Health Care Initiatives Research Articles

Cannabis use and atherosclerotic cardiovascular disease outcomes: A meta-analysis of multinational cohort data.

While an association between cannabis use and the risk of atherosclerotic cardiovascular diseases (ASCVD) has been reported numerous times, it remains inconclusive as to whether this link is causal in nature. We sought to consolidate data from observational studies to explore the association between ever use of cannabis and ASCVD outcomes, including myocardial infarction, stroke, and a combined measure of any adverse cardiovascular events in comparison to non-users or controls. We performed a systematic literature search on PubMed, Scopus, ScienceDirect, and Cochrane Library for relevant studies from inception until April 2024. Statistical analyses utilized RevMan 5.4 with a random effects model. The study protocol has been registered with PROSPERO (CRD42024530366). Our analysis incorporated data from 17 studies involving a total of 1,902,481 individuals aged between 18 and 74 years, with a mean follow-up duration of 8.5 years. Upon pooled analysis, no statistically significant association was found between cannabis use and the risk of myocardial infarction compared to non-users, with an RR of 1.25 (95% CI: 0.91-1.71, p = 0.17). Similarly, while the risk of stroke showed no significant association with cannabis use (RR: 1.38, 95% CI: 0.88 to 2.16, p = 0.16), a statistically significant association was observed between ever use of cannabis and the composite of any adverse cardiovascular events (RR: 1.48, 95% CI: 1.16-1.90, p = 0.002). The evident statistical correlations between cannabis use and adverse cardiovascular outcomes underscore its potential as a risk factor for cardiovascular disease, suggesting plausibility for a causal relationship between cannabis use and ASCVD. With rising trends in medical cannabis use and cannabis use disorder across age demographics, heightened risk awareness and informed decision-making regarding cannabis consumption are critical priorities in healthcare and public health initiatives.

IMPACTS OF COOPERATIVE SOCIETIES AS A STRATEGY FOR SUSTAINABLE COMMUNITY DEVELOPMENT IN NIGERIA

The paper explores the Impacts of Cooperative Societies as a Strategy for Sustainable Community Development in Nigeria. Concepts of community development, elements that make up the local communities were analyzed. The impacts of cooperatives societies in sustainable community development, such as economic empowerment of members, social cohesion and inclusion, capacity building and skills development, access to essential services, environmental sustainability among others were outlined and elaborated. The paper also identified and explained the challenges of cooperatives societies which include among others as financial, structural, regulation and governance/capacity problems, while the way forward to these challenges were analyzed. The paper concluded that cooperative societies play significant roles in sustainable community development which includes among others; contribute to poverty alleviation, support local entrepreneur, promote agriculture development and essential financial services. The paper recommended that Government and financial institutions should provide adequate funding and support to cooperative societies to enable them to fulfill their roles effectively, Training programs should be organized for members and leaders of cooperative societies to improve their management skills and operational efficiency and Cooperative societies should be encouraged to participate in healthcare initiatives to improve community well-being among others.

Support initiatives by agricultural cooperatives in facilitating women's recovery from the socio-economic impacts of the Covid-19 pandemic in Kajiado county

This study investigated the impact of healthcare interventions by agricultural cooperatives on women's recovery during the post-COVID-19 period in Kajiado County, Kenya. It explored how agricultural cooperatives address women's recovery in the post-COVID-19 period in Kajiado County. It examined support initiatives for women's recovery, internal healthcare mechanisms targeting women, and cooperative-led interventions in post-COVID-19 recovery. Supported by Social Capital Theory and Empowerment theory, the study focused on Kajiado County. Kajiado County was selected for its cultural diversity and economic activities. Utilizing a mixed-methods research design, the study included a sample size of 373 respondents, members of agricultural cooperatives. The qualitative phase involved interviews and focus groups, while the quantitative data was collected using structured questionnaires. This study employed a combination of stratified random sampling and purposive sampling. Findings were presented through tables, aiming to inform government regulators in policy formulation. The study concluded that women have largely positive perceptions of the healthcare interventions offered by agricultural cooperatives. The findings also suggested a strong positive correlation between women's experiences with healthcare initiatives and their recovery from the COVID-19 pandemic. The study further concluded that logistical and cultural barriers remain significant obstacles to women's access to healthcare services provided by agricultural cooperatives. Recommending that agricultural cooperatives must develop and implement robust communication strategies to bridge the gap between awareness and actual engagement in healthcare programs for women. The study encourages policymakers to work alongside cooperatives to broaden these programs, create accessible healthcare models that consider rural challenges, and overcome existing logistical and cultural obstacles. By building such collaborative frameworks, these efforts can enhance women’s resilience, support sustainable recovery, and contribute to enduring improvements in community health and economic resilience in rural areas.

Redefining Clinically Significant Blood Loss in Complex Adult Spine Deformity Surgery.

Retrospective analysis of prospectively-collected data. This study aims to define clinically relevant blood loss in adult spinal deformity (ASD) surgery. Current definitions of excessive blood loss following spine surgery are highly variable and may be suboptimal in predicting adverse events (AE). Adults undergoing complex ASD surgery were included. Estimated blood loss (EBL) was extracted for investigation, and estimated blood volume loss (EBVL) was calculated by dividing EBL by the preoperative blood volume utilizing Nadler's formula. LASSO regression was performed to identify five variables from demographic and peri-operative parameters. Logistic regression was subsequently performed to generate a receiver operating characteristics (ROC) curve and estimate an optimal threshold for EBL and EBVL. Finally, the proportion of patients with AE plotted against EBL and EBVL to confirm the identified thresholds. In total 552 patients were included with a mean age of 60.7±15.1 years, 68% females, mean CCI was 1.0±1.6, and 22% experienced AEs. LASSO regression identified ASA score, baseline hypertension, preoperative albumin, and use of intra-operative crystalloids as the top predictors of an AE, in addition to EBL/EBVL. Logistic regression resulted in ROC curve which was used to identify a cut-off of 2.3 liters of EBL and 42% for EBVL. Patients exceeding these thresholds had AE rates of 36% (odds-ratio: 2.1, 95% CI [1.2-3.6]) and 31% (odds-ratio: 1.7, 95% CI [1.1-2.8]), compared to 21% for those below the thresholds of EBL and EBVL, respectively. In complex ASD surgery, intraoperative EBL of 2.3 liters and an EBVL of 42% are associated with clinically-significant AEs. These thresholds may be useful in guiding preoperative-patient-counseling, healthcare system quality initiatives, and clinical perioperative bloodloss management strategies in patients undergoing complex spine surgery. Additionally, similar methodology could be performed in other specialties to establish procedure-specific clinically-relevant bloodloss thresholds.

SNPs in GPCR Genes and Impaired Osteogenic Potency in Osteoporotic Patient Lines-Based Study.

G-protein-coupled receptors (GPCRs) have emerged as critical regulators of bone development and remodeling. In this study, we aimed to identify specific GPCR mutations in osteoporotic patients via next-generation sequencing (NGS). We performed NGS sequencing of six genomic DNA samples taken from osteoporotic patients and two genomic DNA samples from healthy donors. Next, we searched for single-nucleotide polymorphisms (SNPs) in GPCR genes that are associated with osteoporosis. For three osteoporotic patients and one healthy donor, bone biopsies were used to generate patient-specific mesenchymal stem cell (MSC) lines, and their ability to undergo osteodifferentiation was analyzed. We found that MSCs derived from osteoporotic patients have a different response to osteoinductive factors and impaired osteogenic differentiation using qPCR and histochemical staining assays. The NGS analysis revealed specific combinations of SNPs in GPCR genes in these patients, where SNPs in ADRB2 (rs1042713), GIPR (rs1800437), CNR2 (rs2501431, rs3003336), and WLS (rs3762371) were associated with impaired osteogenic differentiation capacity. By integrating NGS data with functional assessments of patient-specific cell lines, we linked GPCR mutations to impaired bone formation, providing a foundation for developing personalized therapeutic strategies. SNP analysis is recognized as a proactive approach to osteoporosis management, enabling earlier interventions and targeted preventive measures for individuals at risk. Furthermore, SNP analysis contributes to the development of robust, holistic risk prediction models that enhance the accuracy of risk assessments across the population. This integration of genetic data into public health strategies facilitates healthcare initiatives. This approach could guide treatment decisions tailored to the patient's genetic profile and provide a foundation for developing personalized therapeutic strategies.

Incentive affects physicians’ willingness to continue participating in urban–rural medical consortia: a comparative study of county and provincial hospitals in Central China

ObjectivesThe World Health Organization asserts that incentives significantly impact physicians’ participation in healthcare initiatives. China introduced incentive programs to boost involvement in urban–rural medical consortia. However, research is limited on: (a) the effectiveness of these incentives on physicians’ willingness to continue participating, (b) disparities in incentive levels between county and provincial hospitals, and (c) the varying impact of incentives on physicians’ continued participation in county versus provincial hospitals. This study aims to address these issues and suggest appropriate strategies.MethodsAn online survey in Henan Province, Central China, was conducted among 1,837 physicians, comprising 1,088 respondents from county hospitals and 749 respondents from provincial hospitals. Participants reported their demographic characteristics, altruism, collaborative projects, incentive levels and willingness to continue participating. Chi-square and multinomial logistic regressions were used to determine the incentive factors of participants’ willingness.Results(a) For all participants, the level of economic returns, position and professional title promotion, skills improvement were positively associated with willingness to continue participating in urban–rural medical consortia. (b) County-level hospitals had lower level of various incentives for urban–rural medical consortium projects than provincial hospitals. (c) County-level physicians who had a high level of position and title promotion, professional skills improvement and provincial physicians who had a high level of economic returns and rewards had a high level of willingness to continue participating in urban–rural medical consortia.ConclusionThis study demonstrates that the current financial incentives in provincial hospitals and non-financial incentives in county hospitals are efficacious in enhancing physicians’ willingness to continue participating. This information can assist policymakers in hospitals at different levels in developing or improving incentive mechanisms.

Using the GRADE‐ADOLOPMENT framework in developing the Philippine national screening guideline recommendations

AbstractBackgroundPreventive health screening is an important strategy in improving health outcomes of the general population and sustaining universal healthcare initiatives. Due to the large resource requirement, we used the GRADE ADOLOPMENT framework to synthesize the evidence and develop recommendations for preventive health screening.ObjectiveOur objectives were to describe the development and feasibility of a national preventive screening practice guideline using the GRADE‐adolopment process and to discuss the methodological process, contextual differences from the source guidelines, and the resulting changes to the final recommendations.MethodsA multidisciplinary team was convened. We used the GRADE‐ADOLOPMENT and Evidence‐to‐Decision (EtD) framework in synthesizing the evidence and developing the recommendations. Evidence from the World Health Organization, United States Preventive Services Task Force, and Canadian Task Force on Preventive Healthcare were used. Values and preferences of the guideline developers were incorporated through the EtD framework.ResultIn 6 months, we developed 16 evidence summaries and developed 23 recommendations for 16 prioritized conditions. Thirteen recommendations were adopted. Four recommendations were modified to address contextual differences. Six recommendations were developed de novo due to either lack of evidence or differences in values and preferences.ConclusionThe GRADE‐adolopment framework was a feasible and efficient framework in adopting guidelines on preventive screening. The EtD framework improved the transparency and highlighted areas to consider in making recommendations for the Philippine context. Challenges encountered were insufficiency of local evidence, and the lack of experience and skills in interpreting and analyzing the evidence especially on screening strategies.

AI in Biomedicine-A Forward-Looking Perspective on Health Equity.

As new artificial intelligence (AI) tools are being developed and as AI continues to revolutionize healthcare, its potential to advance health equity is increasingly recognized. The 2024 Research Centers in Minority Institutions (RCMI) Consortium National Conference session titled "Artificial Intelligence: Safely, Ethically, and Responsibly" brought together experts from diverse institutions to explore AI's role and challenges in advancing health equity. This report summarizes presentations and discussions from the conference focused on AI's potential and its challenges, particularly algorithmic bias, transparency, and the under-representation of minority groups in AI datasets. Key topics included AI's predictive and generative capabilities in healthcare, ethical governance, and key national initiatives, like AIM-AHEAD. The session highlighted the critical role of RCMI institutions in fostering diverse AI/machine learning research and in developing culturally competent AI tools. Other discussions included AI's capacity to improve patient outcomes, especially for underserved communities, and underscored the necessity for robust ethical standards, a diverse AI and scientific workforce, transparency, and inclusive data practices. The engagement of RCMI institutions is critical to ensure practices in AI development and deployment which prioritize health equity, thus paving the way for a more inclusive AI-driven healthcare system.

Sensory Health and Universal Health Coverage in Canada-An Environmental Scan.

Background/Objectives: The World Federation of the Deafblind Global Report 2023 reports that many countries do not have a comprehensive identification, assessment, and referral system for persons with deafblindness, a combination of hearing and vision loss, across all age groups and geographic regions. The scan seeks to inform researchers, policymakers, and community-based organizations about the status of and gaps in sensory healthcare initiatives in Canada, with the intent to raise awareness to enhance the integration and coordination of eye and ear care services. Methods: We conducted an environmental scan of Canada's healthcare system and current public health policies addressing vision and hearing care in Canada at the federal and provincial levels. The scan was conducted using published literature searches from five scientific databases-Embase, Medline, PsycINFO, PubMed, and CINAHL-in combination with the gray literature review of federal, provincial, and territorial governments and non-profit organizations' websites from April 2011-October 2022. Out of 1257 articles screened, 86 studies were included that met the inclusion/exclusion criteria. In total, 13 reports were included in the gray literature search, with 99 total articles used in the analysis. Results: The thematic findings indicate stigma and discrimination toward individuals with disabilities and marginalized communities (Indigenous people, rural communities, recent immigrants, people of older age, and people with disabilities), including hearing, vision, or dual sensory loss, persist. Barriers to vision and hearing healthcare access include inadequate policies, underinvestment in vision and/or hearing services, limited collaboration and coordinated services between hearing and vision services, discrepancies in insurance coverages, and lack of health system support. Conclusions: This scan demonstrates the persisting barriers to vision and/or hearing services present in Canada, stemming from inadequate policy and limited service coordination. Future work to address gaps, evaluate public education, and develop integrated sensory healthcare initiatives to enhance coordinated eye and ear care services, as recommended in the WHO Report on Hearing and Vision, is imperative.

Merck Foundation launches new healthcare initiative.

Merck Foundation launches new healthcare initiative.

This time is different? Lessons from past reform initiatives in the Irish health system

Abstract The publication of the Sláintecare report in May 2017 is a landmark in Irish healthcare policy. For the first time in the history of the state, the Irish political system produced an agreed long-term vision for the health system. The Irish healthcare system has attracted considerable negative comment over a long period and satisfactory healthcare reform had appeared to be impossible to achieve. The history of Irish healthcare reform is replete with policy difficulties. This paper seeks to assess the likelihood that Sláintecare will be implemented given that it is the first long-term, multielectoral cycle healthcare initiative that is agreed by all the main political parties. The paper uses a game theoretic model developed by Dal Bó, Dal Bó, and Di Tella to develop an understanding of the impact of the electoral cycle on politicians and interest groups in negotiating and implementing healthcare reform. It uses a case-study methodology, with previous Irish healthcare reform initiatives as the unit of analysis. Finally, it shows that politicians are at a distinct disadvantage due to the short-term horizon imposed on them due to the electoral cycle and that the adoption of a long-term agreed policy, like Sláintecare, is more likely to be implemented.

The Role of Gram Panchayat in Rural Development: A Case Study of Sabang Gram Panchayat, Paschim Medinipur District, West Bengal

Abstract: This research article examines the role of Gram Panchayats in fostering rural development in Sabang Gram panchayat, Paschim Medinipur district of West Bengal. This study employs a mixed-methods approach, combining qualitative interviews with local officials, community leaders, and residents, along with quantitative data analysis. Data were collected from government reports, surveys, and field visits in selected Gram Panchayats within Paschim Medinipur district. Utilizing both qualitative and quantitative data, the study highlights the contributions of these local self-governance bodies in various sectors such as infrastructure, healthcare, education, and agriculture. The findings underscore the effectiveness of Gram Panchayats while also addressing challenges they face, ultimately suggesting pathways for enhancing their impact on rural development. Hence it is concluded that the role of Gram Panchayats in Paschim Medinipur district is crucial for promoting rural development through infrastructure improvement, healthcare initiatives, education, and agricultural support. Keywords: Gram Panchayats, Grassroots Governance Structure, District, Local Health Programs, Agricultural, Rural Development.

Patient pathways in primary health care – an interview study across various health care personnel in a Canadian and a Norwegian county

BackgroundDue to demographic changes in the Western world governments emphasize the need for viable solutions, e.g. through decentralization of specialist health care services and better coordination within and between health care services. Both Norway and Canada have been through health care reforms and initiatives aiming to improve continuity and coordination of services. Organizational change to primary care in both countries encompasses both team-based service delivery involving allied health professionals, and new blended payment models. The objective of this study was to explore patient pathways in primary healthcare from various health personnel’s perspectives, and across various primary care organizations in Norway and Canada.MethodsThe study had a qualitative design, including interviews with physicians, nurses and managers (n = 19) in primary care, from a county in Norway and a region in Canada. Data were analyzed with a thematic approach, in line with recommendations from Braun & Clarke.ResultsThree themes were identified: 1) Structural challenges, 2) Towards a more specialized primary health care and 3) Dedication could improve continuity. Findings indicate that coordinating health care services was assumed difficult due to different health care levels, funding systems, managements, electronic record systems and organizations. Hospitals were assumed more task oriented, while primary health care services were considered more care oriented, and this challenged the coordination across organizations. Primary care services were perceived to be more and more specialized, also representing a threat for coordination and continuity. Health care personnel in both countries perceived that dedicated personnel for each patient could improve information flow and continuity across services.ConclusionsAchieving continuity and coordination of health care services seems challenging. Integration strategies seem essential for reducing silo thinking and fragmentation of health care services.

The relationship between sleep and menstrual problems in early adolescent girls

IntroductionAdolescence is marked by hormonal, physical, neural, and behavioral changes, including in sleep patterns and, in females, the onset of menarche. Menstrual problems, such as painful menses, are common and contribute to school absences, and could indicate gynecological conditions impacting reproductive health. While studies in adults have shown associations between sleep disturbances and menstrual problems, this relationship is less understood in adolescents. Our study explores the association between sleep, menstrual problems, and menarche in a diverse sample of early adolescent girls in the U.S.MethodsWe used linear mixed-effect models to analyze associations between sleep behavior (self- and caregiver-reported) and menstrual problems (self-reported cycle irregularity, premenstrual symptom and menstrual pain severity and their impact on daily life) and menstrual characteristics (menstrual flow) in 3,037 post-menarcheal adolescent girls (Mean age:13.03 years) from the ABCD Study®. Covariates included years since menarche, race, ethnicity, parental education, and body mass index. We also used longitudinal data to explore changes in sleep behavior as a function of menarche.ResultsOf the sample, 26.2% reported moderate-severe premenstrual symptoms and 20.8% reported moderate-severe menstrual pain. 23.3% reported irregular menstrual cycles, 15.9% reported heavy menstrual flow. Shorter sleep duration was associated with greater menstrual pain intensity (β =—0.19) and impact on daily activities (β = -0.15), irregular cycles (β = -0.17), and severe premenstrual symptoms (β = -0.04). Higher sleep disturbance scores correlated with greater menstrual pain (β = 0.18) and premenstrual symptom severity (β = 0.03). Later wake-up times were linked to greater menstrual pain intensity (β = 0.14). Shorter time since menarche was associated with lower menstrual flow (β = 0.07) and pain intensity (β = 0.51) and less severe premenstrual symptoms (β = 0.07). Being post-menarche was associated with later bedtimes and shorter sleep duration.ConclusionFindings of links between sleep behavior and menstrual problems in early adolescence underscore the importance of addressing sleep and menstrual issues in healthcare screenings and educational initiatives for adolescents. Future research should focus on longitudinal and intervention studies to clarify these relationships.

Community-based smart healthcare initiative reduces carotid intima-media thickness and thrombotic markers in patients with hypertension: A prospective study

ObjectiveUnhealthy lifestyles negatively impact the prognosis and outcomes of cardiovascular disease. The objective of this study is to examine the effects of smart healthcare technology in assisting physicians with monitoring and improving patient lifestyles, as well as adjusting treatment plans on carotid intima-media thickness (IMT) and thrombotic markers during the therapeutic management of hypertension. Furthermore, we compared the efficacy of smart healthcare interventions with conventional hospital-based follow-up in ameliorating cardiovascular complications in patients with established hypertension. The goal is to elucidate the optimal timing for clinical interventions and to develop personalized treatment plans to enhance the long-term prognosis of patients with cardiovascular disease. MethodsA stratified sample of 174 patients with established hypertension from two villages in southeastern China was selected. The study cohort comprised 85 participants in the smart healthcare intervention group and 89 participants in the regular follow-up control group. Changes in median levels of IMT, von Willebrand factor (vWF), P-selectin (P-S), body mass index (BMI), blood pressure, and cholesterol were assessed before and after the study period. Comparative analysis of changes in IMT, vWF, P-S, blood pressure, and cholesterol between the two groups was conducted over the study period. ResultsThe intervention group demonstrated significantly greater improvements in IMT, vWF, and P-S levels compared to the control group (P < 0.05). At the 12-month follow-up (T12), blood pressure, BMI, total cholesterol, IMT, P-S, and vWF levels were significantly lower in the intervention group than in the control group (P < 0.05). The reduction in IMT was particularly notable, with the intervention group revealing a statistically significant improvement compared to the control group (P < 0.001). ConclusionThe smart healthcare intervention model resulted in more significant improvements in IMT and thrombotic markers compared to the traditional hospital follow-up model. Patients using the smart blood pressure monitors exhibited significantly lower levels of IMT, vWF, and P-S compared to their pre-intervention levels.

Evaluation of Peri Menopausal Syndrome at the Age Group of 43-48 Years. A Study from Tamilnadu, India

The perimenopause, sometimes referred to as the menopausal transition, is associated with significant changes in hormones and reproduction. Both these changes and the symptoms that go along with them have been well documented. The perimenopause is an ill- defined time frame that surrounds advancing years of a woman's reproductive life. The onset of irregular menstruation and its cessation after a year of amenorrhea constitute the final menstrual cycle. This study was conducted at the Sree Ramakrishna Medical College of Naturopathy and Yogic Sciences and Hospital in Kulasekharam, Tamil Nadu, India. The study's female participants were between the ages of 43 to 48. Following the description of the investigation's goals, vocal agreement was achieved. This survey had thirty responses. In this study the questionaire were consists of thirty questions such as hot flashes, thirst, pain, increased bleeding, and an unpleasant mood . Female participants who were unwilling or uncooperative were not included in the study. Many women find the menopausal transition to be a challenging time in their lives. If they lost any of their human potential, it would be catastrophic for both individuals and society. Therefore, it is essential to keep working to comprehend how perimenopause fits into women's lives and to predict and treat the common and uncommon symptoms that could lower their quality of life. Future health care initiatives should concentrate on these areas to enhance the general health and well-being of perimenopausal women.

A Review: Blockchain Effect on Healthcare and IoMT

Blockchain technology is changing several sectors of the economy, but healthcare is one of the most affected. This study looks at how blockchain is changing healthcare procedures, especially in terms of improving data sharing security and transparency, which is essential for precise diagnosis and efficient treatment. Traditional healthcare systems can be improved to provide more dependable and accessible health records, guaranteeing prompt and accurate medical care, by integrating blockchain. In discussing how blockchain affects the administration of Electronic Health Records (EHRs), the paper emphasizes how patient data can be protected from the risks associated with private companies&amp;apos; centralized control. The management of health information is more secure thanks to this decentralized method, which lowers the chances of data breaches and unauthorized access. The study also examines the growing market for the Internet of Medical Things (IoMT) and consumer medical devices, highlighting the significance of public-private sector cooperation in the creation of blockchain-based healthcare initiatives. For healthcare technologies to advance and to satisfy customer expectations for linked medical devices, these partnerships are essential. This study essentially offers a thorough examination of how blockchain technology is transforming the healthcare sector, specifically about EHR administration and IoMT integration. The study emphasizes the necessity of implementing this technology to build more safe, effective, and patient-centered healthcare systems by discussing its potential and obstacles.

Health profiling of conscripts from the Orenburg region drafted to serve in the Armed Forces of Russia

Relevance. Amid international unrest, Russia’s top priority is to augment its defense capacities. The President of Russia decided to increase the army and navy corps by 30 %. To fulfill this task, physically strong and healthy conscripts are required to man the military units.The objective is to analyze medical examination data of drafted young men aged 17 to assess the health profile of conscripts from the Orenburg region.Methods. The study relied on Rosstat statistics for the Orenburg region, as well as reports and records of the Military Medical Expertise Center at the Federal Budgetary Institution “Military Commissariat of the Orenburg Region” collected over a decade’s timespan from 2014 to 2023. Conscripts were split into the following categories labelled by letters of the Russian alphabet: ‘A’ for fit for military service, ‘B’ for fit for military service with minor restrictions, ‘V’ for fit for military service with limitations, ‘G’ for temporarily unfit for military service, ‘D’ for unfit for military service. In addition, conjoined analysis of A &amp; B categories of conscripts fit for military service vs V &amp; D ‘unfit or fit for military service with limitations’ was performed for peace-time settings. The incidence of diseases in conscripts was correlated with relevant chapters of the International Classification of Diseases and Behavioral Disorders (ICD-10); calculations per 1000 conscripts (‰) were carried out. The obtained dynamics across different indicators was studied using dynamic series analysis and second-order polynomial trend; the determination coefficient was calculated as well.Results and discussion. Within the last decade, the number of conscripts in the Orenburg region has not shown any sig nificant dynamics and is likely to remain unchanged in the coming years. The results showed that every 1,000 of examined conscripts included 761 those who were fit for military service, 98 needed treatment or rehabilitation, and 141 were unfit or fit with limitations. The annual disease incidence rate among B &amp; D category conscripts was (141.6 ± 2.6) ‰, standing for 14.1% of all the examined conscripts. In terms of significance, rank 1 was assigned to musculoskeletal and connective tissue (ICD-10, Chapter XIII), rank 2 to mental and behavioral disorders (Chapter V), rank 3 to circulatory diseases (Chapter IX), rank 4 to diseases of the eye and adnexa (Chapter VII), rank 5 to nervous system disorders (Chapter VI). Among all military service exemption causes in conscripts, cumulative specific contribution of these diseases was 61.9%. In 2014-2023, the average of 8.3% of conscripts needed conservative treatment, with treatment provided to 87.1% of those in need of treatment; 1.5% needed surgical treatment (treatment received by 79.4%) and 48.3% needed oral cavity sanitation (79.4% treated accordingly). Conscripts with eye-sight disorders underwent vision correction.Conclusion. Follow-up observation, medical and healthcare initiatives, and extensive promotion of healthy lifestyles allowed to improve the conscripts’ health status. The undertaken measures increased in the overall fitness for military service, allowing to sustainably deliver on Russia’s conscription demands.

Virtual Healthcare for Older Adults With Preventable Chronic Conditions: A Meta-synthesis of Quality Aspects.

Our study employed a six-step meta-synthesis approach to understand quality aspects of virtual healthcare trajectories and identify effective strategies for older adults with preventable chronic conditions across the world. Review of twenty-one articles revealed four key themes: functionality of virtual healthcare, equity in service delivery, satisfaction with care, and cost-effectiveness. Despite the challenges posed by technological and clinical complexities, virtual healthcare initiatives have significantly improved accessibility and availability of health services, thereby reducing disparities. Notably, telehealth saved an average of 166-minutes of travel time, demonstrating a clear benefit of virtual healthcare. While all parties expressed satisfaction with virtual healthcare, several challenges were reported, including a digital divide, limited access to digital devices, absence of a multidisciplinary approach, and lack of rural-specific programs.

Effects of Teen Childbearing on the Family Socio-Economic Wellbeing in Ruiru, Kiambu County, Kenya

Purpose: The purpose of the study was to investigate the impact of teenage childbearing on family socio-economic well-being in Ruiru, Kiambu County, Kenya, focusing on financial strain, educational disruption, post-partum experiences, and family support. Methodology: Using family stress, human capital, and social support theories, the study adopted descriptive survey design targeted 378 teenage mothers, with a sample of 195 selected using Yamane’s formula. Data collection involved semi-structured questionnaires and interviews, analyzed quantitatively through descriptive statistics and regression, and qualitatively through thematic analysis. Findings: The findings reveal that 85.5% of respondents faced financial difficulties within six months, and 55% reported disrupted high school education, leading to long-term setbacks. Emotional and health challenges characterized post-partum experiences, and 61.1% of respondents found family support insufficient to meet socio-economic needs. The study concludes that teenage childbearing significantly disrupts family well-being, recommending comprehensive support programs, including financial aid, childcare, healthcare, and community initiatives, to better assist teenage mothers and reduce their socio-economic burdens. Unique Contribution to Theory, Policy and Practice: This research uniquely contributes to theory, policy, and practice by creating a comprehensive model that integrates empirical findings and qualitative insights, thereby enriching existing theories. Additionally, it provides practical recommendations for targeted support programs that guide policymakers in alleviating socio-economic burdens and enhancing family well-being.