Recognition Of Illness Research Articles

Gastrointestinal tract disease detection via deep learning based structural and statistical features optimized hexa-classification model.

Gastrointestinal tract (GIT) diseases impact the entire digestive system, spanning from the mouth to the anus. Wireless Capsule Endoscopy (WCE) stands out as an effective analytic instrument for Gastrointestinal tract diseases. Nevertheless, accurately identifying various lesion features, such as irregular sizes, shapes, colors, and textures, remains challenging in this field. Several computer vision algorithms have been introduced to tackle these challenges, but many relied on handcrafted features, resulting in inaccuracies in various instances. In this work, a novel Deep SS-Hexa model is proposed which is a combination two different deep learning structures for extracting two different features from the WCE images to detect various GIT ailment. The gathered images are denoised by weighted median filter to remove the noisy distortions and augment the images for enhancing the training data. The structural and statistical (SS) feature extraction process is sectioned into two phases for the analysis of distinct regions of gastrointestinal. In the first stage, statistical features of the image are retrieved using MobileNet with the support of SiLU activation function to retrieve the relevant features. In the second phase, the segmented intestine images are transformed into structural features to learn the local information. These SS features are parallelly fused for selecting the best relevant features with walrus optimization algorithm. Finally, Deep belief network (DBN) is used classified the GIT diseases into hexa classes namely normal, ulcer, pylorus, cecum, esophagitis and polyps on the basis of the selected features. The proposed Deep SS-Hexa model attains an overall average accuracy of 99.16% in GIT disease detection based on KVASIR and KID datasets. The proposed Deep SS-Hexa model achieves high level of accuracy with minimal computational cost in the recognition of GIT illness. The proposed Deep SS-Hexa Model progresses the overall accuracy range of 0.04%, 0.80% better than GastroVision, Genetic algorithm based on KVASIR dataset and 0.60%, 1.21% better than Modified U-Net, WCENet based on KID dataset respectively.

Agreement for posttraumatic stress symptoms among unaccompanied young refugees and professional caregivers

ABSTRACT Background: Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment. Objective: This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement. Method: The sample consisted of N = 610 UYRs, aged M = 16.75 (SD = 1.33, range: 12–20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities. Results: Agreement rates across trauma types were poor (accidental trauma: Cohen’s k = .13; community violence: Cohen’s k = .07; domestic violence: Cohen’s k = .19; sexual abuse: Cohen’s k = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted ­R 2 = .21) and across symptom clusters (re-experiencing: Adjusted ­R 2 = .13; avoidance: Adjusted ­R 2 = .07; negative alterations in cognitions and mood: Adjusted ­R 2 = .16; hyperarousal: Adjusted­ R 2 = .16). Age was not significantly associated with disagreement rates. Conclusion: It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

Health care-seeking behavior for childhood illnesses in western Kenya: Qualitative findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) Study

Background Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers’ health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. Methods We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Results Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child’s illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Conclusion Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.

Health care-seeking behavior for childhood illnesses in western Kenya: Qualitative findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) Study.

Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers' health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child's illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.

Leveraging social media for resident training in developing countries: A case study of Libya.

Social media platforms have emerged as invaluable tools for remote training in resource-constrained countries. This study presents the development, implementation, and preliminary assessment of a remote intensive care unit (ICU) training program conducted in Libya utilizing social media platforms. This educational initiative was based on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury (CERTAIN) program, targeting Libyan resident physicians. The initiative comprised a series of live-streamed pulmonary/critical care lectures and asynchronous discussion of clinical cases via a private messaging chat. Participant engagement, satisfaction, and learning outcomes were evaluated using social media analytics and surveys. A total of 323 learners joined the Libyan ICU training program chat group, and two tele-education sessions were broadcast, accumulating a total of 749 views. The majority (72.6%) of learners had graduated from medical school within the past five years and were in residency training. Clinical cases and learning materials were shared through 2,991 messages in the chat group. Learners' objective and subjective clinical knowledge improved after each tele-education session, and 88% of survey respondents rated the remote ICU training program as excellent. This study highlights the potential of using widely available social media platforms for remote ICU education in resource-limited settings.

P-491 Reproductive mental health empowerment: enhancing mental health literacy among women with reproductive health issues

Abstract Study question What is the role of mental health literacy and its impact on women’s help-seeking when there are reproductive mental health issues? Summary answer Mental health literacy and attitudes toward seeking professional help significantly predict one’s emotional well-being and help-seeking behaviour. What is known already Women who encounter reproductive health issues can experience an array of physical issues as well as emotional hurdles. There are barriers at the societal level that impede women from addressing these reproductive health-related mental health challenges, such as social stigma, lack of attention on mental wellness and a disproportionate amount of focus on the fertility treatments’ outcomes. There is limited understanding regarding the relationship between women’s reproductive mental health literacy and their tendencies to seek help in the literature. Study design, size, duration This study used cross-sectional data from an online questionnaire that explored the participants’ reproductive mental health literacy, attitudes towards seeking professional help and their actual help-seeking behaviour. Data were collected between July and September 2023. Participants/materials, setting, methods Participants were 356 Chinese women (mean age = 32.64±7.15) recruited through community network and social media. Participants answered questions related to their knowledge of mental illness, ability of seeking professional help, recognition of mental illness, acceptance of patients with mental illness, recognition of need for psychotherapeutic help, stigma tolerance, interpersonal openness, confidence in mental health practitioner, knowledge on community resource and their actual help seeking behaviour. Main results and the role of chance 59% of the participants attained a Bachelor’s degree or above and 74% were married. 43.5% of the participants experienced emotional disturbances triggered by reproductive health issues. Among these participants, 52% chose not to seek help from others. Among different types of reproductive problems, participants with fertility and reproductive health problem scored lowest in terms of help-seeking behavior (M = .28, SD = .45, p<.05., reproductive mental health knowledge (M = 27.29, SD = 4.39, p<.01), recognition of mental illness (M = 16.73, SD = 4.0,p<.05), recognition of need for psychotherapeutic help (M = 17.99, SD = 3.63, p<.01), and interpersonal openness (M = 16.85, SD = 3.35, p<.01). In terms of emotional disturbances, the result indicated that acceptance of patients with mental illness (b = -.035, p <.05) and recognition of the need for psychotherapeutic help (b = .068, p <.05) predicted the numbers of emotional disturbances one experienced. In terms of help-seeking behaviour, knowledge of mental illness (B = 1.30, p < .01), recognition of the need for psychotherapeutic help (B = 1.49, p < .01), and knowledge of community resources (B = 2.15, p < .01) significantly predicted one’s actual help-seeking behaviour. Limitations, reasons for caution There may be potential confounding factors that influenced the results, such as previous mental health history and use of mental health facilities. The ability to establish a causal relationship between reproductive mental health literacy, help-seeking attitude, and actual help-seeking is constrained due to the study’s utilization of a cross-sectional design. Wider implications of the findings Providing counseling for infertility plays a crucial role in addressing the emotional and psychological needs of individuals by reducing the stigma surrounding reproductive mental health challenges. Incorporating infertility counseling into fertility treatment empowers women with information and facilitates open and honest communication on mental well-being. Trial registration number Not applicable

The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change

BackgroundThis study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. MethodsA community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. ResultsThe intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. ConclusionsThe study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. Trial RegistrationClinicalTrials.gov, ID NCT06192069 retrospectively registered.

Hospital readmission following acute illness among children 2–23 months old in sub-Saharan Africa and South Asia: a secondary analysis of CHAIN cohort

Children in low and middle-income countries remain vulnerable following hospital-discharge. We estimated the incidence and correlates of hospital readmission among young children admitted to nine hospitals in sub-Saharan Africa and South Asia. This was a secondary analysis of the CHAIN Network prospective cohort enrolled between 20th November 2016 and 31st January 2019. Children aged 2-23 months were eligible for enrolment, if admitted for an acute illness to one of the study hospitals. Exclusions were requiring immediate resuscitation, inability to tolerate oral feeds in their normal state of health, had suspected terminal illness, suspected chromosomal abnormality, trauma, admission for surgery, or their parent/caregiver was unwilling to participate and attend follow-up visits. Data from children discharged alive from the index admission were analysed for hospital readmission within 180-days from discharge. We examined ratios of readmission to post-discharge mortality rates. Using models with death as the competing event, we evaluated demographic, nutritional, clinical, and socioeconomic associations with readmission. Of 2874 children (1239 (43%) girls, median (IQR) age 10.8 (6.8-15.6) months), 655 readmission episodes occurred among 506 (18%) children (198 (39%) girls): 391 (14%) with one, and 115 (4%) with multiple readmissions, with a rate of: 41.0 (95% CI 38.0-44.3) readmissions/1000 child-months. Median time to readmission was 42 (IQR 15-93) days. 460/655 (70%) and 195/655 (30%) readmissions occurred at index study hospital and non-study hospitals respectively. One-third (N=213/655, 33%) of readmissions occurred within 30 days of index discharge. Sites with fewest readmissions had the highest post-discharge mortality. Most readmissions to study hospitals (371/450, 81%) were for the same illness as the index admission. Age, prior hospitalisation, chronic conditions, illness severity, and maternal mental health score, but not sex, nutritional status, or physical access to healthcare, were associated with readmission. Readmissions may be appropriate and necessary to reduce post-discharge mortality in high mortality settings. Social and financial support, training on recognition of serious illness for caregivers, and improving discharge procedures, continuity of care and facilitation of readmission need to be tested in intervention studies. We propose the ratio of readmission to post-discharge mortality rates as a marker of overall post-discharge access and care. The Bill & Melinda Gates Foundation (OPP1131320).

Health care-seeking behavior for childhood illnesses in western Kenya: Qualitative findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) Study

Background Child mortality in Kenya is 41 per 1,000 live births, despite extensive investment in maternal, newborn, and child health interventions. Caregivers’ health-seeking for childhood illness is an important determinant of child survival, and delayed healthcare is associated with high child mortality. We explore determinants of health-seeking decisions for childhood illnesses among caregivers in western Kenya. Methods We conducted a qualitative study of 88 community members between April 2017 and February 2018 using purposive sampling in an informal urban settlement in Kisumu County, and in rural Siaya County. Key informant interviews, semi-structured interviews and focus group discussions were performed. We adopted the Partners for Applied Social Sciences model focusing on factors that influence the decision-making process to seek healthcare for sick infants and children. The discussions were audio-recorded and transcribed. Data management was completed on Nvivo® software. Iterative analysis process was utilized and themes were identified and collated. Results Our findings reveal four thematic areas: Illness interpretation, the role of social relationship on illness recognition and response, medical pluralism and healthcare access. Participants reported some illnesses are caused by supernatural powers and some by biological factors, and that the illness etiology would determine the health-seeking pathway. It was common to seek consensus from respected community members on the diagnosis and therefore presumed cause and necessary treatment for a child’s illness. Medical pluralism was commonly practiced and caregivers would alternate between biomedicine and traditional medicine. Accessibility of healthcare may determine the health seeking pathway. Caregivers unable to afford biomedical care may choose traditional medicine as a cheaper alternative. Conclusion Health seeking behavior was driven by illness interpretation, financial cost associated with healthcare and advice from extended family and community. These findings enrich the perspectives of health education programs to develop health messages that address factors that hinder prompt health care seeking.

Exploring Causal Relationships in Mental Health Literacy Through Twitter Content: A Machine Learning Approach

IntroductionThe concept of Mental Health Literacy (MHL) is inherently multidimensional. However, the interrelationships among its various dimensions remain insufficiently elucidated. In recent years, the textual analysis of social media posts has emerged as a promising methodological approach for longitudinal research in this domain.ObjectivesThis study aimed to investigate whether temporal causal associations exist between recognition of mental illness (R), mental illness stigma (S), help-seeking efficacy (HE), maintenance of positive mental health (M), and help-seeking attitude (HA).MethodsTweets were collocted at three distinct time points: T1, T2, and T3, spanning the period from November 1, 2021, to December 31, 2022. We employed a machine-learning approach to categorize the posts into five MHL facets. Using these facets, we trained a machine learning model, specifically Bidirectional Encoder Representations from Transformers (BERT), to determine the MHL scores. To be eligible, an account must have an R facet score at T1, and M, S, HE facet scores at T2, as well as an HA facet score at T3. In total, we retrieved 4,471,951 MHL-related tweets from 941 users. We further employed structural equation modeling to validate the causal relationships within the MHL framework.ResultsIn the evaluation, BERT achieved average accuracy scores exceeding 89% across the five MHL facets in the validation set, along with F1-scores ranging between 0.75 and 0.89. Among the five MHL facets—maintenance of positive mental health, recognition of mental illness, help-seeking efficacy, and help-seeking attitudes—each demonstrated a statistically significant positive correlation with the others. Conversely, mental illness stigma exhibited a statistically significant negative correlation with the remaining four facets. In the analysis using single-mediation models, each of the individual mediator variables—namely, mental illness stigma, help-seeking efficacy, and maintenance of positive mental health—exhibited significant indirect effects. In the multiple-mediation model, two mediator variables—help-seeking efficacy and maintenance of positive mental health—demonstrated significant indirect effects. These findings suggested that the recognition of mental illness exerted an influence on help-seeking attitudes through one or more of these mediators.ConclusionsBy leveraging machine learning techniques for the textual analysis of social media and employing a longitudinal research design with panel data, this study elucidates the potential mechanisms through which the MHL framework influences attitudes toward seeking mental health services. These insights hold significant implications for the design of future interventions and the development of targeted policies aimed at promoting help-seeking behaviors.Disclosure of InterestNone Declared

Medical Disorders in Pregnancy Among Inpatients at a Tertiary Level Hospital of Peshawar (Khyber Pakhtunkhwa)

OBJECTIVES This study aimed to determine the prevalence, type, and demographic makeup of pregnancy-related medical conditions among patients receiving treatment in a tertiary care facility. METHODOLOGY The Monocentric retrospective impact study was conducted in the Department of Obstetrics and Gynaecology of MTI, Hayatabad Medical Complex Peshawar, from January to December 2022. Case records of all pregnant women (n=1811) with previous or recently developed medical conditions treated during the study period were collected from the records / medical registers, and all the information was recorded in a pre-structured proforma. All women with previous or recently developed medical conditions treated during the study were included. All pregnant women without any medical conditions were excluded. Data was analyzed using simple statistical measures, and the results were presented as frequency percentages. Prior approval from the institution’s ethical committee was obtained to conduct the study. vRESULTSAmong 6327 antenatal admissions, 1811 (28.62%) women had medical disorders. The most common medical disorder was PIH, reported in 384 (21.20%) of the females, followed by RH incompatibility and Gestational Diabetes Mellitus (GDM) seen in 235 (12.98%) and 205 (11.32%) females, respectively. Other notable medical conditions include UTI in 170 (9.39%), Chronic HTN in 134 (7.40%), iron deficiency anemia in 122 (6.74%), and pre-eclampsia in 100 (5.52%) of women. CONCLUSION Pre-existing medical conditions in pregnancy are not uncommon. Early recognition of acute illness and treatment of chronic conditions in pregnancy is of clear benefit and needs to be managed to arrest any adversaries to the mother and fetus.

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2024 Update.

The Wilderness Medical Society (WMS) convened an expert panel in 2011 to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. The current panel retained 5 original members and welcomed 2 new members, all of whom collaborated remotely to provide an updated review of the classifications, pathophysiology, evidence-based guidelines for planning and preventive measures, and recommendations for field- and hospital-based therapeutic management of heat illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. This is an updated version of the WMS clinical practice guidelines for the prevention and treatment of heat illness published in Wilderness & Environmental Medicine. 2019;30(4):S33-S46.

Wilderness Medical Society Clinical Practice Guidelines for Treatment of Eye Injuries and Illnesses in the Wilderness: 2024 Update.

A panel convened to develop an evidence-based set of guidelines for the recognition and treatment of eye injuries and illnesses that may occur in the wilderness. These guidelines are meant to serve as a tool to help wilderness providers accurately identify and subsequently treat or evacuate for a variety of ophthalmologic complaints. Recommendations are graded based on the quality of their supporting evidence and the balance between risks and benefits according to criteria developed by the American College of Chest Physicians.

Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1–59 months

Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the “Three Delays-in-Healthcare”, and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical records for infants and children aged 1–59 months who died between December 2016 and February 2022 in six sites in sub-Saharan Africa and one in South Asia (Bangladesh) and were enrolled in Child Health and Mortality Prevention Surveillance (CHAMPS). Delays in 1) illness recognition in the home/decision to seek care, 2) transportation to healthcare facilities, and 3) the receipt of clinical care in healthcare facilities were categorized according to the “Three Delays-in-Healthcare”. Comparisons in factors associated with delays were made using Chi-square testing. Information was available for 1,326 deaths among infants and under 5 children. The majority had at least one identified delay (n = 854, 64%). Waiting >72 hours after illness recognition to seek health care (n = 422, 32%) was the most common delay. Challenges in obtaining transportation occurred infrequently when seeking care (n = 51, 4%). In healthcare facilities, prescribed medications were sometimes unavailable (n = 102, 8%). Deceased children aged 12–59 months experienced more delay than infants aged 1–11 months (68% vs. 61%, P = 0.018). Delays in seeking clinical care were common among deceased infants and children. Additional study to assess the frequency of delays in seeking clinical care and its provision among children who survive is warranted.

Public knowledge and beliefs about the irritable bowel syndrome - results from the SOMA.SOC study

BackgroundDespite the epidemiological and economic relevance of the irritable bowel syndrome (IBS), there is a lack of research on what the general public knows and thinks about this condition (IBS literacy). Therefore, the aim of this study was to explore public knowledge and beliefs about IBS in Germany. Moreover, associations of knowledge and beliefs about IBS with socio-demographic characteristics as well as illness and treatment experiences were analysed.MethodsAnalyses made use of a national telephone survey (N = 1,205). A carefully developed vignette describing a person with typical symptoms of IBS was presented. Respondents were then asked to name the disease in question and beliefs about causes and treatment options were assessed. For the analyses respondents were divided into three groups: (1) people who never had IBS symptoms, (2) people who had or have IBS symptoms but never were in treatment and (3) individuals who reported to be or have been treated for IBS symptoms.ResultsLess than 4% of the respondents recognized IBS after presentation of the vignette. About 75% positively evaluated treatability while psychotherapy was evaluated more effective than medication. Stress and unhealthy lifestyle were the most frequently endorsed possible causes of the presented IBS symptoms. There were variations in knowledge and beliefs about IBS according to age, gender, and education. We found minor differences in beliefs and knowledge between individuals who had or have symptoms but never were in treatment and those without respective illness experience. Respondents with illness/treatment experiences rated their knowledge significantly better than those without any experiences.ConclusionsResults indicate low levels of public knowledge about IBS regarding illness recognition in Germany. A majority disagreed that they have good knowledge about IBS symptoms. Against this background, it seems reasonable to develop and test interventions to improve IBS literacy by increasing knowledge about symptoms, causes and treatment options.

Public stigma and recognition of perinatal obsessive-compulsive disorder

Stigma is a barrier to disclosure of psychiatric symptoms and treatment seeking among perinatal patients, including those with perinatal obsessive-compulsive disorder (POCD), perinatal depression (PPD), and postpartum psychosis (PPP). This study examines the relationship between stigma, illness recognition, and familiarity with illness in six distinct postpartum experiences. In a cross-sectional online survey, participants (N = 572) were randomized to one of six postpartum vignettes: subclinical, depression, psychosis, and three subtypes of obsessive-compulsive disorder: contamination, responsibility for harm, and sexual content. Participants were asked to provide a diagnostic label of the condition and rate different aspects of stigma. Sexual content POCD, responsibility for harm content POCD, and the subclinical vignettes were less likely to be accurately recognized than PPD, contamination POCD, and PPP. A multivariate analysis of variance revealed the sexual POCD and PPP vignettes were met with the highest level of stigma, while the subclinical condition, PPD, and contamination POCD were met with the lowest levels of stigma. Significant interactions were present between accurate recognition of the condition and type of vignette on stigma variables, with recognition generally being associated with lower stigma for POCD and PPD. This demonstrates the need for comprehensive educational efforts on perinatal mental health.

Heat-related illnesses: advice for clinicians and healthcare professionals

The increase in heatwaves, a significant consequence of global warming, represents a major public health issue and is the main cause of death related to hyperthermia. The seriousness of such exposure to extreme ambient temperature lies in the difficulty to the general population to identify the warning signs and take appropriate protective measures. This article therefore presents guidelines for the prevention, recognition and treatment of heat-related illnesses, and thus arms clinicians and healthcare professionals who are on the front line in protecting the general population from this 'silent killer'.

Early Prevention of Critical Illness in Older Adults: Adaptation and Pilot Testing of an Electronic Risk Score and Checklist.

Given limited critical care resources and an aging population, early interventions to prevent critical illness are vital. In this work, we measured post-implementation outcomes after introducing a novel electronic scoring system (Elders Risk Assessment-ERA) and a risk-factor checklist, Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN), to detect older patients at high risk of critical illness in a primary care setting. The study was conducted at a family medicine clinic in Kasson, MN. The ADAPT-ITT framework was used to modify the CERTAIN checklist for primary care during 2 co-design workshops involving interdisciplinary clinicians, held in April 2023. The ERA score and modified CERTAIN checklist were implemented between May and July 2023 and identify and assess all patients age ≥60 years at risk of critical illness during their primary care visits. Implementation outcomes were evaluated at the end of the study via an anonymous survey and EHR data extraction. Fourteen clinicians participated in 2 co-design workshops. A total of 19 clinicians participated in a post-pilot survey. All survey items were rated on a 5-point Likert type scale. Mean acceptability of the ERA score and checklist was rated 3.35 (SD = 0.75) and 3.09 (SD = 0.64), respectively. Appropriateness had a mean rating of 3.38 (SD = 0.82) for the ERA score and 3.19 (SD = 0.59) for the checklist. Mean feasibility was rated 3.38(SD = 0.85) and 2.92 (SD = 0.76) for the ERA score and checklist, respectively. The adoption rate was 50% (19/38) among clinicians, but the reach was low at 17% (49/289) of eligible patients. This pilot study evaluated the implementation of an intervention that introduced the ERA score and CERTAIN checklist into a primary care practice. Results indicate moderate acceptability, appropriateness, and feasibility of the ERA score, and similar ratings for the checklist, with slightly lower feasibility. While checklist adoption was moderate, reach was limited, indicating inconsistent use. We plan to use the open-ended resurvey responses to further modify the CERTAIN-FM checklist and implementation process. The ADAPT-ITT framework is a useful model for adapting the checklist to meet the primary care clinician needs.

Systemic lupus erythematosus - diagnosis and classification of the disease in the past and in present times

The main feature of systemic lupus erythematosus (SLE) is its heterogeneity, which mainly refers to clinical presentation, the course of disease and prognosis which can impact any or many organs and various immunoserological tests. As a result, prompt illness recognition and right diagnosis are extremely complicated processes based on the most recent classification standards and the doctor's clinical expertise with specific patients. In contrast, not all SLE patients are included when using classification criteria, which are based on a definition of a homogenous group by the specified, restricted number of clinical and immunoserological domains and for the purpose of conducting clinical or epidemiological investigations. Classification criteria have evolved over the last fifty years in response to new understandings and advances. This process began with the ACR criteria in 1971 and continued through their updates in 1982 and 1997, followed by SLICC 2012 and EULAR/ACR 2019. EULAR/ACR 2019 criteria have proven their high validity (sensitivity and specificity) in numerous studies, as well as adequate diagnostic usefulness, defined by 24 items in 10 domains, with the fulfillment of the essential precondition of antinuclear antibody positivity

Perceived treatment urgency of common mental disorders in the German population

Perceived treatment urgency of mental disorders are important as they determine utilization of health care. The aim was to analyze variations in perceived treatment urgency in cases of psychosis (adolescents), alcoholism (adults), and depression (older adults) with two levels of severity each by characteristics of the case and the respondents. A telephone survey (N = 1200) with vignettes describing cases of psychosis, alcoholism, and depression was conducted in Hamburg, Germany. Vignettes varied by symptom severity and sex. Perceived treatment urgency was assessed by three items. A sum scale was calculated. Linear regression models were computed to analyze differences in perceived urgency by characteristics of the case (severity, sex) and the respondents (sex, age, education, migration background, illness recognition, personal affliction). Perceived treatment urgency was significantly higher in severe cases and varied by education. Additionally, regarding psychosis, estimated urgency varied significantly by correct illness recognition. With regard to depression, perceived urgency differed significantly by age and correct illness recognition. Interaction effects between case severity and sociodemographic characteristics of the respondents, personal affliction, and correct recognition of the disorder were found. The identified differences should be considered in the development of interventions on mental health literacy with regard to adequate urgency assessment.