Need For Care Research Articles

Evaluating the associations between compliance with CKD guideline component metrics and renal outcomes

Understanding the association between compliance to the Chronic Kidney Disease (CKD) guidelines in real-world clinical settings and renal outcomes remains a critical gap in knowledge. A comprehensive analysis was conducted using data from a national, multicenter CKD registry. This study included 4,455 patients with an estimated glomerular filtration rate (eGFR) measurement on the index date and eight additional metrics recorded within six months. These metrics comprised serum electrolyte levels, low-density lipoprotein cholesterol, hemoglobin, and the use of renin-angiotensin system inhibitors. The primary outcome was a composite of renal events, defined by a decline in eGFR to < 15 mL/min/1.73 m2 or a reduction of ≥ 30% in eGFR, confirmed by follow-up tests. Over a median follow-up of 513 days, 838 renal events were observed. High serum potassium levels (> 5.4 mmol/L) were associated with increased event rates compared to lower levels. Similarly, low serum sodium-chloride levels (< 33) correlated with higher event rates. Usage of renin-angiotensin system inhibitors, low serum calcium (< 8.4 mg/dL), and high uric acid levels (> 7.0 mg/dL) were also linked to increased events. Conversely, higher hemoglobin levels (≥ 13 g/dL) were associated with lower event rates. Compliance to guidelines, categorized into quartiles based on the number of met metrics, revealed a significantly reduced risk of events in the highest compliance group (meeting 8 metrics) compared to the lowest (0–5 metrics). Compliance to CKD guidelines in clinical practice is significantly associated with improved renal outcomes, emphasizing the need for guideline-concordant care in the management of CKD.

Epidemiology and Treatment of Patients With Primary Open Angle Glaucoma in Germany: A Health Claims Data Analysis.

Based on a large administrative database of German claims data, our study provides current estimates of the prevalence and incidence of primary open angle glaucoma (POAG) in Germany and describes selected outcomes for prevalent patients with POAG. To estimate the prevalence and incidence of POAG in Germany, to describe the patient population in terms of comorbidity burden, routine care, and overall healthcare resource utilization (HCRU) and associated costs, and to describe treatment patterns over time in patients undergoing relevant laser procedures. Based on anonymized German claims data, we carried out a retrospective, noninterventional study covering calendar years 2016-2021. For the adult German population (≥18y), we estimated a POAG 1-year prevalence of 1.70% and a 1-year incidence of 0.17% in 2018; both increased with age, peaking in 80- to 89-year-olds. Prevalence and incidence were lower in 2020 (1.65% and 0.16%, respectively), the first year of the SARS-CoV-2 pandemic. Most patients solely received topical treatment. Most surgically treated patients underwent laser trabeculoplasty, followed by laser iridotomy, trabeculectomy, and filtration operations with implant. In patients undergoing laser trabeculoplasty, the treatment regimen was nearly unchanged in the second year after, compared with 2 years before the procedure. Multimorbidity was commonly observed; 75.5% of patients had arterial hypertension and 50.0% had disorders of lipoprotein metabolism and other lipidemias, compared with 60.1% and 39.2%, respectively, in an age- and sex-matched control sample. Our study provides insights into epidemiology and routine care of POAG in Germany and HCRU in prevalent patients. There was little change in treatment regimens in patients who underwent laser trabeculoplasty, 2 years after the procedure. Most patients were multimorbid highlighting the need for comprehensive care.

Accuracy of telephone triage for predicting adverse outcomes in suspected COVID-19: an observational cohort study

ObjectiveTo assess accuracy of telephone triage in identifying need for emergency care among those with suspected COVID-19 infection and identify factors which affect triage accuracy.DesignObservational cohort study.SettingCommunity telephone triage provided...

Skin Grafts in Plastic Surgery: A Comprehensive Review of Procedures, Techniques, and Clinical Considerations

Objective: This study aims to analyze the progress and challenges related to the use of skin grafts in plastic surgery, with the purpose of providing a comprehensive understanding of the associated techniques and clinical considerations. Theoretical Framework: A review of the fundamentals of plastic surgery is presented, emphasizing the importance of skin grafts in wound and deformity reconstruction, as well as exploring the impact of tissue engineering on the evolution of these techniques. Method: This study is based on a systematic review of the scientific literature, following recognized guidelines. Relevant articles addressing different types of skin grafts, their clinical applications, and associated procurement techniques were selected. Results and Discussion: The results of the review highlight the variety of skin grafts available and their respective indications. The discussion addresses the challenges in selecting the appropriate type of graft and the ethical issues related to its procurement and use. Implications of the Research: This study offers important insights for plastic surgeons and researchers on best practices in skin graft utilization, emphasizing the need for ethical considerations and specific care in graft selection and procurement. Originality/Value: It contributes to the literature by providing a comprehensive analysis of skin graft techniques in plastic surgery, including recent advancements and emerging issues. Its relevance lies in the practical guidance it offers to professionals in the field.

Navigating Cardiovascular Risk in Type 1 Diabetes: A Comprehensive Review of Strategies for Prevention and Management.

Type 1 diabetes mellitus (T1DM) poses a significant cardiovascular risk, necessitating comprehensive prevention and management strategies. This review provides insights into the cardiovascular risk landscape in T1DM, emphasizing the importance of glycemic control, lipid management, blood pressure regulation, and lifestyle modifications. Pharmacological interventions, including insulin therapy and lipid-lowering medications, are discussed alongside lifestyle interventions such as diet, exercise, and smoking cessation. Early detection and management of cardiovascular complications are essential, highlighting the need for regular screening and multidisciplinary care. Patient-centered approaches, including shared decision-making and psychosocial support, are vital to effective care delivery. The review concludes with a call to action for healthcare providers and policymakers to prioritize cardiovascular risk management in T1DM. It explores future directions, including emerging therapies and technological innovations. By implementing evidence-based strategies and fostering collaboration across disciplines, we can mitigate cardiovascular risk and improve outcomes for individuals with T1DM.

Towards Inclusive Education: Parental Perspectives on Autism Inclusion in Schools in Morocco

School inclusion for autistic children in Morocco is a crucial issue for ensuring educational equity. Despite the efforts made in recent years in the field of autism, many challenges remain. The aim of this study is to investigate the educational experiences of parents of children with autism in Moroccan schools. It focuses specifically on parents of autistic children attending school in the two regions: Casablanca-Settat and Rabat-salé-kenitra, with a view to adapting educational programs to promote better social integration in more inclusive school environments. This study adopts a mixed-methods research approach, combining qualitative and quantitative methods, including semi-structured interviews with parents of autistic children, questionnaires to assess their satisfaction, and direct observations of children in the school context, aiming to provide an in-depth understanding of school inclusion for autistic children in Morocco. The results indicate a significant demand for adapting teaching methods for autistic children, as well as increased communication with the teaching team and better social integration. In addition, the level of acceptance of autism in Moroccan society is generally considered to be average or low, underlining the need for better care for autistic children. It is recommended that autism awareness programs be strengthened in schools to promote better understanding and acceptance within the educational community.

Quantifying the Need for Specialist Palliative Care Management in Patients With Systemic Sclerosis.

The importance of early integration of palliative care in the management of complex multisystem diseases has been recognized. In this study, we aimed to quantify the need for specialist palliative care in patients with systemic sclerosis (SSc). Using data from 875 patients enrolled in the Australian Scleroderma Cohort Study, we defined the need for palliative care as a high symptom burden at two or more consecutive study visits, at ≥50% of overall study visits, or at the study visit immediately before death. Symptoms of interest included breathlessness, fatigue, pain, depression, anxiety, constipation, and diarrhea. Logistic regression analyses evaluated the association between individual symptoms and SSc manifestations. Linear regression analysis evaluated the relationship between palliative care needs and quality of life (QoL) and function. Almost three-quarters of patients (72.69%) met the threshold for specialist palliative care needs. Severe fatigue (54.17%) was most common, followed by breathlessness (23.66%) and severe constipation (21.14%). Concurrent severe symptoms were frequently observed. Severe breathlessness (coefficient [coef] -7.95, P < 0.01) and pain (coef -7.70, P < 0.01) were associated with the largest reductions in physical QoL. Severe mood symptoms were associated with the greatest reduction in mental QoL (coef -12.91, P < 0.01). Severe pain (coef 0.56, P < 0.01), breathlessness (coef 0.49, P < 0.01), and mood symptoms (coef 0.40, P < 0.01) had a significant impact on function. SSc is frequently associated with multiple severe symptoms that may be amenable to palliative care intervention. Given the strong association between symptom burden and impaired QoL targeted, effective symptom management in parallel with standard-of-care treatments may improve overall patient outcomes.

AN EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF APPLICATION OF CABBAGE LEAVES ON REDUCTION OF BREAST ENGORGEMENT AMONG POSTNATAL MOTHERS IN SELECTED HOSPITALS OF JABALPUR

Background—The most innate and purest of all human activities is breastfeeding. Its an up breast in strengthening the mother baby bonding. Amongst the postpartum complications one of the commonest is breast engorgement. Its an painful overfilling of the mammary glands with milk. If not treated it can result in severe breast complications like mastitis. The nurse practioners knowledge of alternative and complementary therapy of dealing with engorgements would surely help in reducing this post partum morbidity and thereby improving the maternal and newborn care Need Of The Study---The investigator herself is a woman, hence she could discern the urgent requirement of promoting an efficacious technique for decreasing the breast engorgement following labour. Using cabbage leaves is a convenient method for this purpose. Hence the study was undertaken to determine the outcome of cabbage leaves application in reducing it. Method The study utilized a Quasi experimental research approach with two group pretest - posttest design. The data was collected from selected hospitals of Jabalpur city by using purposive sampling technique. The sample comprised 40 postnatal mothers. The tool used for collecting demographic data were a interview along with the analogue pain scale and Hill&amp; Humenic breast engorgement scale, Application of cabbage leaves was done for 20 minutes after the breast feeding for reduction of breast engorgement in post natal mother Result-- The assessment of breast engorgement scale in this study shows that the Assessment control group indicate majority of engorgement scale Severe engorgement (11) 55% group, moderate was (8) 40% and mild engorgement is (1) 5% Finding of the present study shows the assess in breast engorgement scale indicate majority of engorgement scale Severe engorgement (13) 65% group, moderate was (6)30% and mild engorgement is (1)5% in Pre-Experimental group. Finding of the present study shows the assess in breast engorgement scale indicate majority of engorgement scale Severe engorgement (11)55% group, moderate was (8)40% and mild engorgement is (1)5% in Post-Experimental group.The t-test compared result showed positive correlation that calculated value is t=5.075 which is greater than t=1.685 at the 0.05 level of significance. Findings related to the comparison of severity of the breast engorgement score with control group and experimental group by the unpaired t-test, compared result showed positive correlation t=3.90 which is greater than the table value 2.02 at the 0.05 level of significance. Conclusion—In order to foster the MGDs 4 and MGD 5 simple and easily available techniques like cabbage leaves application on breast engorgement should be commonised in practice by the nurse administrators and midwifery practioners so that this major discomfort is relieved .cabbage leaves does not reduce the milk production and suplly but only works on the fluid trapped around . it helps in the capillary dilatation and acts a counter irritant . The inflammation ,pain and engorgement is reduced allowing the milk to flow freely KEY WORDS-- Cabbage Leaves, Reduction of breast Engorgement, Postnatal mothers

Kosambi Green Lane Park, West Jakarta, Indonesia: Urban Recreation and Ecology Center

This research aims to investigate the concrete impact of the Kosambi Green Lane Park on the ecology and comfort of the surrounding environment. Green lane parks are the main focus for balancing urban growth and environmental preservation in sustainable urban development. Descriptive methods are used to provide an in-depth overview of the park's facilities and level of accessibility and analyze visitors' preferences and needs for existing facilities. The research results show that Kosambi Green Route Park offers a variety of facilities, such as a jogging track, huts, and children's play areas, which are visitors' favorites. This park's access is good via private vehicles and public transportation, with supporting infrastructure that supports visitor comfort. Visitor preferences highlight the need for better care and maintenance of existing facilities and requests for further development, such as the addition of sports facilities and further green areas for picnics. The positive impacts felt by local communities include improved physical and social well-being and contributions to the surrounding environment through improved air quality and environmental awareness. Kosambi Green Lane Park is a successful example of the green lane concept in sustainable urban development. Still, there needs to be continuous attention to maintenance and development so that the benefits can continue to be felt in the long term.

Qualitative evaluation of motives for acceptance or refusal of early palliative care in patients included in early-phase clinical trials in a French comprehensive cancer center: the PALPHA study.

The integration of palliative care (PC) into oncological management is recommended well before the end of life. It improves quality of life and symptom control and reduces the aggressiveness of end-of-life care. However, its appropriate timing is still debated. Entry into an early-phase clinical trial (ECT) represents hopes for the patient when standard treatments have failed. It is an opportune moment to integrate PC to preserve the patient's general health status. The objective of this study was to evaluate the motives for acceptance or refusal of early PC management in patients included in an ECT. Patients eligible to enter an ECT were identified and concomitant PC was proposed. All patients received exploratory interviews conducted by a researcher. Their contents were analyzed in a double-blind thematic analysis with a self-determination model. Motives for acceptance (PC acceptors: n = 27) were both intrinsic (e.g., pain relief, psychological support, anticipation of the future) and extrinsic (e.g., trust in the medical profession, for a relative, to support the advance of research). Motives for refusal (PC refusers: n = 3) were solely intrinsic (e.g., PC associated with death, negative representation of psychological support, no need for additional care, claim of independence). The motives of acceptors and refusers are not internalized in the same way and call for different autonomy needs. Acceptors and refusers are influenced by opposite representations of PC and a different perception of mixed management.

The necessity of an empirical study to determine if church congregations function as a family

Scripture’s reference to believers as the ‘family of God’ may indicate that believers should mutually care for one another like members of a caring family do, and not merely that members are part of a ‘spiritual’ family. From this perspective, the article investigated the extent of mutual care within congregations. The increasing need for pastoral care, within and outside church congregations, reveals the need for mutual care between members. The necessity for empirical studies within church congregations were revealed by the differences in the intensity of the answers by the participants. Without knowledge about the experiences of church members, leaders of church congregations may overlook potential needs of their members. A quantitative empirical study was done through an anonymous online survey with church members, pastoral counsellors, and pastors and ministers from various denominations who completed the survey, according to their experiences within their individual church congregation. The concepts of fellowship (koinōnia), service (diakonia), care, and family were used in the survey to determine the experiences of mutual care between members of the church congregation. The deficiency of mutual care between members of the congregation may motivate leaders to intentionally develop relationships through fellowship (koinōnia) to foster mutual care between members, and intentionally develop members to serve (diakonia) one another and their community.Contribution: This article contributes to an interdisciplinary discussion between pastoral theology, practical theology, and systematic theology from a Reformed perspective with a focus on the practical participation of members of the church congregation in pastoral care as the ‘family of God’.

Emergency Care of an Older Adult with Complex Care Needs

Emergency Care of an Older Adult with Complex Care Needs

Trauma exposure correlates among patients receiving care in federally qualified health centers.

Over 80% of adults in the general population experience trauma. Rates of patients with posttraumatic stress disorder (PTSD) are high in primary care settings and are likely to be even higher in federally qualified health centers (FQHCs). Trauma exposure has been linked to psychiatric symptoms and physical health comorbidities, though little research has focused on FQHC patients. This study addresses this by examining clinical and sociodemographic correlates of specific trauma types among FQHC patients. We analyzed secondary data from patients who screened positive for PTSD and were receiving health care in FQHCs in a clinical trial (N = 978). Individuals who did versus did not experience a specific trauma type were compared using between-group tests. In the sample, 91.3% of participants were exposed to a DSM-5 Criterion A traumatic event, with 79.6% experiencing two or more trauma types. Witnessing a life-threatening event (57.3%) and physical assault (55.7%) were the most common traumatic experiences. Physical health comorbidities and worse physical health functioning were associated with a higher likelihood of exposure to all trauma types, with effect sizes larger than PTSD, ds = 0.78-1.35. Depressive and anxiety symptoms were also associated with a higher likelihood of experiencing nearly all trauma types to a lesser magnitude. People of color, OR = 2.45, and individuals experiencing financial inequities, OR = 1.73, had higher odds of experiencing serious accidents as well as other trauma types. The findings highlight the need for trauma-informed care, including routine trauma and PTSD screening, for FQHC patients.

Client satisfaction with abortion care service and its associated factors among women in Ethiopia: a systematic review and meta-analysis

BackgroundThe client’s satisfaction after abortion care is the key to sustaining abortion care and increasing the health status of those who had complications from abortion. Nevertheless, research conducted in Ethiopia stated that the major problem is the need for post-abortion care for females. One of the ways to improve the qualities involved in post abortion care and decrease the mortality and morbidity rates caused by unsafe abortion is by ensuring client satisfaction with abortion care. Strategy making and policy formulation based on systematic review take on the highest priority in developing countries. However, although some independent studies had been carried out in Ethiopia, their findings might not have been representative and conclusive. The main purpose of this systematic review and meta-analysis article is to establish the proportion of abortion clients who are satisfied with their abortion care and the factors that contribute to such satisfaction among clients in Ethiopia.Methods and materialsOnly published articles were considered in this review. The main databases included Medline/Pubmed, Web of Science, Embase, Cinael, Med Nar, Google Scholar, Scopus, the Ethiopian University Repository Online, and the Cochrane Library. The review includes cross-sectional studies that meet the requirements and were written in English. A random effects model was used to calculate the pooled prevalence of client satisfaction with abortion care. The study heterogeneity was tested using Cochrane Q-Static and I2. Publication bias was checked using the Eggers test and funnel plot. PRISMA was used to select and direct the selection of articles for this review. Statistical analyses were conducted using STATA version 14.ResultA review of ten studies comprised 2740 women. In summary, the pooled prevalence of client’s satisfaction with abortion care in Ethiopia was 56.13% [95% CI (42.35; 69.91), I2 = 99.1%, p < 0.001]. In terms of subgroup analysis, Gambella had the highest prevalence of client satisfaction with abortion care at 87.40% [95% CI: 82.38 and 91.82]. However, Amhara had the lowest: 25.00% [95% CI: 21.59, 28.41]. The review also found that client satisfaction with abortion care had a statistical correlation with the type of procedure [OR: 0.25, CI [0.07, 0.42], I2: 76.9%, p-value: 0.041] and the participant’s education level [OR: 0.29, CI [0.09, 0.48], I2: 80.4%, p-value: 0.006].ConclusionThis review found that 56% of Ethiopian women were satisfied with their abortion care. Since this requires a boost to the quality of abortion care in the health facility, understanding women’s expectations and perceptions, training of health care providers, and strict monitoring of the quality of abortion care services by stakeholders like the Ethiopian government, non-governmental organizations, and high-level management of the health facility would help to improve the level of women’s satisfaction with abortion care. Those factors, namely, the type of method to use for the patient and women’s educational level, should be changed through improving awareness among the patients about what procedure to conduct and the health education provided to women about abortion care.

Mental Health Needs, Barriers, and Receipt of Care Among Transgender and Nonbinary Adolescents

PurposeTransgender and nonbinary youth disproportionately experience adverse mental health outcomes compared to cisgender youth. This study examined differences in their mental health needs and supports, barriers to care, and receipt of mental health care. MethodsThis study examined cross-sectional data from 43,339 adolescents who completed the California Healthy Kids Survey, 4% (n = 1,876) of whom identified as transgender and/or nonbinary. Chi-square test and t-test were used to compare mental health needs and supports, resilience, and barriers to and receipt of care experienced by transgender and nonbinary youth compared to cisgender youth. ResultsTransgender and nonbinary youth were significantly more likely to experience chronic sadness/hopelessness (74% vs. 35%) and consider suicide (53% vs. 14%) and less likely to report resilience factors (school connectedness: mean score 3.12 vs. 3.52). Transgender and nonbinary youth were significantly less likely to be willing to talk to teachers/adults from school (12% vs. 18%) or parents/family members (21% vs. 43%), but more willing to talk to counselors (25% vs. 19%) regarding mental health concerns. Transgender and nonbinary youth were significantly more likely to select being afraid (48% vs. 20%), not knowing how to get help (44% vs. 30%), or concern their parents would find out (61% vs. 36%) as barriers to seeking mental health care, yet reported slightly higher odds of receiving care when needed (odds ratio: 1.2). DiscussionTransgender and nonbinary youth are more likely to report mental health concerns and barriers to seeking care than cisgender youth. Increasing access to care is critical for this population.

Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study.

Enhanced recovery after surgery (ERAS), a global surgical quality improvement initiative, reduces the length of stay in the hospital. Temporary stoma care for rectal cancer is complex, and patients require prolonged care services to adjust to the stoma. The shorter stay durations in the new model challenge the conventional care pathways and create new patient needs. This study was designed to explore the supportive care needs of patients under the new surgical model to provide a reference for the design of ERAS nursing care plans. A convergent parallel mixed-methods design was used in this study. Patients with temporary stomas for rectal cancer were recruited using a convenience sampling method in gastrointestinal surgery wards and wound & stoma clinics in two public tertiary care hospitals in China. Standardized questionnaires were administered to 140 patients to collect quantitative data, and semistructured interviews were conducted individually with 13 patients to collect qualitative data. The questionnaire data were analyzed using descriptive statistics, and the interview data were analyzed using thematic analysis. "Health system and information needs" and "care and support needs" were identified in both the qualitative and quantitative analyses as the most significant unmet needs of the participants. In addition, the qualitative analysis identified receiving focused stoma care instructions and easily understandable information as essential to fulfilling health system and information needs. Care and support needs included access to continued postdischarge services and attention from medical professionals. The participants in this study experienced a variety of unmet supportive care needs under the ERAS protocol, with gaps particularly notable in two categories: "health system and information needs" and "care and support needs." Increased perioperative care and shorter hospital stays under the ERAS protocol reduce opportunities for patients to receive targeted instruction and shift much of the ostomy education and care workload out of the hospital, requiring greater attention from clinical nurses to ensure quality of care.

Comparative Analysis of Frailty Risk and Associated Factors: Community-Based vs. Open Recruitment Groups.

Frailty leads to vulnerability to stress, impaired daily functioning, and an increased need for care. Frailty is considered reversible, and it is crucial to detect the risk of frailty early and investigate factors that may delay its progression. To identify tests that can explain frailty risk and compare the situation of local residents with and without frailty support. Participants were recruited in two ways: through public advertisements in Akita City (open recruitment group) and through invites from frailty supporters in their immediate communities (community-based group). We examined the differences in frailty risk and oral, motor, and social functions between the two groups and identified factors associated with frailty risk in both groups. The community-based group exhibited a lower risk of frailty than the open recruitment group despite having more older members on average. Additionally, the community-based group demonstrated better social functioning than the open-recruitment group. Furthermore, factors such as oral diadochokinesis (ODK), one-leg stand test (OLS), and grip strength (GS) showed significant association with frailty risk. The ODK, OLS, and GS were identified as factors explaining frailty risk, and Frailty Supporters may reduce the risk of frailty.

Mode of delivery and birth outcomes before and during COVID-19 -A population-based study in Ontario, Canada.

There is lack of clarity on whether pregnancies during COVID-19 resulted in poorer mode of delivery and birth outcomes in Ontario, Canada. We aimed to compare mode of delivery (C-section), birth (low birthweight, preterm birth, NICU admission), and health services use (HSU, hospitalizations, ED visits, physician visits) outcomes in pregnant Ontario women before and during COVID-19 (pandemic periods). We further stratified for pre-existing chronic diseases (asthma, eczema, allergic rhinitis, diabetes, hypertension). Deliveries before (Jun 2018-Feb 2020) and during (Jul 2020-Mar 2022) pandemic were from health administrative data. We used multivariable logistic regression analyses to estimate adjusted odds ratios (aOR) of delivery and birth outcomes, and negative binomial regression for adjusted rate ratios (aRR) of HSU. We compared outcomes between pre-pandemic and pandemic periods. Possible interactions between study periods and covariates were also examined. 323,359 deliveries were included (50% during pandemic). One in 5 (18.3%) women who delivered during the pandemic had not received any COVID-19 vaccine, while one in 20 women (5.2%) lab-tested positive for COVID-19. The odds of C-section delivery during the pandemic was 9% higher (aOR = 1.09, 95% CI: 1.08-1.11) than pre-pandemic. The odds of preterm birth and NICU admission were 15% (aOR = 0.85, 95% CI: 0.82-0.87) and 10% lower (aOR = 0.90, 95% CI: 0.88-0.92), respectively, during COVID-19. There was a 17% reduction in ED visits but a 16% increase in physician visits during the pandemic (aRR = 0.83, 95% CI: 0.81-0.84 and aRR = 1.16, 95% CI: 1.16-1.17, respectively). These aORs and aRRs were significantly higher in women with pre-existing chronic conditions. During the pandemic, healthcare utilization, especially ED visits (aRR = 0.83), in pregnant women was lower compared to before. Ensuring ongoing prenatal care during the pandemic may reduce risks of adverse mode of delivery and the need for acute care during pregnancy.

Probabilistic neural network based visual data mining for the healthcare sector.

The need for personalised care in the long-term management of patient health is paramount due to the variability in individual features and responses to specific medication. With the availability of large quantities of electronic patient records, big data analysis presents a valuable opportunity to gain insights into disease presentation and patient impact. This study aims to utilise data science in the medical field to extract unknown information from databases, validate previously obtained data, and enhance personalised patient care. An analytics suite is developed for monitoring patient health and treating cholesterol, thyroid, and diabetes disorders. This suite employs exploratory, predictive, and visual analytics to categorise patient data into multiple tiers and forecast related complication risk and treatment response. The study found that the analytics suite could successfully identify correlations between various biological indicators of patients and disorders. The suite also showcased potential in predicting health risks and responses to treatments. The analytics employed in this study suggest advanced methods of data analysis, which could serve as potential decision-making tools for healthcare providers. These methods might lead to improved treatment outcomes, contributing significantly to personalised patient care.

Descriptive study on substance uses and risk of sexually transmitted infections in the practice of Chemsex in Spain.

In recent years, there has been an increasing use of sex-related substances (known as "Chemsex") to facilitate, intensify, and prolong the sexual experience of men who have sex with men. This phenomenon poses a public health problem, increasing the risk of sexually transmitted infections (STIs) and mental disorders. The primary aim of this study was to delve into the correlation between substance use and sexual health, specifically examining the association between different substances used and the risk of sexually transmitted infections (STIs) in the context of Chemsex in Spain. An observational, descriptive, cross-sectional study was conducted among 563 Spanish participants between January and April 2023. Non-probabilistic purposive sampling was used by the investigators. The researchers administered a questionnaire to men who have sex with men who use substances, especially in the sexual sphere, in all the autonomous communities of Spain. 14.7% reported having practiced slamsex in the last year, and 17.94% were diagnosed with a Sexually Transmitted Infection in the previous 6 months. Of these, 21% were on PREP treatment, with the main STIs being gonorrhea (p < 0.001), chlamydia (p < 0.001), genital herpes (p = 0.020), and syphilis (p < 0.001). The 63.7% used methamphetamines as the main drug in the practice of chemsex. Chemsex in Spain is linked to a high prevalence of STIs, especially gonorrhea and chlamydia, even among those on PrEP treatment. The use of various drugs during chemsex, such as amyl nitrite, GHB, ecstasy, and others, correlates with higher rates of STIs, highlighting the need for interventions to reduce risk and harm. The drugs most associated with slamsex include ketamine, mephedrone, and methamphetamine, underscoring the importance of addressing the risk behaviors associated with this activity. This study shows that chemsex appears to be associated with a high prevalence among men who have sex with men. Who use multiple substances in a sexual context, and are particularly exposed to sexually transmitted infections (STIs), indicating a particular need for STI prevention and care in this group.