Impaired Physical Health Research Articles

DO TRAJECTORIES OF SELF-IDENTIFIED RETIREMENT STATUS PREDICT HEALTH AND COGNITIVE OUTCOMES?

Abstract Few studies examined the ways older workers self-identify their retirement status (named ‘retirement identity’) over time before exiting the workforce. Examining the trajectories of retirement identity transitions – between “not retired”, “partly retired”, and “completely retired” – clarifies the heterogeneous outcomes found in ‘static’ retirement identity. In this study, we distinguish and categorize these trajectories using sequence analysis, investigate the common sociodemographic and economic characteristics for each trajectory using multinomial logistic regression, and examine the associations between these trajectories and the physical and mental health conditions of older workers using latent growth modeling. Drawing on a sample of respondents from the Health and Retirement Study (HRS) from 1992 to 2020, we use the first nine waves of the initial HRS birth cohort (born 1931-1936, recruited in 1992, N=1,487) and the Early Baby Boomers (born 1948-1953, recruited in 2004, N=1,017). We determine and name four distinct categories of trajectories – early, late, traditional, and partial transitions – based on the timing and sequence of transitions. The membership of these trajectories is strongly associated with the birth cohort, educational attainment, labor income from career jobs, and household wealth. The latent growth modeling reveals that workers in late or partial transition trajectories tend to have better initial physical, mental, and cognitive health and experience slower deterioration of these than those in early or traditional transition trajectories. These results suggest a close relationship between health and self-identification of retirement status that may influence the work attachment and timing of workforce exit.

Long-Term Quality of Life and Survivorship Priorities in Esophageal Cancer Patients: A Survey-Based Assessment.

This study examines the long-term quality of life (QOL) and priorities of survivors who underwent management for esophageal cancer (EC). We cross-sectionally surveyed EC patients through online support groups to assess the relative importance of their overall survival, experience, costs of care, and QOL. Kendall's co-efficient of Concordance (W) was utilized to assess agreement among respondents. Among 100 respondents (age 57.2 ± 10.4 years, 54% male, 90% Caucasian), median overall survival was 18.0 (7.8-49.8) months, with a maximum survivorship of 48.3 years. Respondents ranked overall survival most important, followed by functional independence, emotional well-being, treatment experience, and costs of care (W = 0.342, p < 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority. The cohort's physical QOL (P-QOL; 39.79 ± 10.16) and mental QOL (M-QOL; 42.29 ± 15.43) were below that of the general population (50.00 ± 10.00); both p < 0.050. There was no difference in P-QOL and M-QOL based on the presence of metastatic disease (both p > 0.050). Patients who underwent curative surgery had superior M-QOL (45.00 ± 15.22 vs. 36.70 ± 14.53, p = 0.010). Although P-QOL was similar based on duration of survival (40.30 ± 9.75 [< 1 year], 39.33 ± 10.52 [1-5 years], 39.81 ± 10.68 [> 5 years], p = 0.873), M-QOL was higher in patients with extended survivorship (36.87 ± 14.24 [< 1 year], 45.05 ± 14.94 [1-5 years], 47.30 ± 16.36 [> 5 years], p = 0.008). Despite enduring physical health impairments, a majority of EC survivors prioritized their survival. However, a few survivors prioritized costs and treatment experience, underscoring the importance of tailoring treatments to ensure alignment with individual patient-driven priorities.

ОСОБЛИВОСТІ ПРОФЕСІЙНОЇ ДЕФОРМАЦІЇ ПРАЦІВНИКІВ ПРОБАЦІЇ В УКРАЇНІ

Professional deformation is a widespread phenomenon among representatives of various occupational groups, especially in roles classified as “people-oriented.” The risk associated with professional deformation among probation officers in Ukraine lies in its negative impact on both job performance and personal life. Several factors contribute to the development of professional deformation in probation officers, including economic, political, social, legal, organizational, pedagogical, and psychological factors. The primary factors leading to professional deformation among probation officers include stress, moral fatigue, job dissatisfaction, psychosocial environment, repeated stressful situations, emotional suppression, personal values, overload of professional duties, lack of professional development, and exposure to traumatic events. The particularities of professional deformation among probation officers manifest in the following ways: emotional burnout, cynicism and loss of empathy, loss of faith in the system, deterioration in physical health, reduced sense of security, behavioral changes, a tendency toward isolation, increased consumption of alcohol or drugs, and a decline in work quality. This article aims to identify the specific characteristics of professional deformation among probation officers in Ukraine. It clarifies the concept of “professional deformation” and identifies its cognitive, emotional, and behavioral levels. The specifics of probation officers’ work are outlined, highlighting the extreme nature of their work with individuals under probation measures. The article identifies the causes of professional deformation in probation officers and describes the manifestations of this phenomenon. Keywords: professional deformation, probation, probation officers, emotional burnout, professional burnout, factors of professional deformation, stress.

КОНЦЕПТУАЛІЗАЦІЯ ПОНЯТТЯ ПРОФЕСІЙНОГО ВИГОРАННЯ У НАУКОВІЙ ЛІТЕРАТУРІ

Purpose. The article reveals the concept of professional burnout in the scientific literature. Methods. To achieve the goal, the following methods of scientific and theoretical study of the problem were used in the study: analysis, synthesis, comparison, generalization, abstraction, systematization of scientific research on the issues of professional burnout. Results. According to the results, it was found that Professional activity occupies one of the key positions in human life, as it becomes not only a means of meeting material needs, but also an important factor for self-realization and self-expression of the individual. In the modern world, with its high dynamism and rapid changes in the socio-economic environment, employees are faced with growing competition in the labor market, continuous changes in the organizational environment and a large amount of work. The outlined trends create conditions for the emergence of professional burnout syndrome, which generates destructive consequences for both the individual and the organization as a whole, determining a decrease in labor productivity, loss of qualified personnel and deterioration of the working climate. Emotional exhaustion is the first reaction to excessive workload and professional stress, which manifests itself in a feeling of constant general fatigue, lack of energy, and a decrease in the level of enthusiasm. Loss of interest in professional tasks is accompanied by the emergence of beliefs about the lack of meaning in their implementation. Negative emotional states such as depression, irritability, depression, impulsivity are often combined with somatic manifestations, for example, sleep disorders, gastrointestinal disorders, headaches, etc. Conclusions. Burnout syndrome is a profound transformation of the personality, which is a consequence of experiencing chronic stress in the process of work and has a destructive effect on the emotional state of the employee, his relationships with the social environment and self-perception in the professional sphere. Burnout has negative consequences for both the individual employee and the organization. A person experiences the negative consequences of this condition in the form of deterioration of physical and mental health. Such disintegration of the personality “distorts” his further life and career prospects. In turn, employees with burnout syndrome do not properly perform their job duties, often make mistakes and make minimal efforts to achieve organizational goals, which leads to a number of negative consequences for the functioning of the institution in which such a specialist works.

Sexual dysfunction among long-term survivors of Hodgkin lymphoma.

Survival rates from childhood cancer continue to increase, with an ongoing interest in long-term survivorship. Although infertility and gonadal failure are well recognized in Hodgkin lymphoma (HL) survivors, sexual dysfunction is less studied. The objective of this study was to compare the prevalence of sexual dysfunction in HL survivors with that in matched community controls. Long-term survivors of HL (n=186; female, 51.61%; mean age at diagnosis. 14.41 years [range, 3.01-22.60 years]; current mean±standard deviation age, 36.73±7.93 years) and matched community controls (n=182; female, 50.55%; mean±standard deviation age, 36.41±9.02 years) completed a comprehensive, in-person clinical assessment, laboratory battery, and the International Index of Erectile Function or the Female Sexual Function Index questionnaire. Male survivors had increased levels of erectile dysfunction (18.89% vs. 6.67%; p=.0239) but indicated no difference in sexual desire. Female survivors had a higher prevalence of sexual dysfunction compared with female controls (46.88% vs. 15.22%; p<.0001) and an increased prevalence of moderate-to-severe loss of sexual desire (38.04% vs. 23.26%; p=.0361). Female survivors with sexual dysfunction indicated increased levels of anxiety (p=.0184), depression (p=.0153), and worse physical and mental health (p=.0141 and p=.0419, respectively). Male survivors with erectile dysfunction had higher rates of anxiety and impaired physical health (p=.0147 and p=.0266, respectively). Sexual dysfunction was prevalent in this childhood and adolescent Hodgkin lymphoma survivor cohort and was associated with effects on quality of life. Health care providers must recognize the need for screening and intervention in this group to hopefully contribute to improved overall quality of life.

Health related outcomes of patients with serious traumatic injury: Results of a longitudinal follow-up program delivered by trauma clinicians

IntroductionThe routine collection of long-term patient health outcomes after serious traumatic injury at the health service level is uncommon. In 2019, we implemented the longitudinal Trauma Service Follow Up (TSFU) program at a level I trauma centre. Delivered by the trauma service clinicians involved in inpatient care, it assesses quality of life and disability. This study reports the 6- and 12-month outcomes of the first two years of operation of the TSFU program. MethodsThis is a prospective cohort study of seriously injured adult trauma patients admitted to a level I trauma centre with 6- and 12-months post-discharge outcome assessments. Outcomes were quality of life and function/disability as measured using the EQ-5D-5L and WHODAS 2.0 validated instruments. Changes from 6 to 12 months were assessed using generalised estimating equations methods. Logistic regression models were used to identify factors associated with ongoing problems at each time point. ResultsFive-hundred and eight seriously injured patients were eligible for the TSFU program with follow-up rates over 80 % at both 6- and 12-month timepoints. At six months, ongoing problems with pain (69.9 %), anxiety and depression (49 %) and carrying out usual activities (57.5 %) were highly prevalent; at 12 months problems with pain (61.4 %) and anxiety and depression (43.8 %) persisted. Lower extremity and/or pelvic surgery was associated with ongoing pain, odds ratio (OR) = 3.77 (95 % CI 1.54–9.21, p=0.01), anxiety and depression (OR 1.95, 95 % CI 1.09–3.48, p=0.02) and problems carrying out their usual activities (OR 3.19, 95 % CI 0.75–13.5, p=0.11) at six months. These patterns mostly persisted at 12 months. Similar associations between surgical intervention and high levels of disability were evident at both time points. ConclusionPersistent impairments in physical and emotional health continues to affect many people following serious traumatic injury. The collection of longitudinal health outcomes by trauma clinicians enables identification of factors that contribute to disability and a reduction in quality of life. This in turn can drive quality improvement initiatives within the hospital trauma system. Longitudinal follow-up programs may provide a platform to provide ongoing specialist trauma-informed care after hospital discharge.

Veterinary medicine under COVID-19: a mixed-methods analysis of student and practitioner experiences in Austria.

This study aimed to provide a detailed analysis of the pandemic's impact on the veterinary profession and education in Austria. Two online surveys were conducted from November 2022 to January 2023, inviting all veterinarians and veterinary students in Austria to share their experiences on the impact of the pandemic on their veterinarian work and education in a free text question. A total of n = 289 veterinarians and n = 272 veterinary students provided an answer. In summary, 39.8% of veterinarians reported no impact by the pandemic, while others experienced changes in workload (19.7%), changes in client behavior (14.9%), implementation of safety measures (13.1%), and organizational changes (13.1%). Additional impacts included effects on mental health, private life, finances, as well as physical health. Changes were more frequently mentioned in veterinarians working with pets compared to those working with livestock. In the student panel, only a minority reported no significant impact (8.1%) but 44.9% reporting changes due to online and hybrid learning. Key issues included impaired learning conditions (34.9%), and social distancing (34.6%) leading to social isolation. Some students appreciated increased flexibility and reduced commuting (10.7%), while others experienced mental health challenges (10.7%). Further impacts were related to the implementation of safety measures (5.5%), organizational changes (4.8%) and impaired physical health due to infection (1.1%). Negative changes related to distance learning were mainly reported by students in the final study phase, whereas those in the first study phase reported more positive aspects related to online/hybrid learning. Overall, this study highlights the significant impact of the COVID-19 pandemic on veterinary education and professional practice in Austria, revealing diverse challenges for students and relatively lower but still notable effects on practicing veterinarians. Future research should monitor these impacts longitudinally and explore the integration of beneficial practices into standard veterinary education and care, such as effective digital learning platforms and appointment-based systems.

Ожирение и депрессия у детей и подростков: проблема коморбидности и профилактики

&lt;p&gt;&lt;strong&gt;The relevance:&lt;/strong&gt; currently, scientists talk about the epidemic of obesity among children and adolescents, which is associated with significant risks and deterioration of mental and physical health of the young generation. &lt;strong&gt;Objective:&lt;/strong&gt; to study association between depression and obesity in children and adolescents. The paper presents a literature review of the widely discussed problem of the relationship between depression and obesity, as well as the results of our own empirical study obtained on a sample of patients from the Center for Treatment and Prevention of Metabolic Diseases and Obesity, FGBU &amp;laquo;National Medical Research Center for Endocrinology&amp;raquo; of the Ministry of Health of Russia. &lt;strong&gt;Sample.&lt;/strong&gt; The study involved respondents aged 7 to 17 years (M=12,5, SD=2,5), a total of 153 people with SDS BMI from 1,2 to 4,2 (M=2,8, SD=0,5), of which 52% were female and 48% were male. The study included a diagnostic interview with the child and parents, each child was asked to fill out the Children's Depression Inventory (Maria Kovacs 1992). The &lt;strong&gt;results&lt;/strong&gt; suggest a high level of comorbidity of obesity and depressive symptoms among children and adolescents &amp;frac34; 52% of girls and 27% of boys who participated in the study have symptoms of depression of varying degrees of severity. Also, more severe forms of obesity were recorded in boys compared to girls at the initial application for specialized care, which indirectly indicates a greater concern for health and appearance on the part of girls and their families. The overwhelming majority of parents of children note unhealthy eating habits, low physical activity and sleep disorders in their children. It is &lt;strong&gt;concluded&lt;/strong&gt; that it is necessary to raise awareness of children, parents, teachers and child specialists of different profiles about the relationship between depressive symptoms and obesity, as well as the importance of appropriate diagnosis and the development of comprehensive treatment and prevention programs for both obesity and depression.&lt;/p&gt;

The prevalence and related factors of compassion fatigue among nursing interns: a cross-sectional study

BackgroundCompassion fatigue is common among nurses and can lead to decreased motivation, impaired physical and mental health, and turnover. Nursing interns often face environments the same as professional nurses, yet their compassion fatigue has received less attention. Therefore, this study aims to assess the prevalence and related factors of compassion fatigue among nursing interns.MethodsThis was a cross-sectional study involving 221 nursing interns in 2 tertiary-level hospitals in Shanghai, China. A general information questionnaire was formulated to investigate the demographic characteristics and internship-related factors of nursing interns. Compassion fatigue was assessed using the Professional Quality of Life Scale [compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS)]. Psychological resilience, empathy, and perceived stress were evaluated by the Connor-Davidson Resilience Scale, Jefferson Scales of Empathy, and Perceived Stress Scale, respectively. Personality traits were assessed using the extroversion/introversion subscale of the Eysenck Personality Inventory. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson’s correlation analysis, and multiple linear regressions were used to determine the predictors of the main research variables.ResultsThe prevalence of mild, moderate, and severe compassion fatigue in 221 nursing interns (mean age 21 years, 202 [91.4%] females) was 10.4%, 46.6%, and 43.0%, respectively, and their mean scores for CS, BO, and STS were 29.75 ± 6.39, 28.72 ± 4.78, and 28.51 ± 7.51, respectively. Psychological resilience and empathy were the strongest protective factors for CS and BO, respectively (p < 0.001), and the number of night shifts monthly was the most significant positive independent predictor of STS (p = 0.001). Additionally, male gender negatively predicted CS (p = 0.009). Younger age and extended daily working hours were associated with elevated levels of both BO and STS (p < 0.05). Clinical nursing teachers with intermediate or senior titles, as well as departments of pediatrics and obstetrics had a positive effect on STS (p < 0.05), while internship time had a negative effect on STS (p = 0.005). Furthermore, the variables of perceived stress, personality traits, and choice of nursing profession did not exhibit statistical significance in the multivariate analysis. Related factors predicted 14.2%, 26.2%, and 23.9% of the variance in the model of CS, BO and STS, respectively (all P < 0.001).ConclusionThe compassion fatigue of nursing interns was more serious, especially for nursing interns who were male and younger, and who had shorter internship time, departments of pediatrics and obstetrics, and clinical nursing teachers with intermediate or senior titles. Nursing educators can improve the psychological resilience and empathy of nursing interns by offering relevant psychological courses according to the different stages of internship, as well as rationalizing their daily working hours and the frequency of night shifts to improve the compassion fatigue of nursing interns.Registration NumberChiCTR2400081968.

The impact of war situation on endometriosis patients: Evaluating physical and mental health outcomes.

To investigate the impact of war situation on physical functioning, mental health status, and disease manifestations among endometriosis patients. Questionnaire-based study analyzing physical and psychosocial well-being. The study includes 50 endometriosis patients at Sheba Medical Center who completed a detailed questionnaire before and after the onset of the October 7, 2023, War in Israel. Significant deterioration in physical and mental health after the onset of war (pain score 6 vs 7; p < 0.001). Although having a first-degree relative affected by the war was associated with health deterioration (OR, 5.44; p = 0.02), similar pattern of health status aggregation was observed also in a subgroup of 19 women without family involvement, suggesting the general war situation as a likely cause. Starting new anti-anxiety or antidepressant medications and psychological therapy had a protective effect (OR, 0.21; p = 0.05). War situation exacerbates endometriosis symptoms, highlighting the importance of early psychological interventions to mitigate negative impacts.

Drinking refusal self-efficacy- a positive effect of attending de-addiction clinic -survey report of South Indian Union territory hospital.

Introduction: Alcoholism is the most common psychiatric disorder that causes impairment in physical health, mental health,and social functioning. “Alcohol dependence syndrome (ADS) is characterized by a state, psychic, and usually also physical,resulting from drinking alcohol. Self-efficacy is an individual’s belief in his/her innate ability to achieve goals. The prevalenceof current alcohol use in Pondicherry is 9.5% for males and 20 % in total. However, more than 40% of alcohol users drinkalcohol in a dependent pattern in Pondicherry. The current study aimed to assess the self-efficacy of clients to quit alcohol.Methodology: In this descriptive cross-sectional study 97 participants were selected by a convenient sampling technique atde addiction clinic, JIPMER, Puducherry. The tools used for the study include socio-demographic variables, modified versionof drinking refusal self-efficacy questionnaire, which consists of 19 questions to assess their belief about the ability to resistalcohol in the various situation on a six-point Likert scale ranged from 1( I am very sure I would drink) to 6 (I am sure I wouldnot drink)The primary objective was analysed using descriptive and inferential statistics and the secondary objectives were analysedusing the chi-square test and Pearson correlation.Results: The result showed that among 97 study participants, the majority of them could resist (58.8%) alcohol during theirde-addiction follow up visit.Conclusion: Our study concluded that patients who regularly attend de-addiction clinic could resist alcohol consumption.There is still a need for health education and counseling to quit Alcohol.

Measuring internalized health-related stigma across health conditions: development and validation of the I-HEARTS Scale.

Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1-7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. STUDY PRE-REGISTRATION: https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f .

Mum'maruntu nūlkaḷil maruttuvam cārnta paḻakka vaḻakkaṅkaḷ [Medical elements in mum'maruntu texts

In the changing human living environment, medicine has become an important aspect. Although human beings are progressing gradually, physical health continues to pose many challenges to human beings. In general, irregular eating habits and an undisciplined lifestyle are the reasons for deterioration of physical health. Although modern medicine provides solutions for diseases that arise from time to time, there is no doubt that following the right way of life as prescribed by ancient medicine helps one to lead a healthy life throughout their lifetime. In this regard, the medical treatment practices followed by people in their daily life during various periods can be known through the study of literature that emerged during those times. Tamil literature also contains many medical references necessary for the people. The Patinenkilkkanakku Texts are the compilations made during the Sangam period. The Patinenkilkkanakku Texts are generally texts that preach moral values. However, many verses contain references to ancient medicine. This article aims to study the medical-related practices found in the three texts called Mummaṟuntu Nūls (Triple Root Treatises) - Ēlāti, Tirikāṭukam and Ciṟupañcamūlam - among the Patinenkilkkanakku Texts. The ancient Tamils gave great importance to maintaining a healthy physical lifestyle in their daily life. They inculcated good conduct and discipline in people's minds and thereby enabled them to lead a disease-free life. By reading the Mummaṟuntu Nūls (Triple Root Treatises), we can understand that they made people lead a life free from diseases through inculcating good conduct and discipline. We can appreciate the greatness of these texts as they reveal medical thoughts that are relevant even for today's people.

IMPACT OF HABITUAL SMOKING ON THE ORGANISM OF ADOLESCENTS LIVING IN THE NORTH OF RUSSIA

The aim of the work is to analyze the impact of habitual smoking on the physiological systems of adolescents living in the north of Russia (65º N). Materials and Methods. Using generally accepted methods, morphofunctional, physiometric, physiological and psychological parameters were determined in 34 boys aged 14–15 years (11 smokers for at least 2–3 years and 23 non-smokers). The level of physical health was assessed according to Apanasenko method. Results. Compared with non-smokers, smoking adolescents have statistically significantly higher body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean blood pressure (MBP) during exercise, heart rate (HR) during exercise and its increase while working, HR recovery after exercise (Martine-Kushelevsky test), rate pressure product (RPP), and scores of activity (WAM questionnaire). At the same time, they demonstrated lower strength index (SI), maximum expiratory pressure (MEP), vital capacity (VC), vital index (VI), Skibinskaya index (SI), level of physical health (LPH), and WAM parameters. Smokers, compared to 11 non-smokers of the same weight, have statistically significantly lower height, strength and SI, Genchi test time, MEP, VC, VI, SI, LPH, and scores of well-being and mood (WAM parameters). However, they have higher HR during exercise, its increase while working, and HR recovery. Excess body weight in smokers leads to hypertension, while long-term smoking in teenagers living in the north of Russia causes physiological decline and physical health deterioration. In some cases, our results (decrease in strength, Genchi test time, VC, VI, increased HR, hypertensive reactions, and health deterioration in smokers) correlate with the data obtained both in our country and abroad.

Youths with Extreme Obesity: A High-Risk Group for Pain and Mental Health Impairments

Introduction: Youths with extreme obesity (body mass index [BMI] ≥40) are at increased risk for physical and mental health impairments. Nevertheless, this patient group has received little attention in research. This study aimed to analyze the pain experience and mental health impairments of youths with extreme obesity compared to those with mild and moderate obesity (BMI = 30–39.9) while also considering potential gender differences. Methods: Cross-sectional data of 431 obese youths (M = 16.6 years; SD = 2.3; range = 13–25 years; 53.1% female) were analyzed. Of these, 159 (36.8%) youths had extreme obesity. Self-reported sociodemographic data, variables related to back or leg pain, depression, and health-related quality of life (HRQoL) were assessed with standardized questionnaires. Data were analyzed with univariate tests and logistic regression models. Results: Youths with extreme obesity reported more pain in the last 4 weeks (p = 0.018), increased pain-related impairments in daily life (p = 0.009), more pain-related days of absence (p = 0.030), higher depression scores (p = 0.030), and reduced HRQoL (p = 0.005) compared to youths with mild and moderate obesity. The association between extreme obesity and pain in the last 4 weeks remained associated after including sociodemographic variables in the regression model. In the subgroup of youth with extreme obesity (n = 159), women (n = 83) reported more pain in the last 4 weeks (p = 0.001), higher depression scores (p < 0.001), and lower HRQoL (p < 0.001) compared to men (n = 76). The association between female gender and pain remained significant in the regression models, even after controlling for sociodemographic variables and depression. Conclusion: These findings highlight the need for standardized assessments of pain and mental health, particularly in the treatment of female youths with extreme obesity. Upcoming studies should analyze the reciprocal interactions of pain and mental health, since both are important barriers to lifestyle changes and weight loss.

Sabatolimab in combination with spartalizumab in patients with non-small cell lung cancer or melanoma who received prior treatment with anti-PD-1/PD-L1 therapy: a phase 2 multicentre study

ObjectiveThis study evaluates the safety/efficacy of sabatolimab plus spartalizumab in patients with melanoma or non-small cell lung cancer (NSCLC).Design, setting and participantsThis is a phase 1–1b/2, open-label, multinational, multicentre study...

Climate change loss and damage from droughts: key insights from Fiji’s sugar industry

ABSTRACT Climate change loss and damage (L&D) due to both sudden and slow-onset events are a growing concern for vulnerable countries. Over the last decade, agricultural communities in Fiji have suffered a range of serious L&D from severe drought events. Through a grounded theoretical lens, qualitative research was used to gain in-depth insights into L&D from droughts in the Fijian sugar industry. In-depth semi-structured interviews (n = 68) were conducted in two Indo-Fijian sugarcane communities, Barotu and Toko settlements in Western Viti Levu, Fiji, and with key stakeholders from government ministries, academia, and climate change experts at the national level. Purposive sampling was initially used to identify smallholder sugarcane farmers and key stakeholders. Theoretical sampling further identified key stakeholders for the interview. Despite implementing various adaptation measures, the Fijian sugar industry has suffered severe L&D, including non-economic L&D (NELD) and associated cascading effects. L&D included reduced yields, loss of crops, and reduced income. NELD included deterioration of mental, physical, and emotional health, loss of hope, and uncertainty. Cascading effects included increased food insecurity risks and impacts on children’s education. Key policy interventions are recommended, such as removing adaptation constraints, developing drought risk profiles and early warning systems, investing in livelihood diversification, and engaging in new markets to facilitate social and ecological transformations that will promote livelihood resilience. Key Policy Highlights: Climatic and non-climatic stressors are inherently interconnected and interact in a complex and complicated manner to enhance social-ecological systems (SES) vulnerability. Inadequate drought adaptation measures further marginalise farmers and ultimately increase their vulnerability to drought risks and loss and damage (L&D). L&D presents itself in various ways, including non-economic L&D and cascading effects that are impacting upon future generations. With projected climate change and the likelihood of impacts worsening, there is an urgency to address L&D more coherently through crucial policy interventions.

Development and Validation of the Dementia Caregiver Burden Scale: A Tool for Community-Dwelling Dementia Caregiver.

The number of patients with dementia increases rapidly in aging populations. Dementia is an irreversible disease that causes a patient to be dependent on others' care and also causes family caregivers to experience difficulties in multiple domains. In this study, a dementia caregiver's burden scale that addresses family caregivers' characteristics and caring environments was developed and validated. In-depth interviews with nine caregivers were conducted to identify the attributes of perceived burden and establish preliminary questions. Content validity was confirmed by seven experts using the item content validity index and scale content validity index/average. Construct validity, criterion-related validity, and reliability were verified using data from 205 primary caregivers of patients with dementia. Exploratory factor analysis revealed that five factors, including physical health deterioration, responsibility and role of caregiver, emotional distress, medical expense concerns, and family conflict, and 24 items explained 68.6% of the total variance. The calculated Cronbach's α for the overall scale was .96. The scale developed in this study may be used to measure the burden perceived by family caregivers of patients with dementia in the physical, emotional, social, financial, and situational domains. Also, the scale may be used to guide the development of tailored interventions that take into consideration different family caregiver and caring situation-related characteristics.

Analyzing the adolescents’ impaired physical health: prevalence and associated factors in more than 100,000 Brazilian schoolchildren

Introduction: Despite the vast evidence on different risk factors and their associations with behaviours that affect the development of young people, there is still a gap in the literature, the evidence bases that ad-dresses the components of health in an integral way. Objective: The present study aims to propose a combined indicator with the intention of concatenating risk behaviours into a single primary outcome, called Health Impaired Physics, and after that, identify socioeconomic indicators that can help to understand how this commitment affects the Brazilian students. Methods: This is a transversal-secondary analysis study of a Brazilian public database (National School Health Survey). The data are available from the Brazilian Institute of Geography and Statistics (https://www.ibge.gov.br/). We selected the information about physical activity, nutritional status perception, and “effort to change weight” from 108778 schoolchildren aged between 11 and 18 years. After proposing the “impaired physical health” variable, we use the Poisson logistic regression with p&lt;0.05 of acceptable significance. Results: Impaired physical health was adopted based on the following composition and criteria: negative classification of physical activity, poor perception of nutritional status and lack of effort to change weight. Individual characteristics (gender and race), food (smoking and drug consumption), family (e.g. not living with parents), phone use and geographic characteristics showed a significant association with the prevalence of impaired physical health. Conclusion: Collectively, our evidence reinforces that physical health impairment is influenced by several factors, including lifestyle, family and demographic context, and technology use. This study provides important information for managers in planning efficient public policies to promote health for this population, especially in intervention in the social context.

Discussion on the Causes and Solutions of Juvenile Bullying Behavior in Rural Schools

As a serious social problem, campus bullying has brought far-reaching negative impact on the victims. Victims not only suffer from impaired physical and mental health, but are more likely to face social difficulties and psychological distress. This study deeply discusses the specific causes and intervention strategies of school bullying behavior. The reasons for the frequent occurrence of school bullying involve many aspects such as family, school, peer relationship and social culture. In response to this problem, this study proposes to construct the "trinity" education model of family, school and community to deal with the school bullying phenomenon of rural teenagers. Through strengthening family education guidance, optimizing school education environment, and strengthening community construction, we can jointly promote the effective solution of school bullying. This study provides a useful reference for building a more perfect school bullying prevention and control system, which is helpful to reduce the occurrence of school bullying and protect the healthy growth of teenagers.