad range of age groups, thus enabling the evaluation of relevant concepts across different stages of life. The research supports development of a conceptual model documenting symptoms, impacts, and treatment experience relevant to PwHA. Conclusion: Insights gathered through the interviews and resulting conceptual model support development of new therapies to address the physical and social challenges identified by PwHA and highlight a need for novel hemophilia A treatments that can ease treatment administration, provide adequate level of protection, and enable life to be lived normally.

Case report: A Unique Case of Brainstem Anesthesia and Contralateral Amaurosis Following a Sub-Tenon Block.

To report and discuss a case of brainstem anesthesia and contralateral amaurosis following a sub-Tenon block. Single surgical case report of a patient who underwent an uncomplicated pars plana vitrectomy for an epiretinal membrane peel in the left eye following a sub-Tenon anesthesia technique. Post-operatively, the patient experienced symptoms of brainstem anesthesia as well as akinesia, a non-reactive pupil, and reduced visual acuity in the contralateral eye which gradually resolved within 24 hours. Imaging was within normal limits and did not reveal any anatomic abnormalities. Despite the use of a blunt-ended cannula in a sub-Tenon block, there is a non-negligible risk of it penetrating surrounding structures such as the optic nerve sheath. This case emphasizes the importance of monitoring for brainstem anesthesia and contralateral eye affections in patients both intra- and post-operatively.