Personal Risk Factors Research Articles

Computer vision syndrome and ergonomic risk factors among workers of the Commercial Bank of Ethiopia in Addis Ababa, Ethiopia: an institutional-based cross-sectional study.

Computer vision syndrome (CVS) is the most pressing public health concern that affects vision and reduces quality of life and productivity, particularly in developing countries. Most of the previous studies conducted in Ethiopia focus on the knowledge and personal risk factors of bank workers. Moreover, ergonomic workstation design was not objectively assessed, which could hinder the implementation of effective intervention strategies. Therefore, this study aimed to determine CVS and ergonomic factors among commercial bank workers in Addis Ababa, Ethiopia. An institutional-based cross-sectional study was carried out among 466 study participants from May 26 to July 24, 2022. A multistage sampling technique was applied to select the study participants. Data were collected via a standardized tool of CVS (CVS-Q). Besides, workstation ergonomics were pertinently assessed. The collected data was entered into EpiData version 3.1 and exported to SPSS version 26 for data analysis and cleaning. Multivariable logistics regression analysis was performed to identify factors associated with CVS. The variables with a p-value < 0.05 were considered statistically significant factors. Prevalence of CVS was 75.3% (95% CI: 71.2-79.2%). Blurred vision, eye redness, and headache, 59.8%, 53.7%, and 50.7%, respectively, were frequently reported symptoms. Glare (AOR = 4.45: 95% CI: 2.45-8.08), 20-20-20 principle (AOR = 1.98, 95% CI: 1.06-3.67), wearing non-prescription eyeglasses (AOR = 4.17; 95% CI: 1.92-9.06), and poor workstation (AOR = 7.39; 95% CI: 4.05-13.49) was significantly associated with CVS. The prevalence of CVS was found to be high. Glare at work, ignoring the 20-20-20 principle, wearing non-prescription eyeglasses, and poor workstation ergonomic design were independent predictors of CVS. Therefore, comprehensive interventional activities like adhering to the 20-20-20 principle, avoiding the use of non-prescription glasses, minimizing glare, and improving workstation ergonomic setup are essential to prevent CVS.

Risk factors in persons with diabetes who underwent major and minor lower limb amputations during 2010-2016

Risk factors in persons with diabetes who underwent major and minor lower limb amputations during 2010-2016

Prevalence of dyslipidemia among persons with type 2 diabetes in Africa: a systematic review and meta-analysis

Background: Dyslipidemia is an established cardiovascular risk factor in persons with type 2 diabetes (T2D), yet the extent to which these conditions co-occur in Africa is unknown. This systematic review and meta-analysis aimed to determine the prevalence of dyslipidemia among persons with T2D in Africa. Methods: Medline, Embase, Global Health, Scopus, and Web of Science were searched on December 5, 2023. This review adhered to the PRISMA guidelines and was prospectively registered on PROSPERO. The prevalence data for dyslipidemia was pooled through a random-effects meta-analysis. We assessed heterogeneity and publication bias using I 2 statistics and Egger’s test, respectively. Results: Our search identified 8035 records, of which 60 articles involving 20,034 individuals with T2D were included in this review. The pooled prevalence of dyslipidemia recorded 38.6% (95% CI: 34.1–43.4) for high TC (≥ 5.2 mmol/L), 52.7% (95% CI: 44.2–61.1) for high LDL-C (≥ 2.6 mmol/L), 43.5% (95% CI: 37.1–50.0) for low HDL-C (&lt; 1.0 mmol/L in men and &lt; 1.3 mmol/L in women), and 37.4% (95% CI: 32.2–42.9) for high TG (≥ 1.7 mmol/L). Subgroup analysis based on gender indicated a notably higher prevalence of dyslipidemia among females compared to males. Conclusion: Dyslipidemia is prevalent among persons with T2D in Africa. This highlights the need for early screening, diagnosis, and management of dyslipidemia to mitigate the risk of cardiovascular complications in this population.

Multiple Sclerosis, Rituximab, Hypogammaglobulinemia, and Risk of Infections.

B-cell-depleting therapies increase the risk of infections and hypogammaglobulinemia. These relationships are poorly understood. The objectives of these analyses were to estimate how much of this rituximab-associated infection risk is mediated by hypogammaglobulinemia and to identify other modifiable risk factors in persons with multiple sclerosis (pwMS). We conducted a retrospective cohort study of rituximab-treated pwMS from January 1, 2008, to December 31, 2020, in Kaiser Permanente Southern California. Cumulative rituximab dose was defined as ≤2, >2 and ≤4, or >4 g. Serious infections were defined as infections requiring or prolonging hospitalizations, and recurrent outpatient infections as seeking care for ≥3 within 12 months. Exposures, outcomes, and covariates were collected from the electronic health record. Adjusted hazard ratios (aHRs) were estimated using Andersen-Gill hazards models, and generalized estimating equations were used to examine correlates of IgG values. Cross-sectional causal mediation analyses of rituximab and hypogammaglobulinemia were conducted. We identified 2,482 pwMS who were treated with rituximab for a median of 2.4 years (interquartile range = 1.3-3.9). The average age at rituximab initiation was 43.0 years, 71.9% were female, 49.7% were White, non-Hispanic patients, and 29.6% had advanced disability (requiring walker or worse). Seven hundred patients (28.2%) developed recurrent outpatient infections, 155 (6.2%) developed serious infections, and only 248 (10.0%) had immunoglobulin G (IgG) < 700 mg/dL. Higher cumulative rituximab dose (>4 g) was correlated with lower IgG levels (Beta = -58.8, p < 0.0001, ref ≤2 g) and, in models mutually adjusted for hypogammaglobulinemia, both were independently associated with an increased risk of serious (>4 g, aHR = 1.56, 95% CI 1.09-2.24; IgG < 500, aHR = 2.98, 95% CI 1.56-5.72) and outpatient infections (>4 g, aHR = 1.73, 95% CI 1.44-2.06; IgG < 500 aHR = 2.06, 95% CI 1.52-2.80; ref = IgG ≥ 700). Hypogammaglobulinemia explained at most 17.9% (95% CI -47.2-119%) of serious infection risk associated with higher cumulative rituximab exposure but was not significant for outpatient infections. Other independent modifiable risk factors were advanced physical disability for serious (aHR = 5.51, 95% CI 3.71-8.18) and outpatient infections (aHR = 1.24, 95% CI 1.06-1.44) and COPD (aHR = 1.68, 95% CI 1.34-2.11) and obesity (aHR = 1.25, 95% CI 1.09-1.45) for outpatient infections. Higher cumulative rituximab doses increase the risk of infections even in this population where 90% of patients maintained normal IgG levels. Clinicians should strive to use minimally effective doses of rituximab and other B-cell-depleting therapies and consider important comorbidities to minimize risks of infections.

Influence of Personal Factors on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by restriction of airflow in airways. Smoking is a major risk factor for disease. Other factors are air pollution from fuels, industrial dust, chemical agents and genetic causes. Main symptoms are shortness of breath, chronic cough with or without sputum and rapid fatigue. Chronic obstructive pulmonary disease /COPD/ is a source of stress and anxiety, due to severity of disease, need for long-term treatment and detachment from social life. Study cohort consisted of 124 patients with a diagnosis of COPD and a control group of 162 without lung disease. Persons studied are over 18 years of age, of different sexes, of Bulgarian ethnic origin and different family and social status. Chronic obstructive pulmonary disease is a disease of increasing social importance and, according to forecast of WHO, by 2030 it is expected to become third leading cause of death in world. Aim of pilot study was to determine influence of some personal risk factors (anxiety and type D personality in dimensions: "negative affectivity" and "social inhibition") on quality of life and social adaptation of patients with COPD.

Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany-Results from the Hamburg City Health Study.

Non-communicable diseases (NCDs) are responsible for many deaths. They are associated with several modifiable and metabolic risk factors and are therefore prone to significant regional variations on different scales. However, only few intra-urban studies examined spatial variation in NCDs and its association with social circumstances, especially in Germany. Thus, the present study aimed to identify associations of personal risk factors and local social conditions with NCDs in a large German city. This study is based on a population-based cohort of the Hamburg City Health Study including 10,000 probands. Six NCDs were analyzed (chronic obstructive pulmonary disease [COPD], coronary heart disease [CHD], diabetes mellitus, heart failure, depression, and hypertension) in 68 city district clusters. As risk factors, we considered socio-demographic variables (age, sex, education) and risk behaviour variables (smoking, alcohol consumption). Logistic regression analyses identified associations between the district clusters and the prevalence rates for each NCD. Regional variation was detected by Gini coefficients and spatial cluster analyses. Local social condition indexes were correlated with prevalence rates of NCDs on city district level and hot-spot analyses were performed for significant high or low values. The analyses included 7,308 participants with a mean age of 63.1 years (51.5% female). The prevalence of hypertension (67.6%) was the highest. Risk factor associations were identified between smoking, alcohol consumption and education and the prevalence of NCDs (hypertension, diabetes, and COPD). Significant regional variations were detected and persisted after adjusting for personal risk factors. Correlations for prevalence rates with the local social conditions were significant for hypertension (r = 0.294, p < 0.02), diabetes (r = 0.259, p = 0.03), and COPD (r = 0.360, p < 0.01). The study shows that regional differences in NCD prevalence persist even after adjusting for personal risk factors. This highlights the central role of both personal socio-economic status and behaviors such as alcohol and tobacco consumption. It also highlights the importance of other potential regional factors (e.g. the environment) in shaping NCD prevalence. This knowledge helps policy- and decision-makers to develop intervention strategies.

Structural Game Characteristics and Problematic Gaming

Abstract: Introduction: The current state of research suggests that personal, environmental, and product-related risk factors contribute to the development and maintenance of gaming disorder. Concerning game related risk factors, evidence points to certain game features contributing to the overall risk of gaming disorder, as for example reward features, social features, and monetization features. However, no standardized instrument is available to capture risk enhancing game characteristics. Methods: Based on theoretical considerations and stepwise conducted qualitative analyses of in-game content, risk-enhancing game features were identified and specified. Furthermore, a pilot study was conducted comprising N = 4,468 students ( M[Age] = 14.54 years, SD = 1.37 years). Game features of the preferred games of the students were analyzed regarding their predictive value of gaming disorder. Results: Data suggests that two features are associated most strongly with gaming disorder: 1) mandatory social interactions ( β = .20), and 2) number of reward categories ( β = .12). Based on these findings and further updates, the RCCG was refined and finalized. Conclusions: With the RCCG, a structured instrument to capture, describe, and evaluate risk enhancing structural characteristics of video games is available. The RCCG enables a general risk assessment of games as well as recommended age-classifications based on certain structural features unsuitable for specific age groups.

Communicating the results of risk-based breast cancer screening through visualizations of risk: a participatory design approach

BackgroundRisk-based breast cancer (BC) screening raises new questions regarding information provision and risk communication. This study aimed to: 1) investigate women’s beliefs and knowledge (i.e., mental models) regarding BC risk and (risk-based) BC screening in view of implications for information development; 2) develop novel informational materials to communicate the screening result in risk-based BC screening, including risk visualizations of both quantitative and qualitative information, from a Human-Centered Design perspective.MethodsPhase 1: Interviews were conducted (n = 15, 40–50 years, 5 lower health literate) on women’s beliefs about BC risk and (risk-based) BC screening. Phase 2: In three participatory design sessions, women (n = 4–6 across sessions, 40–50 years, 2–3 lower health literate) made assignments and created and evaluated visualizations of risk information central to the screening result. Prototypes were evaluated in two additional sessions (n = 2, 54–62 years, 0–1 lower health literate). Phase 3: Experts (n = 5) and women (n = 9, 40–74 years) evaluated the resulting materials. Two other experts were consulted throughout the development process to ensure that the content of the information materials was accurate. Interviews were transcribed literally and analysed using qualitative thematic analysis, focusing on implications for information development. Notes, assignments and materials from the participatory design sessions were summarized and main themes were identified.ResultsWomen in both interviews and design sessions were positive about risk-based BC screening, especially because personal risk factors would be taken into account. However, they emphasized that the rationale of risk-based screening and classification into a risk category should be clearly stated and visualized, especially for higher- and lower-risk categories (which may cause anxiety or feelings of unfairness due to a lower screening frequency). Women wanted to know their personal risk, preferably visualized in an icon array, and wanted advice on risk reduction and breast self-examination. However, most risk factors were considered modifiable by women, and the risk factor breast density was not known, implying that information should emphasize that BC risk depends on multiple factors, including breast density.ConclusionsThe information materials, including risk visualizations of both quantitative and qualitative information, developed from a Human-Centered Design perspective and a mental model approach, were positively evaluated by the target group.

A Prospective Study on the Progression, Recurrence, and Regression of Cervical Lesions: Assessing Various Screening Approaches.

(1) Background: The prediction of cervical lesion evolution is a challenge for clinicians. This prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors in the prediction of progression, regression, or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions who underwent follow-up in a private clinic. We calculated the predictive performance of individual tests (cervical cytology, HPV genotyping, CINtecPlus results, and clinical risk factors) or their combination in the prediction of cervical lesion progression, regression, and persistence; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model comprising a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least three clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesion regression or persistence was modest when using individual or combined tests; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction.

Defining inappropriate thyroid biopsy?-Proposed definition based on clinical evidence and stakeholder engagement.

Identify factors that can be used to assess the appropriateness of a thyroid biopsy and propose a pathway to define inappropriate thyroid biopsies in practice. We identified factors utilized in clinical guidelines and existing literature to determine the clinical indications for a thyroid biopsy. Subsequently, we assembled a multidisciplinary panel of experts, including patients, clinicians, researchers, and quality experts, to integrate these factors and develop a pathway for assessing the appropriateness of thyroid biopsies. Through literature review and stakeholder engagement, we identified multiple factors to determine if a thyroid biopsy is necessary: ultrasound risk assessment, presence of compressive symptoms and/or clinical suspicion of high-risk thyroid cancer, life expectancy, comorbidity burden, surgical risk, personal risk factors for thyroid cancer, thyroid function levels, local resources and medical expertise and patient values and preferences. We proposed a multiple-tier classification for the appropriateness of thyroid biopsy that begins with ultrasound findings (e.g., size, thyroid cancer risk) and encompasses the evaluation of additional patient-specific factors. Assessment of the appropriateness of a thyroid biopsy is possible. Although, thyroid nodule ultrasound risk assessment is a pivotal factor for this assessment, additional factors should be considered (e.g., life expectancy, personal risk factors for thyroid cancer, patient preferences). Yet, additional efforts are needed to operationalize the objective implementation of these factors in clinical practice.

Examining the impact of a health report card on follow through with fall risk recommendations: an observational study

BackgroundIncreasing older adults’ awareness of their personal fall risk factors may increase their engagement in fall prevention. The purpose of this study was to explore the impact of and participant satisfaction with a comprehensive occupational therapy fall risk screening and recommendations for evidence-based fall prevention strategies based on personalized fall risk results for community-dwelling older adults.MethodsCognitively normal participants (Clinical Dementia Rating = 0) were recruited from an ongoing longitudinal study of memory and aging. Participants completed 2 annual in-home visits, fall risk questionnaires, and 12 months of fall monitoring between visits. Participants received a health report card with their fall risks and tailored recommendations in 6 domains. Participants completed follow-up questions at their next annual in-home visit about the fall risk recommendations and their satisfaction with receiving their fall risk results.ResultsTwo hundred five participants completed 2 annual visits and 12 months of fall monitoring. Of the 6 domains of recommendations provided, participants were most likely to follow through with getting an annual eye exam and reviewing their medications with their doctor or pharmacist. Older adults who fell were significantly more likely to receive recommendations for finding fall prevention classes (p = 0.01) and having a doctor or pharmacist review their medications (p = 0.004). The majority of participants were satisfied receiving their fall risk results (92%) and believed it to be beneficial (90%), though few participants shared their results with their doctor (20%).ConclusionsAn occupational therapy fall risk screening and tailored recommendations were not sufficient to encourage follow through with fall risk recommendations. Older adults may benefit from additional support and encouragement to reduce their fall risk. Additional research is needed to examine awareness of fall risks and follow through with fall risk recommendations among community-dwelling older adults.

Topic modeling and social network analysis approach to explore diabetes discourse on Twitter in India.

The utilization of social media presents a promising avenue for the prevention and management of diabetes. To effectively cater to the diabetes-related knowledge, support, and intervention needs of the community, it is imperative to attain a deeper understanding of the extent and content of discussions pertaining to this health issue. This study aims to assess and compare various topic modeling techniques to determine the most effective model for identifying the core themes in diabetes-related tweets, the sources responsible for disseminating this information, the reach of these themes, and the influential individuals within the Twitter community in India. Twitter messages from India, dated between 7 November 2022 and 28 February 2023, were collected using the Twitter API. The unsupervised machine learning topic models, namely, Latent Dirichlet Allocation (LDA), non-negative matrix factorization (NMF), BERTopic, and Top2Vec, were compared, and the best-performing model was used to identify common diabetes-related topics. Influential users were identified through social network analysis. The NMF model outperformed the LDA model, whereas BERTopic performed better than Top2Vec. Diabetes-related conversations revolved around eight topics, namely, promotion, management, drug and personal story, consequences, risk factors and research, raising awareness and providing support, diet, and opinion and lifestyle changes. The influential nodes identified were mainly health professionals and healthcare organizations. The study identified important topics of discussion along with health professionals and healthcare organizations involved in sharing diabetes-related information with the public. Collaborations among influential healthcare organizations, health professionals, and the government can foster awareness and prevent noncommunicable diseases.

Problematic overstudying, Big Five personality, and music performance anxiety: associations with well-being and GPA.

Problematic overstudying is a compulsive and pathological overinvolvement in studying leading to harm and considerable functional impairments. It is conceptualized as "study addiction," a precursor to work addiction. It has been investigated within the addictive behaviours framework in general populations of students for over a decade. A previous study analysed the problem among young musicians as a particularly vulnerable group. It found some important differences in potential personality risk factors among music academy students compared to general populations of students and showed an important role of social anxiety. The current study aimed to validate these findings in a separate larger sample and extend them by investigating the role of music performance anxiety (MPA). The study was conducted among 213 students of music academies. Valid and reliable measures of study addiction, MPA, Big Five personality and well-being were used. The results showed that MPA played a similar role as social anxiety in terms of being a predictor, mediator, and moderator of the main replicated effects supporting the hypothesised mechanisms regulating study addiction. However, extraversion was not associated with study addiction in multiple hierarchical regression analysis, but conscientiousness and neuroticism were. Study addiction was associated with indicators of decreased well-being, above and beyond MPA, and personality. These results show that MPA plays an analogous role to social anxiety and that the role of Big Five personality in study addiction among young musicians requires further investigation due to inconsistent findings.

Personality Risk Factors for Vape Use amongst Young Adults and Its Consequences for Sleep and Mental Health.

(1) Background: The surge in vape (e-cigarette) use among young adults is concerning, as there is limited knowledge about risk factors and health consequences. This study explores the personality traits linked to vape use, and associations between vaping and chronotype, sleep quality, and mental health, among young adults. (2) Methods: 316 participants, aged 18-25, completed measurements of mindfulness, rumination, self-compassion, anxiety/depression, chronotype, and sleep quality. (3) Results: the vape user group scored significantly lower on mindfulness, higher on rumination, and lower on self-compassion. Vape users were more likely to be evening types and had significantly lower sleep quality and higher anxiety symptoms, as well as higher alcohol use and loneliness (at trend) (4) Conclusions: These novel findings enhance our understanding of what might predispose young adults to vaping and the potential impact on their mental health and sleep quality. Findings point to specific cognitive/personality traits as vaping risk factors, which could inform intervention strategies.

Prevalence and Risk Factors for Musculoskeletal Pain when Running During Pregnancy: A Survey of 3102 Women

BackgroundMusculoskeletal pain while running is a concern to women during pregnancy and can lead to running cessation. To support women who wish to run during pregnancy, it is essential to understand the sites, severities and personal risk factors associated with musculoskeletal pain.ObjectiveThe aim was to investigate prevalence and risk factors for musculoskeletal pain when running during pregnancy.MethodsAn online survey was completed by women who had a child in the past 5 years and ran prior to and during pregnancy. Pain frequency informed prevalence rates by body site, and logistic regression odds ratios (ORs) and 95% confidence intervals were calculated.ResultsA total of 3102 women of 23 ethnicities from 25 countries completed the survey. Women were 22–52 years old when they gave birth and ran 2–129 km/week during the 0.5–35 years before the birth of their youngest child. Women ran significantly less distance and less often during pregnancy than before pregnancy. Most women (86%) experienced pain while running during pregnancy (59% pelvis/sacroiliac joint, 52% lower back, 51% abdomen, 44% breast, 40% hip). The highest prevalence of severe-to-worst pain was at the pelvis/sacroiliac joint (9%). Women at greatest risk of pain while running during pregnancy had a previous injury (OR = 3.44) or were older (OR = 1.04). Women with a previous child were less likely to experience breast pain (OR = 0.76) than those running during their first pregnancy.ConclusionHealthcare practices to reduce pain should focus on regions of greatest musculoskeletal change during pregnancy, specifically the pelvis, lower back and abdomen. Efforts to support women to run for longer throughout pregnancy should focus on pain at the pelvis and breasts.

Anxiety-Related Factors Associated With Symptom Severity in Irritable Bowel Syndrome in Jazan, Saudi Arabia.

This study in Jazan, Saudi Arabia aims to identify anxiety-related factors associated with symptom severity in irritable bowel syndrome (IBS). IBS is a common gastrointestinal disorder causing abdominal pain and altered bowel habits. The prevalence of IBS in Saudi Arabia is estimated to be 10%-20% among the general population. Therefore, the present study aimed todetermine anxiety-related factors associated with symptom severity in irritable bowel syndrome in Jazan, Saudi Arabia. Understanding these factors will provide insights into the overall impact of IBS on patients' quality of life. The study utilized a cross-sectional, descriptive observational design to examine the general population in Jazan, Saudi Arabia. The sample size of 385 individuals was calculated based on the population size and desired error margin. A convenience sampling technique was employed to select participants who met the inclusion criteria. A validated anonymous self-administered electronic survey was distributed through social media channels. The survey consisted of four sections gathering demographic information, personal risk factors, IBS types with anxiety and risk factors, and a questionnaire to determine the level of anxiety. A pilot study was conducted to improve the survey's clarity. Ethical considerations were followed, and data were analyzed using Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY, USA). Descriptive statistics and significance tests were performed. A study with 637 participants found a 31.08% prevalence of IBS, which was more common in females. Participants with IBS had a higher rate of chronic disease. There were no significant differences in demographic factors between IBS and non-IBS participants. The duration of IBS diagnosis varied, with the majority of IBS with diarrhea (IBS-D) sufferers being diagnosed five years prior. Symptom severity differed among IBS types, with those with an unspecified type reporting the highest percentage of severe symptoms. IBS types were also correlated with anxiety levels, with IBS-D sufferers reporting moderate anxiety and those with an unspecified type reporting severe anxiety. A study with 637 participants found the prevalence of IBS to be 31.08%, with higher rates in females. IBS was associated with chronic diseases and higher anxiety levels. The findings emphasize the need for comprehensive management of IBS, including psychological interventions and dietary modifications, to improve patients' overall health and quality of life. Further research on genetic and modifiable risk factors is needed.

Abstract 33: An Innovative Digital Health Approach to Enhance Patient Engagement in Stroke Care

Introduction: Patient engagement (PE) is a crucial aspect of health management shown to improve adherence and outcomes. For patients with ischemic stroke (IS) and transient ischemic attack (TIA) PE holds significant value. Novel ways to engage IS/TIA patients and deliver personalized education may enhance knowledge, satisfaction, and adherence while potentially reducing recurrent stroke. Purpose: Develop and implement a stroke-specific 90-day digital health PE platform for IS/TIA patients discharged (DC) home from a Comprehensive Stroke Center (CSC). Utilizing the Twistle TM digital platform the initiative focuses on patient education and adherence. Methods: An expert panel (digital health operations, vascular neurologist, stroke-certified nurse practitioner) designed a 90-day program with 21 modules emphasizing education, adherence, communication, and 90-day mRS self-assessment. A pre-implementation survey assessed confidence to prevent stroke and knowledge of personalized risk factors, lifestyle modification, and medication in 14 IS/TIA patients (Mdn 21 days from DC), with 11 responses (73.3%). After pilot testing with 2 patients and feedback incorporation, 10 more patients were enrolled. A patient engagement and satisfaction survey was administered on day 20. Results: Assessment determined the program was feasible and compared pre-implementation and 20-day survey responses from participants (response rate 6/9). Post-implementation outcomes showed improved patient knowledge and confidence. Patients agreeing/strongly agreeing to having lifestyle modification knowledge increased from 64.6% (n=11) to 83.4% (n=6). Confidence in preventing another stroke/TIA rose from 27.3% (n=11) to 66.7% (n=6). Participants reported heightened engagement through digital messages (83.3%, 5/6), while one respondent (16.7%) remained neutral. Conclusions: Initial findings underscore the potential of digital health, delivered through platforms like Twistle TM , to enhance patient engagement and confidence post-IS/TIA. The program's successful launch suggests promise for expansion at the CSC and potentially across additional health system hospitals. The initiative holds potential for enhancing patient outcomes and well-being.

Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness.

Objective: High-risk professionals and specialised nurses in hospitals are frequently exposed to potentially traumatic events. Psychotrauma researchers have extensively studied personal risk factors of traumatisation among high-risk professionals, but it is hard to understand psychological functioning when professionals are decontextualised from their social environment. Generally, it has been well documented that to reduce the risk of posttraumatic stress disorder (PTSD) or other mental health problems related to traumatisation, it is essential to be embedded in a supportive social environment. However, study results among and within these occupational groups show great variety and even inconsistencies as to what is a supportive social environment.Method: This ethnographical research, including participant observation, in-depth interviews, and document analysis, explored the social environment of firefighters, police officers, ambulance paramedics, specialised nurses, and military personnel and aims to explore their social connections and embeddedness. We performed a thematic content analysis of data to identify themes related to social or emotional support, social relationships, and stress or traumatisation.Results: An analysis of the observational field notes, which covered 332 h of participant observation and 71 evenly distributed formal in-depth interviews, identified four themes related to social connections and embeddedness: Family, Hierarchical relations versus autonomy, Group versus individual, and Conditional family 'love'. Results revealed that the military, police, and professional firefighters have family-like hierarchical connections and highly value group unity. Paramedics and most specialised nurses, however, tend to value individuality and autonomy in their work relationships.Conclusion: This research shows noticeable differences in the social environments and social connections of these professionals, which implicates that prevention and mental health treatment might also have to be differentiated among occupational groups.

Just as Violent: Cyberbullying and In-Person Violence Compared Among Arab Youth in Israel

AbstractThis study examined similarities and differences between adolescent involvement in cyberbullying and in-person violence from a socio-ecological perspective. It explored the associations between individual (gender, age, religiosity, and impulsivity), family (parental support, monitoring, and conflict), and contextual factors (commitment to school, affiliation with delinquent peers and exposure to community violence), on the one hand, and four types of violence: cyberbullying and three subtypes of in-person violence—severe and moderate physical violence and indirect violence—on the other. The sample included 3178 Arab students in grades 7–11 in Israel, who completed a structured survey. “In-person bullying” or face-to face violence was found to be significantly and positively associated with involvement in cyberbullying, and both bullying behaviors were found to share common predictors. Of the four types of violence, involvement in severe physical violence and cyberbullying and was the lower (28.4% and 14.1% and of students, respectively), with significantly higher rates for indirect and moderate violence (65.7% and 47.3%, respectively). The general trend found in the study was one of similarities between cyberbullying and in-person violence, especially of the severe physical type. We conclude that protecting youth against involvement in violent acts can be most effectively achieved by buffering the impact of situational and personal risk factors.

Risk factors, Clinical presentation and In-hospital Outcome of Acute Myocardial Infarction in Elderly Patients

Background: Coronary artery disease (CAD) is the leading cause of mortality, morbidity in the developed and developing country. Ageing is important risk factor for coronary artery disease. The role of conventional cardiovascular risk factors in older persons is incompletely understood because only fragmentary and inadequate data are available in most instance and manifestations of acute myocardial infarction are generally believed to be atypical in the elderly. The aim of the study was to find out the clinical presentation, common risk factors and In-hospital Outcome of Acute Myocardial Infarction in Elderly Patients. Methods: An observational study in tertiary level hospital. Study protocol was approved by ethical review committee of Sir Salimullah Medical College &amp; Mitford Hospital, Dhaka. Sample was selected from the population by purposive sampling technique. Detail demographic data were collected from the subject and recorded in structured case report form. Researcher makes contact with patient and patients caregiver, and describe them about study aim-objective, and then informed consent was taken. All collected questionnaire checked very carefully to identify the error in the data. Data processing work were consisting of registration of schedules, editing, coding and computerization, preparation of dummy tables, analysis and matching data. Result: In this series, the maximum number of patients (57.0%) was between 60-69 years age group, with mean value 67.21 ± 9.05 years. Out of 100 cases (62%) cases were male and (38%) were female (Figure 1). Male – female ratio was 1.63:1. Large numbers of respondents came from urban area (58%). Among the patients the poor class (44%) comprising the major percentage of the myocardial infarction patients. In this study majority (58%) of the patients had sedentary lifestyle before the onset of myocardial infarction. Among all the risk factors hypertension was the most common risk factor, present in 62% cases; next common risk factors were Diabetes mellitus 56%, dyslipidemia 32%, obesity 22%, smoking 40%. In this study majority of patients (56%) presented with shortness of breath as predominant symptoms. Besides typical chest pain others important atypical symptoms were atypical chest pain (31%), upper abdominal pain (18%), giddiness (4%) and confusional state (3%). In this study many of the patients had developed acute LVF (34%), arrhythmia (17%), cardiogenic shock (8%). Conclusion: We concluded that the manifestations of AMI are more subtle in the elderly, with different risk factors. The elderly subjects are under thrombolysed and have higher complication rate. Bangladesh J Medicine 2024; 35(1): 9-14