Higher Lifetime Prevalence Research Articles

Reductive Adjuvant Nanosystem for Alleviated Atopic Dermatitis Syndromes.

Atopic dermatitis (AD) is a recurrent and chronic inflammatory skin condition characterized by a high lifetime prevalence and significant impairment of patients' quality of life, primarily due to intense itching and discomfort. However, current pharmacological interventions provide only moderate efficacy and are frequently accompanied by adverse side effects. The immune-pathogenesis of AD involves dysregulation of the Th2 immune response and exacerbation of inflammation related to excessive reactive oxygen species (ROS). Therefore, to address these issues, in this study, we targeted the upstream pathogenesis by designing a pro-Th1 adjuvant nanoemulsion loaded with poly(I:C) and encapsulated with the ROS-scavenger vitamin E, termed PV-NE. PV-NE effectively rebalanced the Th1/Th2 immune response and reduced ROS levels both in vivo and ex vivo, leading to the restoration of immune balance in AD-affected skin and alleviation of symptoms such as lichenification and erythematous patches. In conclusion, our development of the reductive adjuvant nanosystem PV-NE demonstrates its biocompatibility and efficacy in combating AD progression without the use of immunosuppressant glucocorticoids. This has the potential to significantly impact the design and enhancement of pharmacotherapy in future clinical research aimed at curing AD.

Lifetime prevalence of questionable health behaviors and their psychological roots: A preregistered nationally representative survey.

A growing body of evidence suggests that questionable health behaviors- not following medical recommendations and resorting to non-evidence based treatments-are more frequent than previously thought, and that they seem to have strong psychological roots. We thus aimed to: 1) document the lifetime prevalence of intentional non-adherence to medical recommendations (iNAR) and use of traditional, complementary and alternative medicine (TCAM) in Serbia and 2) understand how they relate to 'distal' psychological factors-personality traits and thinking dispositions, and 'proximal' factors-a set of beliefs and cognitive biases under the term 'irrational mindset'. In this preregistered cross-sectional study on a nationally representative sample (N = 1003), we observed high lifetime prevalence of iNAR (91.3%) and TCAM (99.2%). Irrational beliefs, especially magical health beliefs and medical conspiracy theories, were the strongest predictors of TCAM. They also mediated the relation between Disintegration/lower cognitive reflectiveness and TCAM. High Disintegration, and low Conscientiousness predicted iNAR directly, whilst negative experiences with the healthcare system facilitated both types of questionable health practices. The established psychological profile of people prone to questionable health behaviors and the fact they can be tracked to negative experiences with the system can be used to tailor public health communications.

Complementary and Integrative Health Use in Binge Eating Disorder: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Perspectives.

Binge Eating Disorder (BED) has high lifetime prevalence rates, low treatment success rates, and high rates of treatment dissatisfaction, early discontinuation of care, and recurrence. Complementary and integrative health (CIH) interventions (non-mainstream practices used with conventional approaches for whole-person treatment) hold potential to overcome many treatment barriers and improve BED treatment outcomes. Some CIH interventions have empirical support for use in eating disorders. However, little is known about the current state of CIH use in BED. This mixed-methods cross-sectional study collected information from BED experts about CIH use in adult BED treatment. Fourteen expert BED researchers and clinicians were identified based on federal funding, PubMed-indexed publications, practice in the field, leadership in professional societies, and/or popular press distinction. Anonymously recorded semi-structured interviews were analyzed by ≥2 investigators using reflexive thematic analysis and quantification. Expert opinions and experiences on/with CIH use were generally positive/supportive (64%) with mixed views (36%) varying by intervention and empirical support. The interventions most commonly described were mindfulness (71%), yoga (64%), and supplements/vitamins/pre-/probiotics/herbs (64%). Supplements/vitamins/pre-/probiotics/herbs had mixed views; all other interventions were generally viewed positively. The benefits most commonly associated with specific interventions (e.g., mindfulness, yoga, supplements) were: regulating/tolerating emotions/mood/stress/anxiety (50%); healing the relationship with the body/body image/movement/exercise-trauma (29%); biological/physiological benefits (29%); and directly supporting treatment ("space for self-separate from treatment," behavior change, "tolerating treatment") (29%). Intrinsic self-healing (e.g., patient-driven healing that comes from the patient's innate desire to heal based on the patient's lived experience(s)) and investigative research were also associated with CIH use broadly. Most experts (57%) expressed familiarity with existing literature/research for ≥1 CIH intervention; 50% identified a need for empirical testing. Half (50%) spontaneously described using ≥1 CIH intervention in their own clinical practice/center. The most used interventions were yoga (43%), meditation/mindfulness (29%), and acupuncture (21%). Eight experts (57%) endorsed the importance of correct implementation; 43% acknowledged CIH use in conventional treatments (2nd-wave CBT, 3rd-wave behavior therapies). CIH interventions can complement current BED treatments to improve clinical outcomes, particularly managing anxiety/stress/mood, healing the relationship with the body, addressing biological/physiological deficiencies, and tolerating treatment (thus reducing treatment dropout). Empirical testing is warranted with a particular need for randomized controlled trials and guidelines on implementation and use.

High lifetime prevalence of regular nitrous oxide use in French medical students

ABSTRACT Background: Although nitrous oxide (N₂O) is increasingly misused recreationally, its use and risks among medical students who have professional access to it are rarely explored. Objectives: To investigate the recreational use of N₂O among medical students in Paris Region (France). Methods: This cross-sectional study used an online questionnaire distributed in 2022 through social networks, to all medical students (undergraduate student from the 2nd year of medical studies to residents until the end of the residency) from the six medical universities in Paris Region. We collected demographic characteristics, patterns of N₂O consumption, co-consumptions, and N₂O training (academic course or self-training). Factors associated with N₂O consumption and complications were analyzed using multivariable logistic regressions. Results: The questionnaires of 444 students (mean age: 25.9 years (SD = 2.69), 75.5% female, and 63.74% residents) were analyzed. Recreational N₂O consumption was reported by 71.85% of students and 20.50% consumed at least monthly. N₂O consumption was associated with being a resident (versus undergraduate student) (adjusted OR (aOR) = 3.07[1.45–6.72]; p < .01), receiving training on N₂O (aOR) = 3.13[1.84–6.24]; p < .01), and consumption of cannabis (aOR = 18.21[3.47–104.26]; p < .01), ecstasy (aOR = NA, p = .048) and poppers (aOR = 13.9[2.64–77.94]; p < .01). Complications (mainly dizziness, paresthesia and burns) were reported in 8.15% of students consuming N₂O. They were associated with consuming more than 10 balloons per intake (aOR = 6.04[1.32–25.00); p < .01) and inversely associated with receiving training (aOR = 0.35[0.14–0.86]; p = .01). Conclusions: Almost three-quarters of medical students experienced recreational N₂O consumption, particularly with poly-drug use. Given that complications were associated with high consumption and lack of education, risk training and screening for N₂O consumption could be beneficial.

Changing trends in anabolic-androgenic steroid use within Scottish prisons: Detection, prevalence, and quantitation.

Anabolic-androgenic steroids (AASs) are a subclassification of image performance enhancing drugs (IPEDs). While AAS use is most prevalent among people in athletics, there is also high lifetime prevalence of AAS use among prisoners. This study reports the qualitative detection of AASs in seized samples from the Scottish prisons from 2019-2023. Additionally, methods were developed for the quantitative analysis of AASs using gas chromatography-mass spectrometry (GC-MS) and applied to 61 samples of tablets or powders seized from Scottish prisons between July 2022 and July 2023. Since 2022, there has been an increase in AAS detections in the Scottish prisons. Oxymetholone was the most prevalent AAS, followed by metandienone (methandrostenolone, methandienone), methyltestosterone, oxandrolone, mestanolone (methylandrostanolone), stanozolol, and androstenedione. Multiple AASs were found in 21 samples and 10 samples contained other drugs, including amitriptyline, sertraline, zopiclone, mirtazapine, sildenafil, etizolam, Δ9-tetrahydrocannabinol, and the synthetic cannabinoid MDMB-INACA. Most AAS samples were tablets (77.0%), although they were also detected in powders, herbal material, e-cigarettes, and a fragmented soap bar-type sample. There was a large variation in the concentration of AASs in the tablets and powders seized from the Scottish prisons, demonstrating AASs are another highly variable component of the polydrug use situation in prisons, the effects of which need to be examined further.

Reliability of the Moover® 3D Inertial Motion Sensor in Greek Patients With Chronic Neck Pain in a Primary Care Urban Setting.

Introduction Neck pain has a high lifetime prevalence and represents a significant health issue. Reduced active cervical range of motion (ACROM) has been found in neck pain patients. Inertial sensor technology can provide objective measurements to assess the impaired ACROM. Purpose Primarily, this study investigated the inter- and intra-rater reliability of the Moover® three-dimensional (3D) inertial motion sensor (Sensor Medica, Rome, Italy) in Greek patients with non-specific chronic neck pain. Secondly, the intra-rater reliability of the Neck Disability Index (NDI) was also assessed. Methods Fifty patients (18 males and 32 females) suffering from non-specific chronic neck pain participated in this study. Two physiotherapists measured separately each participant's ACROM in three planes, within a 48-hour period. The participants' position and the sequence and direction of the three cervical movements (cervical rotation, lateral flexion, and flexion-extension) were standardized. Results The inter-rater reliability intraclass correlation coefficient (ICC) values were good to excellent ranging from 0.77 to 0.95 for the first measurement and 0.85 to 0.95 for the second (p < 0.001). The intra-rater reliability ICC values were moderate to excellent ranging from 0.74 to 0.92 for the first rater and good to excellent ranging from 0.83 to 0.94 for the secondrater(p < 0.001). Intra-rater reliability of the overall NDI was indicated as good, and ICC was 0.80 (95%CI: 0.65-0.89; p < 0.001). ICC values for all sections were significant and ranged from 0.40 to 0.88. Conclusion This study showed the reliability of the Moover 3D inertial sensorfor ACROM measurementin Greek patients with chronic neck pain. The NDI scale also showed good intra-rater reliability in the same sample. Both intra- and inter-rater reliability of the Moover 3D were proven to be acceptable over a 48-hour period. The specific sensor might have a potential application in a clinical setting.

Prevalence and incidence of venous thromboembolism in geriatric patients admitted to long-term care hospitals

The risk of venous thromboembolism (VTE) increases with age. However, the risk of VTE in the setting of long-term care hospitals is understudied. Our objective was to provide data on the prevalence and incidence of VTE in older adults admitted to long-term care hospitals. In this retrospective cohort study, we collected data about chronically ill and multimorbid patients aged 65 years and older from two long-term care hospitals. The primary endpoint of this study was the lifetime prevalence of VTE, and the secondary endpoint was VTE incidence during residency in long-term care hospitals. We analysed data from 1148 patients with a mean age of 84.1 ± 7.9 years, of whom 74.2% were women. The lifetime prevalence of VTE at baseline was 9.6% (95% CI 7.9–11.4). Cumulative incidence of VTE at 1, 2, and 3 years from baseline was estimated at 3.5% (95% CI 2.5–4.7), 4.2% (95% CI 3.1–5.5), and 5.4% (95% CI 4.1–7.0), respectively. Overall, the incidence rate of VTE in our study was 2.82 (95% CI 2.18–3.66) per 100 person-years. The study indicated a considerably high lifetime prevalence and incidence of VTE during residence in long-term care hospital settings, requiring further evaluation in larger prospective studies.

Navigating Conflicting Ideals of Masculinity: A Qualitative Study of the Experiences of Male Partners of Women with Vulvodynia

ABSTRACT Vulvodynia, a long-term genital pain disorder with a high lifetime prevalence, profoundly impacts both the affected women and their partners. However, the experiences of these partners have been under-researched. Using Braun and Clarke’s thematic analysis, this qualitative study explored the experiences of male partners of women with vulvodynia. In individual interviews with seven men (20–32 years), four themes were identified: “Trying to be a good and caring partner,” “Fear of sexual and emotional rejection,” “Feelings of insecurity and being misled,” and “Keeping up the façade.” Despite efforts to support their partners, the men often faced rejection, leading to insecurities about their attractiveness, the relationship’s future, and their ability to conform to social expectations. They coped by concealing insecurities from their partners and overemphasizing traditional masculinity among peers. We discuss these results using sexual script theory, suggesting that gendered sexual scripts play a significant role in relationships with vulvodynia, with prevailing cultural assumptions regarding masculinity challenging men’s ability to be simultaneously caring and sexual. As a result, the men found themselves negotiating two contrasting ideals associated with masculine behavior: those of good caregiver and assertive, virile sexual partner. Our research suggests that male partners of women with vulvodynia tend to be left alone to deal with the resulting ambivalence and distress. Supporting these men could benefit both parties in managing vulvodynia.

Obesity and lipid indices as predictors of depressive symptoms in middle-aged and elderly Chinese: insights from a nationwide cohort study

BackgroundDepressive symptoms are one of the most common psychiatric disorders, with a high lifetime prevalence rate among middle-aged and elderly Chinese. Obesity may be one of the risk factors for depressive symptoms, but there is currently no consensus on this view. Therefore, we investigate the relationship and predictive ability of 13 obesity- and lipid-related indices with depressive symptoms among middle-aged and elderly Chinese.MethodsThe data were obtained from The China Health and Retirement Longitudinal Study (CHARLS). Our analysis includes individuals who did not have depressive symptoms at the baseline of the CHARLS Wave 2011 study and were successfully follow-up in 2013 and 2015. Finally, 3790 participants were included in the short-term (from 2011 to 2013), and 3660 participants were included in the long-term (from 2011 to 2015). The average age of participants in short-term and long-term was 58.47 years and 57.88 years. The anthropometric indicators used in this analysis included non-invasive [e.g. waist circumference (WC), body mass index (BMI), and a body mass index (ABSI)], and invasive anthropometric indicators [e.g. lipid accumulation product (LAP), triglyceride glucose index (TyG index), and its-related indices (e.g. TyG-BMI, and TyG-WC)]. Receiver operating characteristic (ROC) analysis was used to examine the predictive ability of various indicators for depressive symptoms. The association of depressive symptoms with various indicators was calculated using binary logistic regression.ResultsThe overall incidence of depressive symptoms was 20.79% in the short-term and 27.43% in the long-term. In males, WC [AUC = 0.452], LAP [AUC = 0.450], and TyG-WC [AUC = 0.451] were weak predictors of depressive symptoms during the short-term (P < 0.05). In females, BMI [AUC = 0.468], LAP [AUC = 0.468], and TyG index [AUC = 0.466] were weak predictors of depressive symptoms during the long-term (P < 0.05). However, ABSI cannot predict depressive symptoms in males and females during both periods (P > 0.05).ConclusionThe research indicates that in the middle-aged and elderly Chinese, most obesity- and lipid-related indices have statistical significance in predicting depressive symptoms, but the accuracy of these indicators in prediction is relatively low and may not be practical predictors.

Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta-analysis of randomized controlled trials.

Despite its high lifetime prevalence rate and the elevated disability caused by posttraumatic stress disorder (PTSD), treatments exhibit modest efficacy. In consideration of the abnormal connectivity between the dorsolateral prefrontal cortex (DLPFC) and amygdala in PTSD, several randomized controlled trials (RCTs) addressing the efficacy of different noninvasive brain stimulation (NIBS) modalities for PTSD management have been undertaken. However, previous RCTs have reported inconsistent results. The current network meta-analysis (NMA) aimed to compare the efficacy and acceptability of various NIBS protocols in PTSD management. We systematically searched ClinicalKey, Cochrane Central Register of Controlled Trials, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov to identify relevant RCTs. The targeted RCTs was those comparing the efficacy of NIBS interventions, such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and transcutaneous cervical vagal nerve stimulation, in patients with PTSD. The NMA was conducted using a frequentist model. The primary outcomes were changes in the overall severity of PTSD and acceptability (to be specific, rates of dropouts for any reason). We identified 14 RCTs that enrolled 686 participants. The NMA demonstrated that among the investigated NIBS types, high-frequency rTMS over bilateral DLPFCs was associated with the greatest reduction in overall PTSD severity. Further, in comparison with the sham controls, excitatory stimulation over the right DLPFC with/without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms, including depression and anxiety symptoms, and overall PTSD severity. This NMA demonstrated that excitatory stimulation over the right DLPFC with or without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms. PROSPERO CRD42023391562.

Healthcare Utilization Among Adults With Vestibular Vertigo in the United States.

Vestibular vertigo has been shown to have a high lifetime prevalence. Previous studies have described the increased morbidities associated with vestibular vertigo. In this cross-sectional study of the 2016 National Health Interview Study, we sought to explore whether individuals with vestibular vertigo were more likely to utilize healthcare resources compared with those without vestibular vertigo. We characterized utilization of specific healthcare resources including general doctors, specialist doctors, emergency departments, mental health professionals, and others among individuals with vestibular vertigo to better understand how individuals with vertigo interact with the US healthcare system. In multivariable analyses, participants with vestibular vertigo had an increased number of nights in the hospital in the last 12 months (mean difference = 0.67 days, 95% confidence interval [CI] = 0.37 to 0.97), increased odds of receiving healthcare 10 or more times in the last 12 months (odds ratio = 2.22, 95% CI = 1.99 to 2.48) and increased number of visits to a healthcare professional in the last 2 weeks (mean difference = 0.17 visits, 95% CI = 0.14 to 0.21). In addition, participants with vestibular vertigo had increased odds of visiting both general doctors, specialist doctors, and other healthcare professionals. These findings characterize how individuals with vestibular vertigo utilize and interact with healthcare resources compared with those without vestibular vertigo.

Revealing receptor-ligand interactions of atypical antipsychotic drugs and screening anti-schizophrenia ingredients in Magnolia officinalis based on 5-HTR2A-SNAP-Tag/CMC and DRD2-SNAP-Tag/CMC models

Schizophrenia is a serious mental illness with unknown etiology, and shows increasing incidence and high lifetime prevalence rate. The main receptors related to the disease are DRD2 and 5-HTR2A. Thus, a comprehensive understanding of the interaction mode between antipsychotic drugs with relevant receptors is very important for developing more effective drugs. 5-HTR2A-SNAP-Tag/CMC and DRD2-SNAP-Tag/CMC models constructed in this work provided a new method for studying the interaction between atypical antipsychotics and the two receptors. The results of comparative experiments showed that the new models not only met the high selectivity and specificity of the screening requirements but were also more stable and long-lasting than the traditional CMC model. Binding assays showed that the effects of three atypical antipsychotics (including clozapine, olanzapine, and quetiapine) on 5-HTR2A were stronger than their effects on DRD2. Additionally, two potentially active components, magnolol and honokiol, were screened in Magnolia officinalis methanol extract using the 5-HTR2A-SNAP-Tag/CMCHPLC-MS system. Nonlinear chromatographic analysis and molecular docking were conducted to study the interactions between screened compounds and the two receptors. The binding constants (KA) of magnolol and honokiol with 5-HTR2A were 17,854 ± 1,117 M–1 and 38,858 ± 4,964 M–1, respectively, and KA values with DRD2 were 4,872 ± 1,618 M–1 and 20,692 ± 10,267 M–1, respectively. We concluded that the established models are reliable for studying receptor-ligand interactions and screening antagonists of schizophrenia.

A POPULATION-BASED CROSS-SECTIONAL STUDY ON PHYSICAL INTIMATE PARTNER VIOLENCE AFFECTING OLDER WOMEN IN A PROVINCE OF NORTHERN TURKEY: PREVALENCE, ASSOCIATED FACTORS, AND INTERGENERATIONAL TRANSMISSION OF VIOLENCE

Introduction: This study aimed to estimate the prevalence of physical intimate partner violence among older women, identify factors associated with victimization, and gather information on the intergenerational transmission of violence. Materials and Method: This population-based cross-sectional study was conducted in Karabuk Province and included 399 ever-married women aged 65 years and older. The dependent variable was exposure to physical violence by a current or former spouse. Independent variables included women’s sociodemographic and reproductive characteristics, their experience of violence in childhood, and some characteristics of their husbands and parents. The crude and adjusted prevalence ratios were estimated to explore the relationship between the dependent and independent variables using robust Poisson regression analysis. Results: The prevalence of physical intimate partner violence was 62.9% for the lifetime and 7.6% for the past year. Lifetime prevalence increased 1.2-fold with low household income, 1.4-fold with seven or more pregnancies, 1.3-fold with daily or weekly alcohol consumption by the husband, 1.3-fold with witnessing father-to-mother violence in childhood, and 1.5-fold with experiencing physical violence by parents in childhood. Women were more likely to use violence against their children if they had experienced violence in childhood and adulthood. Conclusion: This study’s finding of high lifetime and past-year prevalence of exposure to intimate partner violence highlights the need for more efforts to address intimate partner violence among older women. More research is needed to better understand older women’s experiences of intimate partner violence and identify health and social policy approaches to meet their support and assistance needs. Keywords: Intimate Partner Violence; Domestic Violence, Physical Abuse; Prevalence; Aged; Women.

Post traumatic stress disorder in African American men exposed to violent trauma

Research has shown strong association between exposures to violence resulting in post traumatic stress symptoms. Despite the high lifetime prevalence of post traumatic stress disorder (PTSD) and exposure to violence among African American men, research outcomes are limited and inconsistent. African American youth who live in low-income urban areas routinely face various contextual specific risks factors that leave them susceptible to loss and trauma in their lifetime resulting in persistent PTSD over time. Personas of resilience found in African American men exposed to chronic violence often mask trauma symptoms raising concerns on the evaluation of PTSD symptomology among African American men as well as the process of resilience and coping methods within this population. Limitations to research include convenience sampling limited to specific cities and exclusion of incarcerated African American men. In addition, there is a lack of longitudinal studies detailing the physiological and psychological course of PTSD and rates of recovery in African Americans. Health care systems and providers must be equipped, informed, and prepared to responding to mental health needs of African American men. The understanding of the expression and presence of PTSD among African American men will result in improvements of healthcare professionals' ability to evaluate, diagnose, and provide treatment for PTSD among this group whose symptoms of trauma may be misinterpreted or overlooked.

Aggressive sexual fantasy frequency outperforms other characteristics in cross-sectionally predicting self-reported sexual aggression in 4 samples.

Aggressive sexual fantasies (ASFs) have consistently been associated with sexual aggression measures. ASF frequency has mostly been used to indicate ASF, but other ASF characteristics may be important to explain the apparent gap between alleged high lifetime prevalence rates of ASF and lower sexual aggression rates-that is, why ASFs are only sometimes put into action. The present study therefore examined whether additional ASF characteristics show associations with sexual aggression measures above and beyond ASF frequency to identify the most relevant ASF characteristics. The present study is based on cross-sectional survey data from 4 independent mostly community samples with 448, 131, 758, and 415 participants to examine whether ASF elaboration, intrusion, preoccupation, context, and consent were associated with self-reported sexual aggression measures beyond ASF frequency. Self-reported sexual aggression measures included presumably consensual and nonconsensual sexual sadism, self-reports on acting on ASF, sexual harassment, use of coercive strategies, and rape proclivity. The results showed positive correlations among all ASF characteristics. ASF frequency was the most consistent and often strongest predictor of sexual aggression across samples and outcome measures. ASF elaboration and/or its interaction with ASF frequency added to this prediction in study 1 but not in study 2. All other ASF characteristics in studies 1 to 4 either did not add to the predictions or yielded results contrary to expectations, mostly suggesting suppressor effects. Sexual medicine and forensic sexology researchers may want to consider ASF frequency in diagnostics and develop and refine interventions to reduce it in cases of clearly elevated levels. The strengths of the present study include considering 4 independent samples as well as a large number of ASF characteristics and sexual aggression measures. Its limitations include the reliance on cross-sectional data and not being able to examine the potential influences of all ASF characteristics in a single model. ASF frequency seems the most valid and reliable indicator of ASF and the most important associate of sexual aggression. It should be considered the main indicator of ASF by future research and in prevention efforts and risk assessment.

Prevalence, correlates, and trends of intimate partner violence against women in Sierra Leone: findings from 2013 and 2019 demographic and health surveys.

Intimate partner violence (IPV) is a globally pervasive public health and medical problem in addition to being a serious violation of women's rights. The two-fold objectives of this study were to compute the lifetime prevalence and correlates of IPV perpetrated by current/former husbands/partners of ever-married women aged 15-49 years using the nationally representative Sierra Leone Demographic and Health Survey (DHS) conducted in 2019; ethnicity-based levels and trends of IPV were also computed using the data from the DHS conducted in 2013 along with the 2019 DHS. Twelve IPV correlates pertaining to socio-demographic, attitudinal, and experiential attributes were analyzed using logistic regression models for bivariate and multivariable analysis. IPV was computed as a composite variable comprising of physical, emotional, and/or sexual IPV. Lifetime prevalence of experiencing any kind of IPV was a staggering 60.81%, whereas emotional, physical, and sexual IPV prevalence were reported by 45.90%, 49.81%, and 8.14% of the respondents, respectively. No ethnicity reported a statistically significant decrease in any type of IPV during the intervening period between the two surveys. Five out of nine ethnicities reported a statistically significant increase in emotional IPV, while few ethnicities reported a statistically significant increase in one or more types of IPV. The high lifetime prevalence of IPV is alarming and points to the need for targeted health promotion campaigns to reverse the tide of IPV in Sierra Leone, including focusing on changes in cultural and ethnicity-based norms and mores to ensure women's human rights are respected and upheld.

Examination of gaze behaviour in social anxiety disorder using a virtual reality eye-tracking paradigm: protocol for a case–control study

IntroductionSocial anxiety disorder (SAD) has an early onset, a high lifetime prevalence, and may be a risk factor for developing other mental disorders. Gaze behaviour is considered an aberrant feature...

Circulating chromatin conformation signatures to enhance PSA positive predictive value and overall accuracy for prostate cancer detection.

e17016 Background: Prostate cancer (PCa) has a high lifetime prevalence (one out of six men), but currently there is no widely accepted screening programme. Widely used prostate specific antigen (PSA) test at cut-off of 3.0 ng/mL does not have sufficient accuracy for detection of any prostate cancer, resulting in numerous unnecessary prostate biopsies in men with benign disease and false reassurance in some men with PCa. We have recently identified circulating chromosome conformation signatures (CCSs, Episwitch PCa test) allowing PCa detection and risk stratification in line with standards of clinical PCa staging. The purpose of this study was to determine whether combining the Episwitch PCa test with the PSA test will increase its diagnostic accuracy. Methods: n = 109 whole blood samples of men enrolled in the PROSTAGRAM screening pilot study and n = 38 samples of patients with established PCa diagnosis and cancer-negative controls from Imperial College NHS Trust were used. Samples were tested for PSA, and the presence of CCSs in the loci encoding for of DAPK1, HSD3B2, SRD5A3, MMP1, and miRNA98 associated with high-risk PCa identified in our previous work. Results: PSA &gt; 3 ng/mL alone showed a low positive predicted value (PPV) of 0.14 and a high negative predicted value (NPV) of 0.93. EpiSwitch alone showed a PPV of 0.91 and a NPV of 0.32. Combining PSA and Episwitch tests has significantly increased the PPV to 0.81 although reducing the NPV to 0.78. Furthermore, integrating PSA, as a continuous variable (rather than a dichotomised 3 ng/mL cut-off), with EpiSwitch in a new multivariant stratification model, Prostate Screening EpiSwitch (PSE) test, has yielded a remarkable combined PPV of 0.93 and NPV of 0.95 when tested on the independent prospective cohort. Conclusions: Our results demonstrate that combining the standard PSA readout with circulating chromosome conformations (PSE test) allows for significantly enhanced PSA PPV and overall accuracy for PCa detection. The PSE test is accurate, rapid, minimally invasive, and inexpensive, suggesting significant screening diagnostic potential to minimise unnecessary referrals for expensive and invasive MRI and/or biopsy testing, with further extended prospective blinded validation of the new combined signature in a screening cohort with low cancer prevalence as the next step for PSE adoption in PCa screening.

Lifetime prevalence and adherence rate of cervical cancer screening among women living with HIV: a systematic review and meta-analysis.

Women living with HIV (WLWH) are more likely to develop cervical cancer. Screening and available healthcare can effectively reduce its incidence and mortality rates. We aimed to summarize the lifetime prevalence and adherence rate of cervical cancer screening among WLWH across low- and middle-income countries (LMICs), and high-income countries (HICs). We systematically searched PubMed, Web of Science and Embase for studies published between database inception and 2 September 2022, without language or geographical restrictions. Those reporting the lifetime prevalence and/or adherence rate of cervical cancer screening among WLWH were included. Pooled estimates across LMICs and HICs were obtained using DerSimonian-Laird random-effects models. When the number of eligible studies was greater than 10, we further conducted stratified analyses by the World Health Organization (WHO) region, setting (rural vs. urban), investigation year, screening method, type of cervical cancer screening programme, age and education level. Among the 63 included articles, 26 provided data on lifetime prevalence, 24 on adherence rate and 13 on both. The pooled lifetime prevalence in LMICs was 30.2% (95% confidence interval [CI]: 21.0-41.3), compared to 92.4% in HICs (95% CI: 89.6-94.6). The pooled adherence rate was 20.1% in LMICs (95% CI: 16.4-24.3) and 59.5% in HICs (95% CI: 51.2-67.2). There was a large gap in cervical cancer screening among WLWH between LMICs and HICs. Further analysis found that those in LMICs had higher lifetime prevalence in subgroups with urban settings, with older age and with higher education levels; and those in HICs had higher adherence in subgroups with younger age and with higher education levels. Cervical cancer screening among WLWH falls considerably short of the WHO's goal. There should be continuous efforts to further increase screening among these women, especially those residing in the rural areas of LMICs and with lower education levels.

Vestibular Vertigo and Disparities in Healthcare Access Among Adults in the United States.

Vertigo and dizziness have a high lifetime prevalence with significant impacts on daily life. We sought to explore differences in access to and ability to afford care among adults with vestibular vertigo by race/ethnicity, income, and insurance type. This is a cross-sectional study using the 2016 National Health Interview Survey. A total of 32,047 adults who completed the 2016 National Health Interview Survey Balance Supplement were analyzed. We used a previously validated definition of vertigo defined as (1) positional vertigo, (2) rotational vertigo, or (3) recurrent dizziness with nausea and either oscillopsia or imbalance. We examined several self-reported measures of healthcare utilization and access. Among adults with vestibular vertigo, African Americans had significantly increased odds of delayed care due to lack of transportation; Hispanic ethnicity was associated with decreased odds of skipping medication doses and asking a doctor for a lower-cost medication. Adults with public insurance had significantly lower odds of reporting delayed care due to worry about cost, not receiving medical care due to cost, and delayed filling of a prescription, but had greater odds of reporting delayed care due to lack of transportation. Lack of insurance and lower income were associated with increased odds of delaying and not receiving care due to cost. These findings demonstrate significant differences in access to care among adults with vestibular vertigo in the United States based on race, income, and health insurance status.