Family Level Research Articles

Causal roles of skin and gut microbiota in skin appendage disorders suggested by genetic study.

There is evidence from observational studies that human microbiota is linked to skin appendage Disorders (SADs). Nevertheless, the causal association between microbiota and SADs is yet to be fully clarified. A comprehensive two-sample Mendelian randomization (MR) was first performed to determine the causal effect of skin and gut microbiota on SADs. A total of 294 skin taxa and 211 gut taxa based on phylum, class, order, family, genus, and ASV level information were identified. Summary data of SADs and eight subtypes (acne vulgaris, hidradenitis suppurativa, alopecia areata, rogenic alopecia, rosacea, rhinophyma, seborrhoeic dermatitis, and pilonidal cyst) were obtained from the FinnGen consortium. We performed bidirectional MR to determine whether the skin and gut microbiota are causally associated with multiple SADs. Furthermore, sensitivity analysis was conducted to examine horizontal pleiotropy and heterogeneity. A total of 65 and 161 causal relationships between genetic liability in the skin and gut microbiota with SADs were identified, respectively. Among these, we separately found 5 and 11 strong causal associations that passed Bonferroni correction in the skin and gut microbiota with SADs. Several skin bacteria, such as Staphylococcus, Streptococcus, and Propionibacterium, were considered associated with multiple SADs. As gut probiotics, Bifidobacteria and Lactobacilli were associated with a protective effect on SAD risk. There was no significant heterogeneity in instrumental variables or horizontal pleiotropy. Our MR analysis unveiled bidirectional causal relationships between SADs and the gut and skin microbiota, and had the potential to offer novel perspectives on the mechanistic of microbiota-facilitated dermatosis.

Ready to Learn: A Concept Analysis for the Intersection of Health and Education.

Since the inception of the National Education Goals in 1989, the United States has enacted policies focused on student readiness to learn, but there is no single or clear definition of ready to learn. Education quality and access are social determinants of health. However, students do not learn well if they are not healthy. This concept analysis explores the connection between health and education across multiple domains. Utilizing the Walker-Avant method, CINAHL, SCOPUS, and the Journal of School Nursing were searched for literature related to ready to learn. Definitions were synthesized from the literature, resulting in a concept of ready to learn encompassing health and thriving at individual, family, school, and community levels. Ready to learn is the result of multiple domains working synergistically to support health and thriving across the lifespan. School health practice improves with a robust understanding of this ready to learn model.

Large-scale phylogenomic insights into the evolution of the Hymenochaetales

ABSTRACT The Hymenochaetales is an order with most species as wood-inhabiting fungi that have high phylogenetic complexity and morphological diversity. Species in this order play important roles in forest ecosystems and include wood decomposers, pathogens, and those that form ectomycorrhizal associations. However, we have limited knowledge of the patterns of large-scale evolutionary history of the order. In this study, using 171 genomes, including 113 newly assembled, we reconstructed the phylogenomic relationships, divergence times, biogeographic patterns, morphological evolution of basidiomata, and patterns of speciation/extinction in the Hymenochaetales. The phylogenomic relationships of 12 families within the Hymenochaetales suggested that 10 families can be accepted, and 2 families rejected. Molecular clock dating analyses suggested that the Hymenochaetales possibly started a rapid family-wide and genus-wide radiation during the early Cretaceous to late Jurassic and Cretaceous, respectively. Reconstruction of the ancestral state implied that Hymenochaetales probably originated from the temperate regions of Asia, with the basidiomata of the common ancestor likely being a corticioid species that rapidly transformed between the early Cretaceous and late Jurassic, coinciding with radiations at the family level. Furthermore, we detected a gradually increasing trend of speciation, extinction, and net diversification rates. We provided large-scale genomes of the Hymenochaetales and revealed evolutionary history patterns, which are key to understanding the evolution of fungi.

Uncovering principal factors influencing english performance in Chinese middle school students: a statistical and machine learning approach

This study delves into the predictors of English proficiency among middle school students in China, utilizing the rich dataset provided by the China Education Panel Survey (CEPS). By integrating multilevel modeling and Support Vector Regression (SVR), this research scrutinizes a broad spectrum of factors at the individual, family, class, and school levels. Key predictors identified include students’ native language proficiency (Chinese), cognitive aptitude, perceptions of English difficulty, attitudes toward English teachers, and parental involvement. The findings emphasize the significant impact of individual and family-level variables on English proficiency, highlighting the critical role of these modifiable factors (i.e. individual-level factors, such as students’ native language proficiency and perceptions and attitudes towards the English subject). The comparative analysis demonstrates that while both multilevel models and SVR offer valuable insights, their combined application yields a more comprehensive understanding of the predictors and their interactions. This dual-method approach showcases the potential of integrating multilevel modeling with support vector regression to enhance educational research, thereby informing policy and practice. The study’s insights are vital for developing targeted educational strategies and policies to support bilingual learners in China, ultimately improving language proficiency and educational outcomes.

Workplace violence against junior doctors in Iraq: implications for job satisfaction and retention

IntroductionHealth workers worldwide report being exposed to workplace violence, but those in conflict settings (or post-conflict settings) are especially targeted, as political conflict shifts societal norms. Iraq has suffered war and conflict for decades. A 2013 study of 567 Iraqi-trained physicians found nearly 2/3 had emigrated to mostly English-speaking countries; further, half of those remaining wished to leave Iraq. While prior studies have examined the phenomenon of violence against health workers in Iraq, no qualitative study has characterized Iraqi front line junior doctors’ experiences of workplace violence within a workplace violence causal framework, to inform an educational and policy response.MethodsWe consented and interviewed 73 junior physicians at six teaching hospitals across Central Iraq between December 2021, and January 2022. We analyzed 22 of the 73 conversations, after rejecting 29 because they were terminated prematurely when doctors were called away for patient care, and 22 others where doctors indicated they had no experience with workplace violence. (Our goal was to understand these interactions, not to quantify them).ResultsThe physicians we interviewed had been practicing an average 3 years since graduating from medical school (ranging from 6 months to 7 years). Interviewees represented eight hospital departments, with most coming from internal medicine and surgery. Within a socio-ecological framework, we identified two primary individual-level factors prompting patient-associated violence: patients and their families don’t understand triage (and resent being pushed to the side when doctors focus on more serious cases), and junior doctors (by definition) are young and inexperienced. At the family level, doctors reported patient relatives often demonstrate their devotion to the patient by acting out. At the hospital level, institutions are operating in an environment of scarcity, which generates high emotions as patients compete for attention, supplies and space. At a societal level, doctors reported family attacks persist because perpetrators face no real legal consequences. In addition to causes of violence, there are consequences. Doctors who are targets of violence reported experiencing mental health problems, including depression and loss of self-esteem, and reported thoughts of leaving their positions and even their country. Doctors also expressed regret for choosing a career in medicine.ConclusionYoung, inexperienced junior doctors in Iraq are bearing the brunt of patient frustrations with the scarcity of resources in the health system. Hospitals would likely improve the job satisfaction of junior physicians, and their longevity in the health system, by attending to this problem.

Is MIStreatment of women during facility-based childbirth an independent risk factor for POstpartum Depression in Ethiopia and Guinea? A mixed methods prospective study protocol—MISPOD study

BackgroundWorldwide, 10% of postpartum women experience postpartum depression, which can lead to diverse sequalae at individual, family, and societal levels. In sub-Saharan Africa, it is estimated that 17% of women experience depression in the postpartum period, which could be an underestimate as 48% of women in the region do not receive postnatal care (81% in Ethiopia and 51% in Guinea) and a large share of postpartum depression remains undiagnosed and untreated as a result. Globally, despite a critical evidence gap, there are growing reports of postpartum depression among women mistreated (disrespected and abused) during childbirth in health facilities, making a strong case to examine the association between mistreatment and postpartum depression. This study in Addis Ababa (Ethiopia) and Conakry (Guinea) uses a mixed methods design to 1) examine the link between mistreatment and postpartum depression, 2) explore the health system capacity to provide respectful maternity care and maternal mental health services, and 3) explore the experiences of women in accessing care and support for postpartum depression.MethodsWe will conduct a prospective longitudinal survey of women (434 in Addis Ababa and 408 in Conakry) from the third trimester of pregnancy to eight weeks postpartum and carry out in-depth interviews with key health system informants (20–25 in each city) and women who recovered from a clinically confirmed episode of postpartum depression (15–25 in each city). Quantitative data from the women’s survey will be analysed using a multilevel mixed-effects model; qualitative data from key-informants will be analysed by using a hybrid thematic analysis approach, whereas data from women’s in-depth interviews will be analysed using the phenomenological approach. The inclusion of two different settings in our study (Addis Ababa and Conakry) will enable us to apply a comparative health systems lens to explore the dynamics of respectful maternity care and maternal mental health services within the broader health systems of the two countries (Ethiopia and Guinea).DiscussionThe findings from this study will inform actions aimed at mitigating the mistreatment of women in maternity settings and improving promotive, preventive, and treatment interventions for postpartum depression in Ethiopia and Guinea. The findings can also be extrapolated to other low-resource settings.

Exploring serine-arginine rich splicing factors: potential predictive markers for dysregulation in oral cancer

BackgroundDysregulated splicing events are a common phenomenon in cancer with the Serine-arginine-rich splicing factor (SRSF) family emerging as pivotal regulators of gene expression, exerting influence over constitutive and alternative splicing processes. Although aberrations in a few SRSF family members have been implicated in various cancers, the comprehensive roles of other family constituents remain underexplored.MethodsThis study delves into the expression profile of the entire SRSF family (SRSF1-SRSF12) in 23 cancerous cell lines originating from diverse tissues using quantitative Real-Time PCR. Further, the transcript levels of the SRSF family were examined in oral cancer patient samples stratified into Pre-cancer (n = 15), Early cancer (n = 11), Late cancer (n = 14), and adjacent non-tumor tissues (n = 26) as controls. The results were corroborated by a parallel investigation utilizing the transcriptomics data of oral squamous cell carcinoma (OSCC) patients (n = 319) and controls (n = 35) available in The Cancer Genome Atlas (TCGA) database.ResultsOur investigation reveals a notable upregulation in the expression levels of key splicing factors, namely SRSF3, SRSF9, and SRSF10 in all oral cancer cell lines (SCC-4, UM-SCC-84, CAL33, SAS-H1). Conversely, no significant associations between SRSF family members and other cancer cell lines were discerned. Further, the expression profile of the SRSF family in oral cancer patient samples revealed significant upregulation of SRSF1, SRSF3, SRSF7, SRSF9, SRSF10, and SRSF11 in patients with late-stage oral cancer compared to controls. Transcriptomics data from TCGA database demonstrated remarkable upregulation of SRSF1, SRSF4, SRSF9, SRSF10, and SRSF11 in OSCC patients.ConclusionCollectively our results underscore the critical involvement of SRSF family members in the context of oral cancer, highlighting their potential as key players in the altered splicing dynamics associated with cancer progression.Graphical abstract

A scoping review of early childhood caries, poverty and the first sustainable development goal

BackgroundPoverty is a well-known risk factor for poor health. This scoping review (ScR) mapped research linking early childhood caries (ECC) and poverty using the targets and indicators of the Sustainable Development Goal 1 (SDG1).MethodsWe searched PubMed, Web of Science, and Scopus in December 2023 using search terms derived from SDG1. Studies were included if they addressed clinically assessed or reported ECC, used indicators of monetary or multidimensional poverty or both, and were published in English with no date restriction. We excluded books and studies where data of children under 6 years of age could not be extracted. We charted the publication year, study location (categorized into income levels and continents), children age, sample size, study design, measures of ECC, types and levels of poverty indicators and adjusted analysis. The publications were also classified based on how the relation between poverty and ECC was conceptualized.ResultsIn total, 193 publications were included with 3.4 million children. The studies were published from 1989 to 2023. Europe and North America produced the highest number of publications, predominantly from the UK and the US, respectively. Age-wise, 3–5-year-olds were the most studied (62.2%). Primary studies (83.9%) were the majority, primarily of cross-sectional design (69.8%). Non-primary studies (16.1%) included reviews and systematic reviews. ECC was mainly measured using the dmf indices (79.3%), while poverty indicators varied, with the most common used indicator being income (46.1%). Most studies measured poverty at family (48.7%) and individual (30.1%) levels. The greatest percentage of publications addressed poverty as an exposure or confounder (53.4%), with some studies using poverty to describe groups (11.9%) or report policies or programs addressing ECC in disadvantaged communities (11.4%). In addition, 24.1% of studies requiring adjusted analysis lacked it. Only 13% of publications aligned with SDG1 indicators and targets.ConclusionThe ScR highlight the need for studies to use indicators that provide a comprehensive understanding of poverty and thoroughly examine the social, political, and economic determinants and impact of ECC. More studies in low and middle-income countries and country-level studies may help design interventions that are setting- and economic context-relevant.

Short-term soil fungal community dynamics following fire in mediterranean climate-type banksia woodlands

Fire is a dominant ecosystem process in many Mediterranean climate type ecosystems, and is predicted to increase in severity and frequency, shifting away from previous regimes in many regions. Responses of flora and fauna to fire are relatively well studied, but less is known about the responses of belowground microbiota. We quantified soil fungal dynamics over the first 12–15 months after fire, focusing on attributes of the fire regime (season, interval, severity). Soil samples were collected from three sites in a threatened woodland ecosystem in southwestern Australia, a Mediterranean-type climate region. Fungal taxa were identified via high throughput sequencing of the ITS subregion and taxonomy assigned using reference databases. Richness, diversity, abundance, community composition, and functional groups were quantified. Over the post-fire sampling period, richness and diversity declined and soil fungal community composition changed significantly throughout the sampling period, with family level taxa and functional groupings experiencing the most change. Through the sampling period, an increase in saprotrophic and endophytic fungi was observed, along with a decrease in all pathogenic fungi. We found that the post-fire fungal community is quite dynamic in the first 12–15 months after fire. We found little effect of fire interval or fire season, though our inference was limited. Our work contributes to putting belowground biota into the same conceptual frameworks as aboveground taxa and serves to inform fire managers in fire-prone Mediterranean climate type regions.

Progressive Muscle Relaxation on Family Anxiety with Hypertension

Since hypertension is a chronic condition, long-term care is required. Anxiety within the family is one of the ways that long-term care and the possibility of complications impact the loving family. Extended family stress may lead to subpar treatment for hypertensive individuals, which will impact their pulse. The purpose of this study was to examine what increasing muscle relaxation meant for the anxiety levels of hypertensive families. Analytical methods are utilized in this kind of quasi-experimental study. All households with family members who experience the ill effects of hypertension are the target population. samples from 35 participants in the control group and another 35 participants in the experimental group. The HARS questionnaire was the tool used to gauge the level of anxiety. Using the SPSS software, data management employed the Wilcoxon Signed Ranks Test at a significance threshold of <α (0.05). The outcomes demonstrated that gradual muscle relaxation had an impact on the anxiety levels of the experimental group's families with hypertension. ρ = 0.000 (0.000 <0.05) was the result of the Wilcoxon sign rank test at a significance level of 0.05. The control group's Wilcoxon sign rank test result, at a significance level of 0.05, was ρ = 1.000 (1.000 > 0.05), indicating no effect of progressive muscle relaxation on anxiety. According to the study's findings, gradual muscular relaxation can diminish anxiety. To bring down anxiety levels, this technique can be utilized as a non-pharmacological therapy.

Once upon a time: exploring the biogeographic history of the largest endemic lizard family in the Neotropics (Squamata: Gymnophthalmidae)

Abstract Gymnophthalmids are a diverse lineage of Neotropical lizards that present challenges in the understanding of their phylogenetic relationships and biogeographic history. Using a densely sampled phylogeny and distribution data, we investigated their biogeography at the family level. Dividing South and Central America into 12 regions, we tested six biogeographic models considering dispersal-extinction, vicariance, and founder events. Our analysis revealed high taxonomic and phylogenetic endemism in the Andes, Amazon, and Guiana Shield. The best-fit model identified the Guiana Shield as the likely ancestral area of the family, with dispersal events dominating over vicariance. Key areas for species interchange were the Amazon, Northern Andes, and Guiana Shield. The core regions of diversification included the Andes, Amazon, and Guiana Shield, with elevated species richness and biotic interchange events during the Eocene and Oligocene. The Guiana Shield stood out as a stronghold of gymnophthalmid diversity, driven by dispersal rates and ancient lineages. Our findings challenge previous hypotheses about the diversification of these lizards, suggesting a colonization pattern from lowlands to high elevations rather than the South-to-North Speciation Hypothesis for Andean lineages.

HDAC10 inhibits non-small-cell lung cancer cell ferroptosis through the microRNA-223-5p-SLC7A11 axis.

Non-small-cell lung cancer (NSCLC) is a leading attributor to cancer deaths. High HDAC10 and low microRNA (miR)-223-5p levels have been observed in NSCLC. But their roles remain elusive. This study illustrated their roles in NSCLC cell ferroptosis and the mechanism. HDAC10, miR-223-5p, and solute carrier family 7 member 11 (SLC7A11) levels in cells were determined by RT-qPCR. Iron ion content, reactive oxygen species (ROS), and glutathione (GSH) levels were tested using reagent kits, and levels of SLC7A11 and Acyl-CoA synthesis long chain family (ACSL4) were examined using Western blot. Chromatin immunoprecision was performed to analyze the enrichment of HDAC10 and acetylated lysine 9 of histone H3 (H3K9ac) on the miR-223-5p promoter. The targeted binding of miR-223-5p and SLC7A11 was analyzed by dual-luciferase assay. Joint experiments were designed to identify the role of miR-223-5p/SLC7A11 axis in HDAC10-regulated ferroptosis in NSCLC cells. HDAC10 was highly expressed in NSCLC cells. Silencing HDAC10 significantly reduced GSH and SLC7A11 levels, upregulated iron ion content, ROS levels, and ACSL4 expression, promoting cell ferroptosis. Mechanically, HDAC10 inhibited miR-223-5p expression through H3K9ac deacetylation of the miR-223-5p promoter, thereby targeting SLC7A11. The joint experimental results showed that overexpression of SLC7A11 or downregulation of miR-223-5p alleviated the promoting effect of silencing HDAC10 on ferroptosis in NSCLC cells. HDAC10 inhibits miR-223-5p expression through H3K9ac deacetylation of the miR-223-5p promoter, thereby promoting SLC7A11 expression and inhibiting ferroptosis in NSCLC cells.

Comparative analysis of size-fractional eukaryotic microbes in subtropical riverine systems inferred from 18S rRNA gene V4 and V9 regions

Eukaryotic microbes play key ecological roles in riverine ecosystems. Amplicon sequencing has greatly facilitated the identification and characterization of eukaryotic microbial communities. Currently, 18S rRNA gene V4 and V9 hypervariable regions are widely used for sequencing eukaryotic microbes. Identifying optimal regions for the profiling of size-fractional eukaryotic microbial communities is critical for microbial ecological studies. In this study, we spanned three rivers with typical natural-human influenced transition gradients to evaluate the performance of the 18S rRNA gene V4 and V9 hypervariable regions for sequencing size-fractional eukaryotic microbes (>180 μm, 20-180 μm, 5-20 μm, 3-5 μm, 0.8-3 μm). Our comparative analysis revealed that amplicon results depend on the specific species and microbial size. The V9 region was most effective for detecting a broad taxonomic range of species. The V4 region was superior to the V9 region for the identification of microbes in the minor 3 μm and at the family and genus levels, especially for specific microbial groups, such as Labyrinthulomycetes. However, the V9 region was more effective for studies of diverse eukaryotic groups, including Archamoebae, Heterolobosea, and Microsporidia, and various algae, such as Haptophyta, Florideophycidae, and Bangiales. Our results highlight the importance of accounting for potential misclassifications when employing both V4 and V9 regions for the identification of microbial sequences. The use of optimal regions for amplification could enhance the utility of amplicon sequencing in environmental studies. The insights gained from this work will aid future studies that employ amplicon-based identification approaches for the characterization of eukaryotic microbial communities and contribute to our understanding of microbial ecology within aquatic systems.

Lipoprotein, Cholesterol, Treatment Strategies, and its Impact on Cardiovascular Diseases

A main cause of death internationally, cardiovascular (CV) illness accounted for about 31.4% of fatalities worldwide in 2012. According to estimates, a 33% decline in coronary heart disease (CHD) mortality in the United States between 1980 and 2000 was caused by a decrease in total cholesterol levels. Similar declines in CHD fatalities (varying from 19% to 46%) in other wealthy nations have been linked to lower total cholesterol levels. Lipoproteins are complex particles with a central core containing cholesterol esters and triglycerides surrounded by free cholesterol, phospholipids, and apolipoproteins, which facilitate lipoprotein formation and function. However, numerous individuals do not achieve LDL-C goal values because of statin resistance or adherence to statin medication. If cholesterol targets are not achieved with statins alone, alternative medicines include ezetimibe, fibrates, and nicotinic acid. In addition, people with familial high cholesterol levels (FH). Lipoprotein may act as a proinflammatory mediator that augments the lesion formation in atherosclerotic plaques. HDL metabolism represents a major target for the development of therapies intended to reduce the risk of atherosclerotic cardiovascular disease. Individual cardiovascular preventative treatments should be targeted largely at individuals at higher risk who will benefit most, with the prevention and treatment of dyslipidemia being viewed as a crucial component of those interventions. Since statins have been demonstrated to lessen the risk of serious vascular events by lowering low-density lipoprotein cholesterol (LDL-C), they continue to be the first-choice medication.

Optimizing psychiatric social work interventions: Formulating guidelines for mental health settings.

Psychiatric social workers typically play an important role in the treatment and management of psychosocial issues at different levels, such as individual, family, and community levels. However, despite the field having a long history, there are significantly fewer standardized guidelines for interventions in mental health settings. This study aims to develop guidelines for psychiatric social work interventions in mental health settings. Psychiatric social workers with a degree of M.Phil. in Psychiatric Social Work, 2 years of working experience, and working in mental health settings were selected for this study. Using purposive sampling, 15 psychiatric social workers were selected for this study and were interviewed using a semi-structured interview schedule. The data were analyzed using the qualitative method of content analysis. There is a high level of satisfaction rate among psychiatric social workers about their work and profession, however, they face challenges because of non-clarity of roles and responsibilities, lack of theories, and difficulties in implementing theories into practice. More training, discussion, supervision, and exposure to different cases help improve the interventions' quality. Although psychiatric social work interventions are effective in addressing the treatment gap by providing curative, preventive, promotive, and rehabilitative services, there is no uniformity in the interventions, which in turn, explains the need for standardized guidelines for intervention. The study explains the guidelines for psychiatric social work interventions at the community, group, family, and individual levels.

The brachiopod faunas from the Fezouata Shale (Lower Ordovician; Tremadocian–Floian) of the Zagora area, Anti‐Atlas, Morocco: evidence for a biodiversity hub in Gondwana

AbstractSince the early 2000s, the discovery of fossils and their collection from the Fezouata Shale has accelerated; enabling us to understand the faunas more thoroughly. The brachiopod fauna has not been investigated for the past 50 years, and we present here the results of our recent studies. From the material (c. 350 samples), 30 species were identified and assigned to 23 genera. Among these, one new genus (Tinzoulinorthis) and four new species (Wosekella maghribi, Rafanoglossa inversa, Orbithele tazagurta, Lacunites punctum) are erected; one taxon is recognized at the family level. The fauna described from the upper Tremadocian horizons is more diverse than those in the Floian. The former is characterized by a high γ‐diversity, although at the horizon level the α‐diversity is low to medium. This fauna is typical of high‐energy, shallow‐water, unstable environmental conditions, in which long‐lived communities were prevented from developing into climax communities, and the succession of opportunists were regularly smothered in situ and killed by storm deposits. Multivariate analyses of the faunas indicate that the Tremadocian fauna, characterized by many endemic taxa, has closer affinities with faunas from peri‐Gondwanan terranes, in particular Bohemia. The Tremadocian Fezouata fauna is very rich in taxon first occurrences, which, coupled with a high γ‐diversity, suggest that it may have been a diversity hub. In contrast, the Floian Fezouata fauna not only shows stronger connections with Bohemia and the Montagne Noire, it also has links with the South Urals and Baltica, reflecting the changing Early Ordovician palaeogeography.

P029 PERCEPTIONS AND PERSPECTIVES OF RURAL NEPALESE PATIENTS WITH HYPERTENSION: A QUALITATIVE STUDY GUIDED BY THE LEVESQUE FRAMEWORK

Background and objective: High blood pressure is a major risk factor for heart disease and stroke. These diseases can be reduced if hypertension is identified, managed and controlled. Disease burden in Nepal is high, resources are limited, and the population is socioeconomically vulnerable. Developing tailored interventions for hypertension management requires understanding of challenges and facilitators of healthcare. This qualitative study investigated barriers and facilitators impacting treatment and control of patients with hypertension in rural Nepal. Methods: We conducted in-depth interviews among hypertensive patients(n=15), medical officers(n=3), Female Community Health Volunteers(FCHVs)(n=9), Frontline Health Workers(FLHWs)(n=15), medical officers(n=3), and local government representatives(n=5) from Panchkhal and Bethanchowk municipalities of Kavrepalanchok district, Nepal. Focus group discussions with FCHVs(n=7) were also conducted. Recordings were coded, transcribed and themes were identified. Patients with hypertension were approached door-to-door by FCHVs. FCHVs and FLHWs were accessed through health facilities. The framework developed by Levesque et al., was used to conceptualize access to care from the viewpoints of various stakeholders. Emerging themes were mapped as the ability to-perceive, seek, reach, pay and engage. Results: Most participants felt the need for care after experiencing symptoms like headaches, dizziness, and blurred vision. Trust in health facilities facilitated care, although unavailability of medicines and insufficient qualified staff were important obstacles. Some used homemade therapies for hypertension control highlighting a gap in awareness of treatment methods. Geographical inaccessibility of health facilities, as well as financial difficulties, were other important barriers identified. Patient's expected prompt service and reduced out-of-pocket expenditure. Medication-taking behavior was influenced by factors including forgetfulness, perceived need and side effects. Support from family, community, and local levels was identified as crucial for hypertension management. Conclusions: This qualitative study highlights the multifaceted challenges for hypertension treatment and control in rural Nepal. Addressing identified barriers and leveraging facilitating factors are essential for reducing hypertension.

Progress for all: addressing disparities in sarcoidosis.

The impact of healthcare disparities in the treatment, care, and outcomes of patients with sarcoidosis has been described. There is paucity of literature on ways to address these disparities with a goal to improving health outcomes for patients with sarcoidosis. Recent findings in other respiratory and systemic diseases suggest that multifaceted interventions directed at improving care at various levels including individual, family, and larger societal levels have been successful in dismantling some of the social and structural barriers to care and consequently have resulted in a reduction in disparate disease outcomes. We explore what some of these interventions would look like in sarcoidosis. The impact of healthcare disparities in the treatment, care, and outcomes of patients with sarcoidosis has been described. We outline various steps and approaches aimed at addressing these health disparities with a goal to improving outcomes for those most impacted by disease.

Smartphone use and its addiction among Jammu adolescents

Background: Smartphones play a crucial role in our everyday life. Smartphones help users to develop social connections with others, gain information and entertain themselves through various applications. With the widespread use of smartphone, the number of smartphone users has been increasing worldwide. As smartphones are getting popular, smartphone addiction has become a serious mental health problem among adolescents. Objectives: To find out significant differences in smartphone addiction among adolescents with respect to their gender and locale. Methodology: Descriptive survey method was used for conducting the study. The sample consists of 200 adolescents of government and private schools from Jammu and Kathua. ‘Smartphone Addiction Scale’ (2021) developed by Vijayshri and Masaud Ansari was used for data collection. Results: It was found that smartphone addiction was significantly higher among female adolescents (M=65.34) as compared to their male counterparts (58.61). Further, it was also found that smartphone addiction was significantly higher in urban adolescents (M=64.37) than rural adolescents (M=59.08). Conclusion: In order to combat smartphone addiction among adolescents, we advise the creation of healthy environment at the family and school levels. Teachers should provide knowledge to the students about smartphone security tips and educational programmes should be organized for protecting psychological well-being of the adolescents.

Dental caries prevalence and caries-associated risk factors of students aged 12–15 in Xide County of Liangshan Prefecture, China: a cross-sectional study

ObjectiveAbout 2 billion people have caries in permanent teeth, and 514 million children have caries in primary teeth worldwide. Regional disparities in caries prevalence are evident in various areas of...