Context Of Health Research Articles

Adventure and mental health: an ecological perspective.

In this paper, we explore the concept of outdoor adventure in the context of mental health, proposing an ecological perspective to redefine adventure beyond its traditional associations with risk and physical challenge. We critically examine current frameworks and definitions of adventure, which often emphasise specific activities and natural environments yet overlook the individual's experience and potential mental health benefits. From an ecological perspective, we emphasise the dynamic interplay between the individual, the activity, and the environment. This approach, grounded in ecological psychology, considers the multi-dimensional nature of adventure, including social, psychological, physical, and spiritual aspects. The paper challenges the traditional risk-focused view of adventure, advocating for a broader definition that includes diverse experiences and interactions, as well as the transformative potential of adventure in various environments, including urban settings. We highlight the changing demographics and motivations of adventure participants, moving away from the stereotypical young male risk-seeker, to more diverse and inclusive participant profiles. We argue that adventure facilitates the realisation of fundamental human affordances, often untapped in daily life, thereby enhancing mental health and wellbeing. This ecological perspective opens new avenues for understanding the role of adventure in mental health and wellbeing, offering a more comprehensive and inclusive approach to adventure activities as therapeutic interventions. This redefined understanding of adventure emphasises its potential as a powerful tool for enhancing human wellbeing, harmonising the relationship between people, tasks, and the environment, and offering profound implications for mental health contexts.

Dissemination of resistance to antimicrobials in the unique health context: a brief review

Dissemination of resistance to antimicrobials in the unique health context: a brief review

Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens.

Diagnostic excellence refers to the optimal process to attain an accurate and precise explanation about a patient's condition and incorporates the perspectives of patients and their care partners. Patient-reported measures (PRMs), designed to capture patient-reported information, have potential to contribute to achieving diagnostic excellence. We aimed to craft a set of roadmaps illustrating goals and guiding the development of PRMs for diagnostic excellence ("Roadmaps"). We used iterative inputs from environmental literature scans, expert consultations, and patient voice and employed human-centred design (HCD) and equity-focused road-mapping. The culminating activity of these approaches was an Expert Convening. Use of PRMs can achieve multiple goals for diagnostic excellence, including but not limited to: (1) PRMs for diagnostic continuity, (2) diagnostic PRM alerts, (3) PRM-based quality improvement, (4) PRMs for research, (5) PRMs for routine screening, (6) PRM-based diagnostic excellence population-level patterns, and (7) PRMs supporting patient storytelling. Equity is considered as a cross-cutting goal. Altogether these and future goals support operationalising a vision of patient-reported diagnostic excellence. Roadmaps were developed as a dynamic tool to illustrate PRMs in relation to specific steps with feedback loops to accomplish goals, anticipated timeframes (8-15 years), synergies to foster, and challenges to overcome. Roadmaps are practical in their following PRMs through the stages of development, endorsement, implementation and scaling, and acting upon those measures. Timeframe estimates assume immediate transitions between these stages and no acceleration through incentives and active coordination. PRMs for diagnostic excellence have potential to connect patient perspectives, equity, and achievable goals. Roadmaps offer a design approach to enable coordinating measurement activities among diverse stakeholders. Roadmaps also highlight versatility in ways patient-reported information can be collected and used, from clinical settings to public health contexts. Patient-reported diagnostic excellence cannot be established as a solely top-down endeavour, but inherently benefits from bottom-up approaches.

Are remote health clinics primary health care focused? Validation of the Primary Health Care Engagement (PHCE) Scale for the Australian remote primary health care setting.

To test and validate a measure of primary health care (PHC) engagement in the Australian remote health context. PHC principles include quality improvement, community participation and orientation of health care, patient-centred continuity of care, accessibility, and interdisciplinary collaboration. Measuring the alignment of services with the principles of PHC provides a method of evaluating the quality of care in community settings. A two-stage design of initial content and face validity evaluation by a panel of experts and then pilot-testing the instrument via survey methods was conducted. Twelve experts from clinical, education, management and research roles within the remote health setting evaluated each item in the original instrument. Panel members evaluated the representativeness and clarity of each item for face and content validity. Qualitative responses were also collected and included suggestions for changes to item wording. The modified tool was pilot-tested with 47 remote area nurses. Internal consistency reliability of the Australian Primary Health Care Engagement scale was evaluated using Cronbach's alpha. Construct validity of the Australian scale was evaluated using exploratory factor analysis and principal component analysis. Modifications to suit the Australian context were made to 8 of the 28 original items. This modified instrument was pilot-tested with 47 complete responses. Overall, the scale showed high internal consistency reliability. The subscale constructs 'Quality improvement', 'Accessibility-availability' and 'population orientation' showed low levels of internal consistency reliability. However, the mean inter-item correlation was 0.31, 0.26 and 0.31, respectively, which are in the recommended range of 0.15 to 0.50 and indicate that the items are correlated and are measuring the same construct. The Australian PHCE scale is recommended as a tool for the evaluation of health services. Further testing on a larger sample may provide clarity over some items which may be open to interpretation.

Suicide prevention in a virtual environment: a roadmap for simulation-based education.

to build and validate a simulation-based education roadmap on suicide prevention in the virtual environment. methodological research subdivided into a development and validation stage. The roadmap was built using a previously drafted template based on international guidelines on good clinical simulation practices and scientific literature on suicide prevention in the virtual environment. For validation, the roadmap was validated by experts through self-application of an assessment form with answers based on "adequate, fair, and inadequate", with a field for suggestions. Descriptive statistics and the Content Validity Index (CVI≥0.8) were used. nine experts took part in the study, the majority of whom were nurses (66.7%), female (55.6%), with an average age of 42.22 years. All the items in the roadmap met the acceptance criteria (CVI≥0.8). this study provides a useful roadmap for teaching suicide prevention in the virtual environment. (1) Innovative study on suicide prevention, simulated teaching, and the virtual environment. (2) Script validated by experts and available in full for simulated teaching. (3) Introduction of a prototype of a fictional virtual social network for simulated practice. (4) Results indicated the appropriateness of the construction, with good agreement in the analyses. (5) The script enhances professional training and development in the mental health context.

Stress management preferences and stress experiences among Latinx immigrants in the United States during the COVID-19 pandemic: Mixed-methods results from a community-academic research team.

Latinx individuals in the U.S. have higher levels of stress than other ethnic groups. Latinx immigrants living in non-traditional immigration destinations (NTIDs) have worse access to social and medical support and were particularly vulnerable during the COVID-19 pandemic. This study aims to contextualize stress in Latinx immigrants in an NTID during the COVID-19 pandemic and to understand Latinx immigrants' preferences for stress management interventions given the sociopolitical and public health context. Using a community-based participatory research approach with mixed methods research design, community co-researchers gathered data using a quantitative survey and then contextualized survey results using a qualitative community conversation. Community conversation participants were surprised at the relatively low levels of reported stress and pandemic impact in survey participants, and they proposed the reason was the level of pre-pandemic stressors. Guatemalan immigrants in an NTID reported more stigma but fewer changes between pre- and post-pandemic stress levels. Survey respondents preferred to learn about stress management through YouTube videos or groups led by professionals. Understanding the diversity of stress experiences among Latinx immigrant groups is critical to developing effective interventions. Coping strategy preferences are variable among different Latinx immigration groups, but asynchronous and/or professional-led stress management was preferred.

Multi-task learning for predicting quality-of-life and independence in activities of daily living after stroke: a proof-of-concept study.

A health-related (HR) profile is a set of multiple health-related items recording the status of the patient at different follow-up times post-stroke. In order to support clinicians in designing rehabilitation treatment programs, we propose a novel multi-task learning (MTL) strategy for predicting post-stroke patient HR profiles. The HR profile in this study is measured by the Barthel index (BI) assessment or by the EQ-5D-3L questionnaire. Three datasets are used in this work and for each dataset six neural network architectures are developed and tested. Results indicate that an MTL architecture combining a pre-trained network for all tasks with a concatenation strategy conditioned by a task grouping method is a promising approach for predicting the HR profile of a patient with stroke at different phases of the patient journey. These models obtained a mean F1-score of 0.434 (standard deviation 0.022, confidence interval at 95% [0.428, 0.44]) calculated across all the items when predicting BI at 3 months after stroke (MaS), 0.388 (standard deviation 0.029, confidence interval at 95% [0.38, 0.397]) when predicting EQ-5D-3L at 6MaS, and 0.462 (standard deviation 0.029, confidence interval at 95% [0.454, 0.47]) when predicting the EQ-5D-3L at 18MaS. Furthermore, our MTL architecture outperforms the reference single-task learning models and the classic MTL of all tasks in 8 out of 10 tasks when predicting BI at 3MaS and has better prediction performance than the reference models on all tasks when predicting EQ-5D-3L at 6 and 18MaS. The models we present in this paper are the first models to predict the components of the BI or the EQ-5D-3L, and our results demonstrate the potential benefits of using MTL in a health context to predict patient profiles.

A critical qualitative content analysis of media representations of underrepresented groups in the context of health identity

Information accuracy is imperative for the media representation regardless of what information or context is. A variety of health-related information is conveyed to viewers through television news and entertainment programs, which include but not restrict to the information about healthcare structure and health professionals, knowledge regarding general health issues, specific illnesses, or topics, and health-promoting behaviors. It is crucial to examine what messages viewers perceive through television programs given the impact on their perceptions, expectations, and actions in reality. Apart from the portrayal of health information, the framing of characters within a context can significantly contribute to the understanding of how exposure to media influences viewers’ lives. By conducting a critical content analysis, this qualitative study has explored media portrayals of individuals from underrepresented groups within the context of health in a fictional medical television drama. The findings provide a critical understanding of media exposure on how viewers perceive the social positioning of underrepresented groups in the context of health identity. Portrayals of underrepresented groups are understood through the discourses of condescension, cultural appropriation, stereotyping, and negativity.

Communicative Leadership among Local Leaders in Indonesia during covid-19 Crisis Management

The covid-19 pandemic is one of the health crises that demand effective communication and timely, accurate, and culturally sensitive communication to reach coordinated and more effective responses. Regarding this function, communicative leadership becomes critical in reaching the success of a health crisis, particularly among local communities which are frequently associated with resistance towards health initiatives. This research is intended to explore the communicative leadership performed by local leaders in managing covid-19 pandemic from 2020 to 2022. To meet this aim, the present study employed interviews with 6 local leaders in Kabupaten Pasuruan, Jawa Timur as informants. This research revealed that in responding health crisis due to covid-19 pandemic, leadership involved communication to construct and negotiate meaning through shared narratives about covid-19. This leadership had been performed to help communities in the sense-making process about the pandemic through a series of strategies comprising (1) operating religious frame and local values to construct a shared reality about covid-19 pandemic and how to respond to it, (2) providing narratives as the evidence, (3) performing openness, presence and empathy. This research also found that maintaining sustainable coordination with the authorities is performed by local leaders to assure communities about the pandemic response plan, thus, community involvement in covid-19 measures could be developed easily. This study confirmed some previous research highlighting the importance of faith-based organizations (FBOs) in communication intervention in the health context and research on the importance of narrative to persuade people to adopt new health behaviours.

In their own words: Mental health nurses' experiences of trauma-informed care in acute mental health settings or hospitals.

Trauma-informed care has emerged as a prominent strategy to eliminate coercive practices and improve experiences of care in mental health settings, with advocacy from international bodies for mental health reform. Despite this, there remains a significant gap in research understanding the integration of trauma-informed care in mental health nursing practice, particularly when applied to the acute mental health or hospital-based setting. The study aimed to explore the experiences of mental health nurses employed in acute hospital-based settings from a trauma-informed care perspective. The study design was qualitative, using a phenomenological approach to research. A total of 29 nurses employed in acute mental health or hospital-based environments participated. Three over-arching themes were uncovered: 'Embodied Awareness': highlighting mental health nursing emotional capabilities are deeply rooted in bodily awareness. 'Navigating Safety': signifying spatial elements of fear and how some mental health nurses' resort to coercive or restrictive practices for self-preservation. 'Caring Amidst Uncertainty': revealing the relational influences of security guards in mental health nursing. The study reveals a significant gap in trauma-informed care implementation when applied to the context of mental health nursing practice in this setting. Limited evidence on trauma-informed care for mental health nurses, coupled with inadequate workforce preparation and challenging work environments, hinder the effective integration of it. To genuinely embed TIC in acute mental health settings, the study emphasises the need for a thorough exploration of what this entails for mental health nurses.

Spina Bifida Global Learning Collaborative: Educating the next generation of clinicians, researchers, and advocates.

This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees. Using a descriptive study design, a convenience sample of SB curricula were identified in 2022-23 by members of the Spina Bifida World Congress Outreach Committee and evaluated during a series of monthly Zoom calls to discuss SB education in a global health context. Participants included (1) leadership from the ReachAnother Foundation, (2) invited panelists from the Spina Bifida World Congress Global Health Symposium, and (3) global health students and preceptors. Education initiatives in Ethiopia, Sweden, Argentina, Ecuador, and the United States were evaluated vis-à-vis format and content. All of the education initiatives referenced the framework of the World Health Organization International Classification of Functioning, Disability and Health. Formats varied and included both virtual and interactive workshops, print materials, videos, and guides for small group discussion. Content addressed four domains: Folate Prevention, Neurosurgical Training, After Care, and Data Collection. A multidisciplinary approach, partnerships with families, and workforce pipeline training were identified as guiding themes for educating the next generation of SB researchers and clinicians in global health settings. The Spina Bifida Global Learning Collaborative is a transnational group of advocates, clinicians, and investigators whose mission is the advancement of SB-related global health education. Lessons learned from the collaborative are being leveraged to develop a global health curriculum for learners, which may improve services for individuals with SB around the globe.

A qualitative study of pharmacists' perceptions and awareness of homoeopathic medicines in Durban, South Africa.

There is growing interest in the demand for and use of homoeopathic medicines by the public; however, little is known about the perspectives of pharmacists regarding the use of these medicines, particularly in the South African private health context. A qualitative approach using an exploratory cross-sectional descriptive design was used. Data were collected from a purposive sample of 15 participants comprising pharmacy managers, pharmacists and pharmacy assistants from six different conveniently selected private pharmacy retail outlets. Data were collected using individual interviews utilising a semi-structured interview guide. An audiotape was used to record the data which were transcribed verbatim and analysed thematically, following Tech's steps of data analysis. Ethical approval to conduct the study was obtained from the Durban University of Technology's Institutional Research Ethics Committee. The findings of this study revealed four superordinate themes related to pharmacists' perceptions and self-reported awareness regarding homoeopathic medicines. These are (1) negative perceptions regarding homoeopathic medicines, (2) perceived benefits of homoeopathic medicines, (3) poor knowledge and awareness of homoeopathic medicines and (4) capacity development and curriculum aspects. The findings highlight the need for an educational intervention on homoeopathic medicines targeting pre-service and in-service pharmacy practitioners, to enable them to provide effective education regarding all types of medicines as the demand for homoeopathic medicines increases.Contribution:The study findings provide evidence to support advocacy for an educational intervention to improve awareness and knowledge of pharmacists to enable provision of effective health education for patients. More research, however, is required to inform the contents of this training intervention for pharmacists.

“We need a little strength as well”: Examining the social context of informal caregivers for Black women with breast cancer

BackgroundInformal caregivers (e.g., partners, other family members, friends) often provide social support to Black women with breast cancer, and caregivers find both benefits and challenges in their caregiving role. MethodsIn this qualitative study, twenty-four caregivers for Black women with breast cancer participated in focus groups and interviews. Participants responded to a brief close-ended questionnaire as well as semi-structured questions about their experiences as cancer caregivers. Demographic information was collected, and relationship satisfaction was measured by the Relationship Assessment Scale-General scale (RAS-G). Focus groups and interviews were recorded, transcribed verbatim, and coded by two independent coders. Using an iterative, discussion-based process, the study team developed and refined themes. ResultsAll caregivers described themselves as Black/African American, and the majority identified as female (79%). The mean RAS-G score was 4.5 (SD = 0.5), indicating high levels of relationship satisfaction. Qualitative themes included using a range of strategies to provide emotional support; shifting between roles; needing time and space; and trying to stay strong. Several female caregivers described how the cumulative experiences of providing care for multiple family members and friends could be draining, as could their own experiences in the patient role. ConclusionsThese findings show a complex, multilayered social context that affects both the patient-caregiver relationship and the health and wellbeing of caregivers. Clinicians providing treatment and support for Black women with breast cancer should be mindful of how the health context of the family may affect patient and caregiver outcomes.

Psycho-emotional stress and its impact on the intestine before and after artificial abortion

This study explores the psycho-emotional stress and related intestinal symptoms among women of fertile age who underwent an artificial abortion, utilizing a well-defined point-based questionnaire for stress levels and the revised version of the questionnaire for healthcare professionals to evaluate intestinal symptoms. The cohort consisted of 400 participants, with stress levels categorized as low (0–30 points), medium (31–70 points), or high (71+ points) according to the Perceived Stress Scale-10 (PSS). Further, perceived helplessness and perceived self-efficacy were evaluated via negative and positive PSS items, respectively. Findings indicated that most (65.5 %) women experienced high, and 27.5 % — medium stress before an abortion. Notably, pre-abortion stress levels were generally higher compared to those after an abortion. Concurrently, the frequency of bowel symptoms declined after an abortion. A significant relationship was found between pre-abortion bowel symptoms and higher post-abortion PSS scores, and an increase in the perceived helplessness subgroup (p = 0.051, R2 = 0.156; p = 0.029, R2 = 0.138, respectively). Furthermore, higher perceived helplessness scores were linked with increased pre-abortion intestinal symptoms (p = 0.043, R2 = 0.341). The study, however, found no significant correlations between bowel symptoms and the perceived self-efficacy subgroup. These results suggest an association between pre-abortion psychological factors (lower self-efficacy and higher stress levels) and the incidence of intestinal symptoms, thus shedding light on the intersection of psychological and physical well-being in reproductive health contexts. Further research is needed to explore these mechanisms and develop effective support strategies.

Intersociety Position Statement on the Prevention of Ophthalmia Neonatorum in Italy.

There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy.

DESIGN, DELIVERY, AND EVALUATION OF DYADIC INTERVENTIONS WITH OLDER ADULTS

Abstract With increasing evidence of the interpersonal context of health and illness, there is growing interest in interventions that target the needs of the family care dyad. Yet, there are often specific challenges to the design, delivery and evaluation of dyadic interventions that are not often disseminated. This session includes four papers that will discuss the benefits (but also challenges and lessons learned) of four different dyadic interventions targeted at older adults and their care partners in both cognitive impairment and chronic illness contexts. First, Dr. Rashelle Hoffman and colleagues will present results from focus groups with rural MCI care dyads that inform the adaptation of an existing efficacious telerehabilitation physical activity intervention (TPAB). Second, Dr. Glenna Brewster and colleagues will discuss recruitment and delivery challenges, and the benefits of a pilot behavioral sleep intervention for adults with cognitive impairment and their care partners. Third, Dr. Lyndsey Miller and colleagues will report the feasibility, acceptability and preliminary efficacy of a program to support preparation for future care needs and improved well-being in care dyads living with dementia. Finally, Dr. Karen Lyons and colleagues will present findings from a pilot communication-based intervention for couples living with heart failure. The presentation will discuss the individual versus dyadic benefits of the program and challenges related to recruitment and retention. Speakers and Discussant, Dr. Kalisha Bonds Johnson, will share challenges and best-practices in designing, delivering, and evaluating interventions to optimize the health and well-being of the older adult care dyad.

Chatbots and mental health: Insights into the safety of generativeAI

AbstractChatbots are now able to engage in sophisticated conversations with consumers. Due to the “black box” nature of the algorithms, it is impossible to predict in advance how these conversations will unfold. Behavioral research provides little insight into potential safety issues emerging from the current rapid deployment of this technology at scale. We begin to address this urgent question by focusing on the context of mental health and “companion AI”: Applications designed to provide consumers with synthetic interaction partners. Studies 1a and 1b present field evidence: Actual consumer interactions with two different companion AIs. Study 2 reports an extensive performance test of several commercially available companion AIs. Study 3 is an experiment testing consumer reaction to risky and unhelpful chatbot responses. The findings show that (1) mental health crises are apparent in a nonnegligible minority of conversations with users; (2) companion AIs are often unable to recognize, and respond appropriately to, signs of distress; and (3) consumers display negative reactions to unhelpful and risky chatbot responses, highlighting emerging reputational risks for generative AI companies.

In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19.

The primary objective was to evaluate if the percentage of patients with missing or inaccurate code status documentation at a Trauma Level 1 hospital could be reduced through daily updates. The secondary objective was to examine if patient preferences for DNR changed during the COVID-19 pandemic. This retrospective study, spanning March 2019 to December 2022, compared the code status in ICU and ED patients drawn from two data sets. The first was based on historical electronic medical records (EHR), and the second involved daily updates of code status following patient admission. Implementing daily updates upon admission was more effective in ICUs than in the ED in reducing missing code status documentation. Around 20% of patients without a specific code status chose DNR under the new system. During COVID-19, a decrease in ICU patients choosing DNR and an increase in full code (FC) choices were observed. This study highlights the importance of regular updates and discussions regarding code status to enhance patient care and resource allocation in ICU and ED settings. The COVID-19 pandemic's influence on shifting patient preferences towards full code status underscores the need for adaptable documentation practices. Emphasizing patient education about DNR implications and benefits is key to supporting informed decisions that reflect individual health contexts and values. This approach will help balance the considerations for DNR and full code choices, especially during health care crises.

Hypertensive supratentorial intracerebral hemorrhage: clinical picture, diagnosis, treatment

Background. The paper analyzed the severity and prevalence of hypertensive supratentorial intracerebral hemorrhages (ICH). This pathology is an urgent problem in the global health context, as it leads to severe consequences, including disability and death of patients. Recent discoveries and clinical guidelines provide physicians and researchers with new opportunities to improve clinical practice and improve the effectiveness of treatment for these complications. An increase in the number of cases of hypertensive supratentorial intracerebral hemorrhages and their impact on public health makes this problem extremely relevant in the field of medicine. Materials and methods. Two hundred and thirty-two patients with supratentorial intracerebral hemorrhages caused by hypertension were examined and treated in 2019–2020 at the Kyiv City Clinical Emergency Hospital. The average age of patients was 60 years: for men, it was 56 years, for women 69 years. They were observed during treatment in the hospital for up to 21 days. On the 21st day, the degree of disability was assessed. All patients underwent a neurological examination with an assessment of consciousness according to the Glasgow Coma Scale, Intracerebral Hemorrhage Score, Barthel index, modified Rankin scale, National Institutes of Health Stroke Scale (NIHSS). We have used neuroimaging methods (computed tomography, magnetic resonance angiography, if necessary). Clinical and laboratory studies were conducted. Results. It was found that 127 (57 %) patients had putaminal supratentorial hemorrhage, 24 (10 %) — thalamic, 34 (15 %) — subcortical (in the white matter of the cerebral hemispheres), 47 (20 %) — mixed. Seventy-seven (33 %) patients were hospitalized in a coma (Glasgow Coma Scale ≤ 8 points), 36 (16 %) in a sopor, 81 (35 %) in a stunned state, and 31 (13 %) patients were conscious. Patients over 60 years of age had ICH of deep localization, while young patients had cortical ones. Ninety-four surgical interventions were performed in 84 patients with lobar and lateral hematomas, as well as with breakthrough into the ventricular system (liquid drainage surgery). General mortality was 39.5 %, surgical — 46.4 %. Contraindications for surgical interventions were as follows: an existing severe coma, unstable hemodynamics, the need for constant administration of vasopressors, as well as severe comorbid conditions. Conclusions. It was found that the clinical picture of acute supratentorial intracerebral hemorrhages against the background of hypertension is characterized by polymorphic neurological symptoms according to the localization of the hematoma, its volume, cerebral edema, and intracranial hypertension. The results of the treatment of patients with hypertensive ICH indicate the need for early hospitalization, early computed tomography scan, and a differentiated approach to surgical removal of the hematoma. The favorable outcome of supratentorial ICH is more typical for patients with initial mild and moderate neurological symptoms in case of a hemorrhage volume of less than 30 cm3. The presence of blood breakthrough into the ventricular system increases the risk of death by 35 times.

Preventative and therapeutic potential of tocotrienols on musculoskeletal diseases in ageing.

Musculoskeletal health is paramount in an ageing population susceptible to conditions such as osteoporosis, arthritis and fractures. Age-related changes in bone, muscle, and joint function result in declining musculoskeletal health, reduced mobility, increased risk of falls, and persistent discomfort. Preserving musculoskeletal wellbeing is essential for maintaining independence and enhancing the overall quality of life for the elderly. The global burden of musculoskeletal disorders is significant, impacting 1.71 billion individuals worldwide, with age-related muscle atrophy being a well-established phenomenon. Tocotrienols, a unique type of vitamin E found in various sources, demonstrate exceptional antioxidant capabilities compared to tocopherols. This characteristic positions them as promising candidates for addressing musculoskeletal challenges, particularly in mitigating inflammation and oxidative stress underlying musculoskeletal disorders. This review paper comprehensively examines existing research into the preventive and therapeutic potential of tocotrienols in addressing age-related musculoskeletal issues. It sheds light on the promising role of tocotrienols in enhancing musculoskeletal health and overall wellbeing, emphasizing their significance within the broader context of age-related health concerns.