Health Screening Research Articles

68 Screen & Intervene: Mental Health Screening in the Burn Center

68 Screen & Intervene: Mental Health Screening in the Burn Center

Prevalence and factors associated with psychological distress among key populations in Nigeria.

Stigmatization and discrimination within healthcare settings deter key populations (KPs) from seeking mental health and psychosocial support (MHPS). Consequently, understanding the prevalence, associated factors, and impact of the MHPSS intervention on psychological distress among Nigeria's KPs is crucial. This is a cross-sectional study focused on KPs, including Female Sex Workers (FSW), Men who have Sex with Men (MSM), and People Who Inject Drugs (PWID) enrolled in Heartland Alliance LTD/GTE across 17 One-Stop Shops (OSS) in six states of Nigeria. Data were extracted from the databases of the OSS. PD was assessed using the Mental Health Screening Form III (MHSF-III). Descriptive statistics and univariable and multivariable binary logistic regression models were done using IBM-SPSS version 28. The prevalence of PD among the KPs was 9.7%. Higher rates were observed among FSWs (12.0%). Of the 22310 KPs, the prevalence of PD was 9.7%. The major dependants of PD include being a PWID with PD prevalence of 8.5% and AOR of 1.95 (95% CI: 0.60-0.98, p = 0.015), alcohol intake with PD prevalence of 97.7% and AOR of 21.83 (95% CI: 15.13-56.83, p<0.001), and having experienced gender-based violence with PD prevalence of 99.0% and AOR of 25.70(95% CI: 17.10-38.73, p<0.001). All Participants (100%) were given brief intervention, and 1595 of 2159 (73.8%) were referred for further psychological intervention. The services with the highest proportion were psychoeducation (21.20%), followed by coping skills training (17.70%) and motivational enhancement (12.90%). The study highlights the critical need for targeted mental health interventions among KPs in Nigeria, primarily focusing on those with a history of substance abuse and gender-based violence. Despite universal brief interventions, the proportion enrolled in further Psychosocial support indicates a need to improve mental health service utilization among the KPs in Nigeria.

Retrospective Study of the Prevalence and Associated Factors of Gallbladder Polyps among Residents of Two Korean Cities.

Background/Aims: Well-known risk factors for gallbladder polyps include metabolic syndrome, age, and dyslipidemia. Jeju Island is approximately 80 km from the Korean peninsula and is divided into two administrative regions (Jeju City and Seogwipo City), with Mount Halla intervening in the center. Jeju City has higher employment and birth rates than Seogwipo City. Age and alcohol consumption differ between the two regions, and these factors may affect the prevalence of gallbladder polyps (GBPs). Therefore, we investigated the prevalence of GBPs and compared various factors, including alcohol consumption habits and age, associated with GBPs among residents in the two regions. Methods: This study included 21,734 residents who visited the Health Screening and Promotion Center of Jeju National University Hospital between January 2009 and December 2019. We investigated the prevalence and associated factors of GBPs among residents of Jeju City and Seogwipo City. Results: The prevalence of GBPs in Jeju City and Seogwipo City was 9.8% and 8.9% (p = 0.043), respectively. The mean age and rate of high-risk alcohol intake were higher in Seogwipo City. The mean body mass index and levels of fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase were lower in Jeju City. Conclusions: This study demonstrated a significant difference in GBP prevalence between the two regions of Jeju Island. Age and alcohol consumption might contribute to this difference; however, further prospective cohort studies are warranted to confirm our findings.

Anxiety and Depression Prevalence in Free Clinic Patients

Background: Disparities in mental health services are often observed in under-resourced low-income communities, which are at an increased risk for compromised mental health. By surveying patients at JayDoc Free Clinic, a student-run free clinic (SRFC) in Kansas City, Kansas, this study sought to as-sess the prevalence of depression and anxiety and compare screening outcomes among various de-mographic groups seeking safety-net care.Methods: From May through November 2022, patients aged 12 and older were offered a Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and demographic survey. Demo-graphic variables included household income, gender, insurance status, and race and ethnicity. GAD-7 and PHQ-9 questionnaire scores were categorized into minimal, mild, moderate, or severe catego-ries. Relationships between demographic variables and scores on screening questionnaires were an-alyzed using multivariable analyses, with linear regression and analysis of variance one-way tests for significance (p-value &lt;0.05).Results: Of 232 participants who consented to the study, 222 completed the GAD-7 and 228 com-pleted the PHQ-9. In comparison to 2019 United States national data, the percentage of respondents experiencing anxiety and depression was greater across all severity classifications. Approximately 18.1% reported symptoms of moderate to severe anxiety and 21.5% reported symptoms of moderate to severe depression, compared to national distributions of 6.1% and 7%, respectively. Of 232 participants, 54 completed the demographic survey. There was no correlation between PHQ-9 scores or GAD-7 scores and gender, household income, insurance status.Conclusion: While no association was identified between screening outcomes and demographic var-iables, the findings that the prevalence of anxiety and depression at JayDoc SRFC is greater than na-tional rates reaffirm the need for accessible mental health services for patients receiving care at SRFCs. This study provides insight into the status of mental health in an SRFC patient population and discusses mental health screening implementation at SRFCs.

Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): a nested cross-sectional assessment of falls risk within a cluster randomised trial

BackgroundTo investigate the feasibility of using the Stopping Elderly Accidents, Deaths and Injuries (STEADI) Falls Risk Tool Kit during community-based eye health screenings to assess falls risk of participants enrolled...

Mental Distress, Label Avoidance, and Use of a Mental Health Chatbot: Results From a US Survey.

For almost two decades, researchers and clinicians have argued that certain aspects of mental health treatment can be removed from clinicians' responsibilities and allocated to technology, preserving valuable clinician time and alleviating the burden on the behavioral health care system. The service delivery tasks that could arguably be allocated to technology without negatively impacting patient outcomes include screening, triage, and referral. We pilot-tested a chatbot for mental health screening and referral to understand the relationship between potential users' demographics and chatbot use; the completion rate of mental health screening when delivered by a chatbot; and the acceptability of a prototype chatbot designed for mental health screening and referral. This chatbot not only screened participants for psychological distress but also referred them to appropriate resources that matched their level of distress and preferences. The goal of this study was to determine whether a mental health screening and referral chatbot would be feasible and acceptable to users. We conducted an internet-based survey among a sample of US-based adults. Our survey collected demographic data along with a battery of measures assessing behavioral health and symptoms, stigma (label avoidance and perceived stigma), attitudes toward treatment-seeking, readiness for change, and technology readiness and acceptance. Participants were then offered to engage with our chatbot. Those who engaged with the chatbot completed a mental health screening, received a distress score based on this screening, were referred to resources appropriate for their current level of distress, and were asked to rate the acceptability of the chatbot. We found that mental health screening using a chatbot was feasible, with 168 (75.7%) of our 222 participants completing mental health screening within the chatbot sessions. Various demographic characteristics were associated with a willingness to use the chatbot. The participants who used the chatbot found it to be acceptable. Logistic regression produced a significant model with perceived usefulness and symptoms as significant positive predictors of chatbot use for the overall sample, and label avoidance as the only significant predictor of chatbot use for those currently experiencing distress. Label avoidance, the desire to avoid mental health services to avoid the stigmatized label of mental illness, is a significant negative predictor of care seeking. Therefore, our finding regarding label avoidance and chatbot use has significant public health implications in terms of facilitating access to mental health resources. Those who are high on label avoidance are not likely to seek care in a community mental health clinic, yet they are likely willing to engage with a mental health chatbot, participate in mental health screening, and receive mental health resources within the chatbot session. Chatbot technology may prove to be a way to engage those in care who have previously avoided treatment due to stigma.

Listening to Black Pregnant and Postpartum People: Using Technology to Enhance Equity in Screening and Treatment of Perinatal Mental Health and Substance Use Disorders.

Perinatal mood and anxiety disorders (PMADs), perinatal substance use disorders (PSUDs), and intimate partner violence (IPV) are leading causes of pregnancy-related deaths in the United States. Screening and referral for PMADs, PSUDs and IPV is recommended, however, racial disparities are prominent: Black pregnant and postpartum people (PPP) are less likely to be screened and attend treatment compared to White PPP. We conducted qualitative interviews to better understand the experience of Black PPP who used a text/phone-based screening and referral program for PMADs/PSUDs and IPV-Listening to Women and Pregnant and Postpartum People (LTWP). We previously demonstrated that LTWP led to a significant reduction in racial disparities compared to in-person screening and referral, and through the current study, sought to identify facilitators of PMAD/PSUD symptom endorsement and treatment attendance. Semi-structured interviews were conducted with 68 Black PPP who were or had been pregnant within the last 24 months, and who either had or did not have a PMAD or PSUD. Participants were enrolled in LTWP and provided feedback on their experience. Using a grounded theory approach, four themes emerged: usability, comfort, necessity, and recommendations. Ease of use, brevity, convenience, and comfort in discussing mental health and substance use via text were highlighted. Need for a program like LTWP in Black communities was discussed, given the reduction in perceived judgement and access to trusted information and resources for PMADs/PSUDs, which may lessen stigma. These qualitative findings illuminate how technology-based adaptations to behavioral health screening and referral can reduce perceived negative judgment and facilitate identification and referral to treatment, thereby more adequately meeting needs of Black PPP.

Exploring a multimodal approach for utilizing digital biomarkers for childhood mental health screening.

Depression and anxiety are prevalent mental health concerns among children and adolescents. The application of conventional assessment methods, such as survey questionnaires to children, may lead to self-reporting issues. Digital biomarkers provide extensive data, reducing bias in mental health self-reporting, and significantly influence patient screening. Our primary objectives were to accurately assess children's mental health and to investigate the feasibility of using various digital biomarkers. This study included a total of 54 boys and girls aged between 7 to 11 years. Each participant's mental state was assessed using the Depression, Anxiety, and Stress Scale. Subsequently, the subjects participated in digital biomarker collection tasks. Heart rate variability (HRV) data were collected using a camera sensor. Eye-tracking data were collected through tasks displaying emotion-face stimuli. Voice data were obtained by recording the participants' voices while they engaged in free speech and description tasks. Depressive symptoms were positively correlated with low frequency (LF, 0.04-0.15 Hz of HRV) in HRV and negatively associated with eye-tracking variables. Anxiety symptoms had a negative correlation with high frequency (HF, 0.15-0.40 Hz of HRV) in HRV and a positive association with LF/HF. Regarding stress, eye-tracking variables indicated a positive correlation, while pNN50, which represents the proportion of NN50 (the number of pairs of successive R-R intervals differing by more than 50 milliseconds) divided by the total number of NN (R-R) intervals, exhibited a negative association. Variables identified for childhood depression included LF and the total time spent looking at a sad face. Those variables recognized for anxiety were LF/HF, heart rate (HR), and pNN50. For childhood stress, HF, LF, and Jitter showed different correlation patterns between the two grade groups. We examined the potential of multimodal biomarkers in children, identifying features linked to childhood depression, particularly LF and the Sad.TF:time. Anxiety was most effectively explained by HRV features. To explore reasons for non-replication of previous studies, we categorized participants by elementary school grades into lower grades (1st, 2nd, 3rd) and upper grades (4th, 5th, 6th). This study confirmed the potential use of multimodal digital biomarkers for children's mental health screening, serving as foundational research.

Relationship between METS-IR and thyroid cancer incidence in Korea: a nationwide population-based study.

Several previous studies found a positive relationship between metabolic syndrome (MetS) and thyroid cancer (TC) risk. However, there is no research that has studied the relationship between the metabolic score for insulin resistance (METS-IR), a novel surrogate marker for IR, and TC incidence. Thus, we designed this retrospective cohort study to evaluate the relationship between the incidence of TC and METS-IR. We analyzed a cohort of 314,321 Korean adults aged over 40 years who participated in the National Health Screening Program from 2009 to 2010. The individuals were divided into four groups based on METS-IR quartiles. Follow-up was until the diagnosis of TC or death, or until December 31, 2019, if neither. The relationship between METS-IR and TC incidence was analyzed using the Cox proportional-hazards model with multi-variable adjustments. A total of 4,137 participants (1.3%) were diagnosed with TC during a mean follow-up of 9.5 ± 1.5 years. The population with Q1 METS-IR scores showed higher disease-free probabilities than those with Q4 METS-IR scores (p <0.001). The hazard ratio (95% confidential interval) for TC incidence in Q2, Q3, and Q4 METS-IR value were 1.14 (1.05 to 1.25), 1.21 (1.11 to 1.33), and 1.30 (1.18 to 1.42) compared with Q1 of METS-IR, respectively. The incidence of TC tended to increase with increasing METS-IR values in the total population, especially the male population in the restricted cubic spline. In subgroup analysis, the TC risk was more pronounced in the subgroups under 65 and with a BMI < 25 kg/m2. METS-IR was positively correlated with TC incidence in Korea.

Social Support Is Protective Against the Effects of Discrimination on Parental Mental Health Outcomes.

Discrimination, or unfair treatment based on individual characteristics such as gender, race, skin color, and or sexual orientation, is a pervasive social stressor that perpetuates health disparities by limiting social and economic opportunity and is associated with poor mental and physical health outcomes. The purpose of the present study is to (1) examine the association between maternal experiences of discrimination and paternal experiences of discrimination; (2) explore how discrimination relates to parental (maternal and paternal) stress and depressive symptoms; and (3) examine whether social support exerts protective effects. The sample was 2,510 mothers and 1,249 fathers from the Child Community Health Network study. Linear regression models were conducted to explore associations between maternal and paternal discrimination. In addition, mediation analyses were conducted to explore if social support functioned as a mediator between discrimination on parental stress and depressive symptoms. Most mothers (40.3%) and fathers (50.7%) identified race as the predominant reason for discrimination. Experiencing discrimination was significantly related to stress and depressive symptoms for both parents, and all forms of social support mediated these relationships. Our findings suggest that social support can act as a protective factor against the negative association between discrimination and both stress and depressive symptoms. These findings highlight the need to integrate social support into existing interventions and include fathers in mental health screenings in primary-care settings. Finally, we briefly describe the role of nurses and other allied health professionals in addressing discrimination in health care and health policy implications.

CA19-9 producing locally advanced papillary thyroid carcinoma: a case report.

CA19-9 is a tumor marker for gastrointestinal and biliary-pancreatic adenocarcinomas; however, its association with thyroid cancer is unknown. Here, we report a case of CA19-9 producing locally advanced papillary thyroid carcinoma (PTC). A 66-year-old woman who was identified with a thyroid tumor after a close examination of an elevated serum CA19-9 level, which was detected at health screening, was referred to our hospital. Ultrasonography revealed a 34 × 31mm hypoechoic lesion in the lower pole of the left thyroid lobe. Computed tomography revealed a solid thyroid tumor with tracheal invasion without any distant metastases. Bronchoscopy revealed tumor exposure into the tracheal lumen on the left side of the trachea. Fine-needle aspiration cytology led to a diagnosis of papillary thyroid carcinoma (PTC). The patient underwent a total thyroidectomy, tracheal sleeve resection with end-to-end anastomosis, and lymph node dissection in the left cervical and superior mediastinal regions (D3c) with a reversed T-shaped upper sternotomy down to the third intercostal level. Histopathological analysis confirmed the diagnosis of PTC with tracheal invasion and no lymph node metastases (pT4a Ex2 N0). Immunohistochemical staining showed the expression of CA19-9 in cancer cells. Postoperatively, the serum CA19-9 level of the patient decreased to within the normal range. Some PTCs produce CA19-9, although less frequently. When elevated serum CA19-9 levels are observed, PTC should be included in the differential diagnosis for further investigation.

Association between obesity and cancer risk in HIV-infected Asians.

This study aimed to investigate the association between obesity and cancer risk as well as site-specific cancer risks in adults with HIV using a nationwide health screening database in Korea. Of the 16,671 adults with a new diagnosis of HIV from 2004 to 2020, 456 incident cancer cases and 1,814 individually matched controls by sex, year of birth, year of HIV diagnosis, and follow-up duration (1:4 ratio) were included in this nested case-control study. The association between obesity (body mass index ≥25 kg/m 2 ) and cancer risks was estimated and presented as odds ratios (ORs) and 95% confidence intervals (CIs). Of the 456 cancer incident cases, there were 146 AIDS-defining cancer cases and 310 non-AIDS-defining cancer cases. Compared with non-obese adults with HIV, obese adults with HIV were at higher risk of non-AIDS-defining cancer (OR = 1.478, 95% CI = 1.118-1.955). Otherwise, the overall risk of AIDS-defining cancer (OR = 0.816, 95% CI = 0.520-1.279) and each type of AIDS-defining cancer (Kaposi sarcoma and non-Hodgkin's lymphoma) were not high in obese adults with HIV. Of the specific types of non-AIDS-defining cancers, obesity was associated with an increased risk of colorectal cancer (OR = 3.090, 95% CI = 1.110-8.604) and liver, bile duct, and pancreatic cancers (OR = 2.532, 95% CI = 1.141-5.617). Obesity, which is one of the important health concerns in HIV management, was associated with an increased risk of non-AIDS-defining cancer but not AIDS-defining cancer.

Perspectives of refugee parents and unaccompanied minors on initial health assessment and access to care.

To explore the needs, expectations, and experiences of asylum-seeking parents and unaccompanied minors under the age of 18years on the initial health assessment for children and adolescents and access to care upon entry in the Netherlands,We conducted five semi-structured focus group discussions with asylum-seeking parents and unaccompanied minors, from Syria, Eritrea, Afghanistan, and other Middle-East and African countries, supported by professional interpreters. To triangulate findings, semi-structured interviews with health care professionals involved in care for refugee children were conducted. Transcripts of focus group discussions were inductively and deductively coded and content analyzed; transcripts of interviews were deductively coded and content analyzed.In total, 31 asylum-seeking participants: 23 parents of 101 children (between 0 and 18years old), 8 unaccompanied minors (between 15 and 17years), and 6 healthcare professionals participated. Parents and minors expressed that upon entry, their needs were met for vaccinations, but not for screening or care for physical and mental health problems. Parents, minors, and health professionals emphasized the necessity of appropriate information and education about health, diseases, and the health system. Cultural change was mentioned as stressful for the parent-child interaction and parental well-being. Conclusion: The perspectives of refugee parents and unaccompanied minors revealed opportunities to improve the experience of and access to health care of refugees entering the Netherlands, especially risk-specific screening and more adequate education about health, diseases, and the Dutch health care system. What is Known: • Refugees have specific health needs due to pre-flight, flight, and resettlement conditions. Health assessment upon entry was non-obligatory in the Netherlands, except for the tuberculosis screening. Health needs were not always met, and refugees experienced barriers in access to care. What is New: • The initial health assessment met the needs concerning vaccinations but mismatched the needs regarding physical and mental health assessment. Screening for specific risk-related diseases and mental health could enable refugee parents and minors to engage better with the health system.

Associations between Peritonsillar Abscess and Deep Neck Infection in Chronic Periodontitis Patients: Two Nested Case-Control Studies Using a National Health Screening Cohort.

Background/Introduction: Odontogenic infection is one of the main etiologies of deep neck infection (DNI). However, the relationship between chronic periodontitis (CP) and the incidence of DNI has not been examined. This study aimed to evaluate the incidence of DNI and peritonsillar abscess (PTA) after CP. Methods: The Korean National Health Insurance Service-National Sample Cohort 2002-2019 was used. In Study I, 4585 PTA patients were matched with 19,340 control I participants. A previous history of CP for 1 year was collected, and the odds ratios (ORs) of CP for PTA were analyzed using conditional logistic regression. In Study II, 46,293 DNI patients and 185,172 control II participants were matched. A previous history of CP for 1 year was collected, and conditional logistic regression was conducted for the ORs of CP for DNI. Secondary analyses were conducted in demographic, socioeconomic, and comorbidity subgroups. Results: In Study I, a history of CP was not related to the incidence of PTA (adjusted OR = 1.28, 95% confidence interval [CI] = 0.91-1.81). In Study II, the incidence of DNI was greater in participants with a history of CP (adjusted OR = 1.55, 95% CI = 1.41-1.71). The relationship between CP history and DNI was greater in groups with young, male, low-income, and rural residents. Conclusions: A prior history of CP was associated with a high incidence of DNI in the general population of Korea. Patients with CP need to be managed for the potential risk of DNI.

The predictors of voluntary participation in pulmonary tuberculosis screening program: a study in a suburban community of southern Thailand.

The health belief model (HBM), baseline health condition, and sociocultural factors impact the decision to participate in a tuberculosis screening program. This cross-sectional and descriptive study was carried out among the "Kao Taew" community dwellers aged 18 years and above, who voluntarily underwent the provided pulmonary tuberculosis (PTB) screening by chest radiographs (CXRs). The level of individual HBM domain perception, attitudes toward PTB prevention, and regularity of PTB prevention practices by the participants were evaluated. The significantly associated or correlated factors such as demographic characteristics, individual HBM domain perception, and attitudes toward PTB prevention with the regularity of PTB prevention practices from the univariate analysis were further analyzed by multiple linear regression (p < 0.05) to determine the independent significant predictors of PTB prevention practices. Among 311 participants comprising 65% women, 57.9% aged ≥ 65 years and 67.2% had an underlying disease. The study participants had a high level of perception of HBM domains but a low level of perception of the barrier. In addition, a high level of attitudes toward PTB prevention and a high regularity of PTB prevention practices were found. A multiple linear regression analysis revealed that the perceived benefits of PTB screening [Beta = 0.20 (0.04, 0.36) p = 0.016] and acquiring underlying diseases [Beta = 1.06 (0.38, 1.73), p = 0.002] were significant predictors for PTB prevention practices, while belief in Islam was a reverse predictor [Beta = -0.84 (-1.47, -0.21), p = 0.010]. The level of perception of the individual domain of HBM, health status, and religious belief significantly predicted voluntary participation in PTB screening programs. Careful consideration by integration of the relevant health psychology, physical, and sociocultural factors is crucial for planning a health screening program.

Association between Congestive Heart Failure and Ossification of the Posterior Longitudinal Ligament in Korea: A Nationwide Longitudinal Cohort Study

Objective: The objective of this nationwide, long-term follow-up study was to explore the connection between congestive heart failure (CHF) and ossification of the posterior longitudinal ligament (OPLL) in Korea.Methods: Patient information was collected from the Health Screening cohort of the National Health Insurance Service. Individuals diagnosed with OPLL were identified using specific International Classification of Diseases, 10th revision codes (M48.8, M48.81, M48.82, and M48.83). A total of 1,289 OPLL patients and 6,445 controls were included in the study, selected through 1:5 age and sex matching. The data spanned from January 1, 2004 to July 31, 2015. To compute the incidence rate of CHF in each group, the Kaplan-Meier method was employed. Additionally, Cox proportional-hazards regression analysis was utilized to estimate the hazard ratio of CHF.Results: CHF was present in 19 patients (1.47%) in the OPLL group and 71 patients (1.10%) in the control group. After accounting for age and sex, the hazard ratio for CHF in the OPLL group was 3.164 (95% confidence interval [CI], 1.867-5.360). When additionally considering income and underlying diseases, the hazard ratio for CHF within the OPLL group was 3.355 (95% CI, 1.977-5.694). All subgroups of OPLL patients exhibited an increased risk ratio for CHF across parameters such as sex, age, diabetes, hypertension, and dyslipidemia.Conclusion: According to this nationwide longitudinal study, an elevated incidence rate of CHF was associated with OPLL.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development.MethodsThe study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic’s impact varied depending on SES or regional inequality.ResultsThis study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22; P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17; P-value: < 0.0001) domains among children of 30–36 months’ ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group.ConclusionsThese findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.

Prevalence of Infectious Diseases in Children at Preschool Education Institutions and Stakeholder Opinions.

Preschool education institutions, where children have close contact and social interactions, can serve as potential environments for the transmission of infectious diseases. This issue poses a significant health concern, impacting both individual and public well-being. Thus, the present research set out to determine the prevalence of infectious diseases in preschool children and the views of parents and teachers on the prevention of infectious diseases. The study employed a mixed-method approach and involved 397 parents and 46 preschool teachers. The study was survey-based via in-person interviews. The results revealed that after they started school (almost in 5 months), children with a mean age of 4.7 ± 0.5 years experienced illness approximately 3.5 ± 2.0 times, of whom 91.5% used antibiotics. The prevalence of infectious diseases was found to be associated with the child's being born at term, maternal education level, and the public/private status of preschool institutions. The presence of a sick child in the classroom elicits negative emotions from both teachers and parents. They recommend that studies on education, safety, hygiene, school health, health screenings, regulation of the learning environment, legal regulations, and school exclusion policies be carried out to prevent infectious diseases. When children with infectious diseases come to school, nearly half of the teachers admit them to the classroom due to various reasons and pressures. Parents request teachers to monitor medication, control sweating, and use a nebulizer for their sick children. Some of the teachers meet these requests, but they claim that the educational process is negatively affected. At preschool education institutions, the risk factors of infectious diseases have a complex structure and can be influenced by variables related to teachers, children, parents and the institution itself. Infectious diseases not only pose a threat to health but also impact teachers' and parents' emotions, teacher-child relationships, and the overall atmosphere within schools and classrooms.

Ageing, osteoporosis and intellectual disability; risks differ, and diagnosis can be missed

AbstractBackgroundPeople with intellectual disability often present atypically for various health conditions, making it challenging to identify concerns, particularly when communication challenges are also considered. Additionally, they may face barriers to healthcare access, resulting in many conditions going unnoticed. Health screening inequities are also evident in this population, and osteoporosis, a silent condition often only diagnosed postfracture, requires screening; however, if this does not happen, it may result in unnecessary fracture. Therefore the aim of this study is to identify predictors of osteoporosis in older adults with intellectual disability and examine potential inequity in the diagnosis of the condition.MethodsThe study used data from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS‐TILDA). Bone quality was measured using quantitative ultrasound (QUS). Logistic regression was performed to identify significant predictors of poor bone quality, including chronic health conditions, dietary intake, medication use and activity levels.ResultsOut of 575 participants who completed QUS, osteoporosis prevalence was objectively measured at 41%, with a further 33.2% measured within the osteopenic range, but less than 2 in 10 had a doctor's diagnosis of osteoporosis. Reported Dual‐Energy X‐ray Absorptiometry screening uptake was low at 18.2%. Three major predictor variables of osteoporosis and osteopenia were found significant: difficulty walking 100 yards, taking antiepileptic drugs medicines and taking proton pump inhibitors. The model achieved an overall classification accuracy of 70.8% for osteopenia and 72.5% for identifying osteoporosis.ConclusionThe study highlights the different risk factors in people with intellectual disability, the potential for missed diagnoses and the likelihood there is inadequate screening. There is an urgent need for robust risk assessment and reasonable adjustments to ensure equitable screening and targeted preventive strategies. Clinicians must consider specific concerns for this population to avoid missed diagnoses and reduce the adverse effects of osteoporosis/osteopenia, such as an increased risk of fragility fractures.

Association between hemoglobin trajectories and the incidence of dementia in a cohort of females aged 55-79 years.

To assess the association between pattern changes in hemoglobin levels over time and the incidence of dementia using trajectories in females aged 55-79 years. We conducted a retrospective cohort study using females of aged 55-79 years from the National Health Insurance Service National Health Screening Cohort in Korea. To identify hemoglobin trajectories over eight years (2002-2009), we performed a three-step approach comprising measures of change, factor analysis, and cluster analysis. Univariate and multivariate Cox proportional hazard models were used to assess the associations between hemoglobin trajectories and the incidence of dementia. We included 20,195 of 235,742 female participants. New dementia (N = 2664) was developed during follow-up period (2010-2015). Five hemoglobin trajectories were identified: high, mid, low, increasing, and decreasing. With high as a reference, the hazard ratios (HRs) for low and decreasing trajectories were significant, 1.28 (95% confidence interval [CI], 1.13-1.45) and 1.21 (95% CI, 1.10-1.34) in univariate models, respectively. However, only the HR for the decreasing trajectory was significant, 1.12 (95% CI, 1.01-1.24) after adjustment for confounders. The decreasing trajectory of hemoglobin levels within the normal range was associated with dementia. Even females aged 55-79 years without anemia might be vulnerable to dementia development risk.