Preventive Care Research Articles

Intimate Partner Violence during the Index Pregnancy and its correlates among a panel of pregnant women in Ethiopia, evidence from performance, and monitoring for action (PMA) 2021 cohort two baseline survey.

Current intimate partner violence (IPV) in Ethiopia is considerably high. This study aimed at determining the prevalence of IPV among a panel of pregnant women during their index pregnancy and identify its correlates using Performance Monitoring for action (PMA) cohort 2 baseline data. Documenting the magnitude of IPV thus far during the index pregnancy and identifying factors affecting it contributes its share for the ministry and relevant developmental partners in tracking progress towards eliminating all forms of violence against women and girls by 2030. We conducted a further analysis of national level follow up secondary data sets from Performance Monitoring for action Ethiopian (E_PMA). This study used PMA cohort two baseline data which enrolled pregnant and recently postpartum women and collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 1,796 pregnant women at the enrollment. Frequency was computed to describe the study participant's characteristics, and chi-square statistics was used to assess cell sample size adequacy. Multilevel binary logistics regression model building process was employed to identify correlates of IPV. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05. One in six; 16.7% (14.81%, 18.76%) pregnant women have reported experiencing at least one form of physical and/or sexual IPV thus far in their index pregnancy. The prevalence of encountering at least one form of sexual violence was 12.53% (10.91%, 14.35%) while 7% (5.5%, 8.3%) of them experienced at least one form physical intimate partner violence thus far during their index pregnancy. Women perceived risk about contraceptive use ((AOR: 95% CI: 1.66 (1.10, 2.47)), higher birth order ((AOR: 95% CI: 1.88 (1.05, 3.34)), unhappy emotional fertility intention when learned their index pregnancy ((AOR: 95% CI: 1.7 (1.02, 2.84)) and a family size of 4to 5 ((AOR: 95% CI: 1.87 (1.11. 3.14)) were the fixed effects factors found to increase the odds of IPV significantly and positively. On the contrary, being in the third trimester of gestation at enrollment was another fixed effect variable which contributed for the 44% lower odds ((AOR: 95% CI: 0.56 (0.34, 0.92)) of experiencing IPV thus far in their index pregnancy. The overall burden of IPV reported was high; with nearly double the percentage of women experiencing sexual violence during the index pregnancy compared to physical IPV. More work needs to be done to achieve zero tolerance against any form of violence among women and girls in general and among pregnant women in particular. Efforts targeted in improving women perception on issue related with their contraceptive use, counseling women on how to prevent IPV during their antenatal care (ANC) visit along with advising the use of inter pregnancy contraception and empowering them to control on their fertility are hoped to mitigate such considerably higher odds of IPV among pregnant women. Further programs and intervention on awareness creation towards the misconception that women held about contraceptive use would contribute much. These activities and efforts need to target younger women. The implication of the findings calls key actors and the Federal Democratic Republic of Ethiopia Health Minster to design and implement programs on women emotional fertility readiness and empowering them to control over their fertility through diversified contraceptive provision which is critical in combating the reported substantial IPV experience during pregnancy. Creating institutional capacity in the health system through strengthening and expanding one stop centers to provide medical treatment, care, and psychosocial support for victims and survivors could play a pivotal role. In addition, installing rapid referral system and linkage to the legal system could play a vital role. Moreover, working on early marriage and counseling on childbirth; and spaced pregnancy for those young couples is imperative. Further implication of this study was installing contraceptive and violence related preconception care packages in the health system is very critical in the combat against IPV and any form of gender based violence.

Implementing the WHO ICOPE program in clinical practice: three years of lessons from monitoring 27,082 participants using the ICOPE Monitor digital tool.

To describe the implementation of the ICOPE program in France using digital tool in order to: 1) describe the characteristics of people completing the screener, identifying differences across assessors (Health Care Professionals (HCP), non-HCPs or self-assessment) 2) describe the characteristics of follow-up and assessments for people with abnormal screening test 3) describe the recommendations in the intervention care plans for people with a decline in intrinsic capacity (IC). A descriptive study, presenting the results at initial screening, as well as at assessment when needed; and the recommendations issued during Step 3. We compared these results based on whether the participant was enrolled by an HCP, by a non-HCP, or self-assessment. 27,082 participants were enrolled. 67.9% were registered by HCPs. 90.8% participants screened positive at Step 1. Participants who completed the self-assessment were significantly younger (70.9 years versus 76.4 for HCPs or 77.9 for non-HCPs, p<0.01) and less frequently had alerts in Step 1 (83.8% versus 90.8 for HCPs or 94.8 for non-HCPs). Step 2 in-depth assessments were carried out for 8.9% of the participants. In step 2, only the SPPB showed significantly better motor abilities in individuals enrolled through self-assessment (median and IQR: 11(10 - 12) versus 10(8 - 12) for HCPs and 10(7 - 12) for non-HCPs). Prevention care plans were proposed, mainly physical activity (n=833 - 33.7%) and nutrition counseling (n=1,233 - 51.7%). This study highlights the major role of HCPs in the implementation of the ICOPE program. Self-assessment enables the enrollment of more robust seniors, allowing to an early detection and treatment.

Patient-centered medical homes and vision care for children: a cross-sectional analysis with data from the national survey of children's health 2018-2019.

Vision screening as part of well-child visits is recommended annually for US children 3 to 6 years. However, 63% of children do not get a vision screening in well-child visits. The Patient-Centered Medical Home (PCMH) improves the receipt of preventive care visits in other medical specialties but it is unknown if it improves receipt of vision screening. The objective of this study is to determine whether caregiver-reported receipt of care in a PCMH is associated with receiving a vision screening test in a well-child visit for children 3 to 6 years in a pediatrician/general doctor's office ('primary care'). Population-based data for US children aged 3 to 6 years was derived from the National Survey of Children's Health (2018-2019). Children were excluded if they did not have a well-child visit in the previous 12 months. The primary exposure was receipt of care in a PCMH ('PCMH care'), and the primary outcome was receipt of a vision screening in primary care. Adjusted odds ratios (aOR) and predicted probabilities were computed for children with and without PCMH care. Among 9,587 children with well-child visits, 4,984 (50.9%) were males. There were 1,107 (23.3%) Hispanic, 6704 (52.8%) White/Non-Hispanic and 545 (11.8%) Black/Non-Hispanic children. There were 5,482 (51.8%) children who received PCMH care. Of those with PCMH care, 2,629 (52.2%) received a vision screening in primary care. Those with PCMH care (52.2%) had a higher odds of receiving a vision screening (aOR, 1.31; 95% CI 1.11, 1.55) in primary care compared to children without PCMH care (42.8%). The predicted probability of vision screening in primary care was 50.8% (95% CI 48.2, 53.5) for children that received PCMH care, and 44.3% (95% CI 41.3, 47.3) without PCMH care. Caregiver-reported receipt of PCMH care was associated with a greater likelihood of vision screening for children 3 to 6 years in a well-child visit. Further studies are needed to understand the mechanisms through which PCMH care contributes to the greater odds of vision screening in primary care to inform the creation of strategic interventions to prevent vision loss and its long-term implications.

A One Health Approach to Reducing Livestock Disease Prevalence in Developing Countries: Advances, Challenges, and Prospects.

Challenges in livestock production in developing countries are often linked to a high disease prevalence and may be related to poor husbandry, feeding, and nutrition practices, as well as to inadequate access to preventive veterinary care. Structural barriers including chronic poverty, gender roles, inadequate supply chains, and limitations in surveillance infrastructure further complicate progress. Despite many challenges, the livestock sector substantially contributes to agricultural GDP, and reducing livestock disease prevalence is a goal for many countries. One Health initiatives that work across disciplines and sectors to reduce livestock diseases are underway around the world and use integrated approaches that consider the connections between humans, animals, and their shared environments. The growing recognition of the role livestock play in sustainability and livelihoods, as well as their involvement in zoonotic disease transmission and global health security, has highlighted the need for disease reduction strategies as described in this review.

Metabolic syndrome and spatial disparities: The role of socioeconomic deprivation and medical resource availability in the Cijin district, Taiwan.

Metabolic syndrome (MetS) is a global health concern with spatial disparities, especially in disadvantaged neighborhoods. This study aimed to examine the association between area-level socioeconomic deprivation, the availability of medical resources in disadvantaged areas such as the Cijin district, and the prevalence of MetS in Taiwan. We used two representative secondary cross-sectional datasets, including physical examinations and lifestyle surveys from 2016 to 2020, sourced from the Taiwan Biobank and the Cijin District Adult Lifestyle and Health Survey. Our findings indicate that residing in the Cijin district, characterized by socioeconomic deprivation and limited medical resources, is associated with significantly higher odds of MetS (aOR = 1.45, 95% CI = 1.28-1.64, p <0.001). Additionally, living in areas with medium (aOR = 1.12, 95% CI = 1.07-1.17, p <0.001) and high area-level socioeconomic deprivation indexes (aOR = 1.13, 95% CI = 1.01-1.25, p <0.001) is linked to a higher likelihood of MetS. Conversely, residing in high medical resource availability index areas is associated with a lower risk of MetS (aOR = 0.92, 95% CI = 0.86-0.99, p = 0.026). We found a link between socioeconomic deprivation and limited medical resources, especially in disadvantaged areas such as the Cijin district, contributing to a higher MetS risk. Residents in these areas often struggle to access healthcare and preventive care. Addressing these disparities requires comprehensive public health initiatives and targeted policy interventions to improve residents' well-being.

Causes of Mortality From Acute Carbon Monoxide Exposure: A Step Towards Preventative Long-Term Care?*

Causes of Mortality From Acute Carbon Monoxide Exposure: A Step Towards Preventative Long-Term Care?*

Addressing tobacco screening and treatment among racially and ethnically minoritized parents in pediatric clinics: barriers and facilitators.

Household secondhand smoke (SHS) exposure remains a significant health issue for racially and ethnically minoritized children in the United States. Delivering parental tobacco treatment during pediatric primary care visits can reduce children's SHS exposure. This study examined current tobacco screening practices and health system stakeholder perceptions of facilitators and barriers to addressing tobacco use during pediatric visits among racially and ethnically minoritized parents. We conducted 25 semi-structured interviews with clinicians, staff, and health system leaders from 5 pediatric primary care clinics in Minneapolis-St. Paul, Minnesota. The study was informed by the Health Equity Implementation Framework. Interviews were analyzed using both directed content and thematic analysis. Participants identified multilevel facilitators and barriers to addressing parental tobacco use in minoritized families. Within the clinical encounter, barriers included linguistic and cultural barriers, health system navigational challenges, medical mistrust, low levels of clinician and staff knowledge, skills, and confidence, time constraints, and lack of alignment with external metrics. Facilitators centered on leveraging interpreters' cultural knowledge and the presence of culturally-congruent clinicians and staff to reduce medical mistrust and stigma, developing linguistically and culturally relevant resources, and integrating prompts and resources into the electronic health record. Participants described how lessons from previous system change mechanisms would facilitate this work. Addressing health system, training and resources, and linguistic and cultural barriers among clinicians and staff is essential to strengthen their capacity to address household SHS exposure among racially and ethnically minoritized populations as a component of pediatric preventive care. Clinicians and health system staff perceive unique barriers to identifying and addressing parental tobacco use among racially and ethnically minoritized parents during pediatric primary care visits. Solutions to expand tobacco treatment access to minoritized parents in pediatric settings must attend to clinician training needs on tobacco treatment, embedding clinical encounter resources and reminders that match the linguistic and cultural needs and preferences of their patient populations, and increasing access to high quality interpreting services and culturally-congruent staff.

Dog owners and preventative healthcare: knowledge level, interest, and impact on perceptions of veterinarians' trustworthiness and empathy.

Gain a better understanding of dog owners' knowledge and interest level for 13 preventative healthcare (PHC) topics. Examine the potential predictive value of owners' satisfaction with how their veterinarian communicates about PHC topics and perceived veterinarian-related trust and empathy and frequency of PHC veterinary visits. An electronic survey was created in Qualtrics and distributed to dog owners within the US via a link offered in Prolific, an open online marketplace whereby respondents receive small monetary compensation for completing surveys. A total of 738 participants completed the survey, all of whom were dog owners living in the US. Owners reported knowing the most about the importance of mental engagement, how to assess their dog's everyday quality of life, vaccines, and parasites. Owners were most interested in learning more about how to assess their dog's everyday quality of life, importance of mental enrichment, diseases related to their dog's breed, and senior care. Veterinarians were the primary source of information for 13 of 14 topics. Owners' satisfaction with how PHC information is discussed was a significant predictor for perceived veterinarian empathy and trustworthiness, as well as frequency of PHC visits. Dog owners understand the value of PHC and look to their veterinarian for this information. Satisfaction with PHC dissemination predicts owners' views of their veterinarian's trustworthiness and empathy. Dissemination of PHC information can improve animal health and well-being not only directly but also indirectly through its impact on owners' perceptions of their veterinarian.

A principles-based community health center for addressing refugee health: the New Canadians Health Centre

The provision of timely and comprehensive healthcare is a fundamental aspect of resettlement for refugees, who often experience critical unmet health needs. In Canada, this includes connecting refugees with primary care providers to treat acute health conditions, as well as to provide longitudinal and preventative care. However, refugee access to healthcare is often complicated by numerous barriers, such as difficulty navigating health services, financial constraints, language barriers, discrimination, and limited access to physicians. Due to these unmet health needs and barriers to access, there has been a need for dedicated primary healthcare models for refugees that provide integrated and culturally safe care. In response, a refugee community health center, the New Canadians Health Centre (NCHC), was established in Edmonton, Alberta, Canada in 2021. The NCHC operates through an innovative, principles-based model that delivers interdisciplinary primary healthcare services to refugees that are culturally safe, include clients as partners in their care, and are grounded in principles of social justice, equity, and inclusion. Early and effective healthcare services are needed to address the health of refugees; however, there is a lack of research on the development and implementation of dedicated refugee health service models. This paper addresses this gap by providing an in-depth account of the opening of the NCHC as a principles-based community health center for refugees, including the process by which it was established in response to local needs and the development of its principles-based model for supporting refugee health. This community case description will support the development and implementation of other dedicated models for refugee health, and comes at a critical time in which there are rapidly growing refugee populations in Canada and internationally.

#stayathome?: Increased children’s emotion regulation in covid-19 pandemic

Emotion Regulation is an important resource over children development, especially when facing adversities. The arrival of Convid-19 pandemic has resulted in procedures as quarantine and social distancing, which may cause mental health status challenges for children. The aim of this study was to compare parents’ perception on their children’s emotional regulation before and during quarantine. The results showed positive correlation between Covid’s behavioral and cognitive variables, as risk perception, virus exposure, preventive care, social distancing and Covid-19 knowledge with emotion regulation. Unexpectedly there was an increment on children’s emotion regulation during quarantine period perceived by their parents. This data can provide clues regarding the emotion development, the route of how mental health preventive measures should go, prioritizing parents support and psychoeducation.

Distance and Angle Insensitive Radar-Based Multi-Human Posture Recognition Using Deep Learning

Human posture recognition has a wide range of applicability in the detective and preventive healthcare industry. Recognizing posture through frequency-modulated continuous wave (FMCW) radar poses a significant challenge as the human subject is static. Unlike existing radar-based studies, this study proposes a novel framework to extract the postures of two humans in close proximity using FMCW radar point cloud. With radar extracted range, velocity, and angle information, point clouds in the Cartesian domain are retrieved. Afterwards, unsupervised clustering is implemented to segregate the two humans, and finally a deep learning model named DenseNet is applied to classify the postures of both human subjects. Using four base postures (namely, standing, sitting on chair, sitting on floor, and lying down), ten posture combinations for two human scenarios are classified with an average accuracy of 96%. Additionally, using the centroid information of human clusters, an approach to detect and classify overlapping human participants is also introduced. Experiments with five posture combinations of two overlapping humans yielded an accuracy of above 96%. The proposed framework has the potential to offer a privacy-preserving preventive healthcare sensing platform for an elderly couple living alone.

Prevalence and risk factors for Achilles tendon rupture in the military population from 2006 to 2015: a retrospective cohort study

IntroductionAchilles tendon rupture (ATR) is a serious musculoskeletal injury that results in substantial functional decline, especially in highly physically demanding occupations such as service in the military. The purpose of...

Preventing health care worker burnout in primary care settings through the trauma-informed CARES leadership competency model.

Staff burnout, a pervasive and persistent issue in the Canadian primary care environment, demands urgent and immediate attention. The managerial response to this problem has been largely reactive, especially in the post-COVID era. The need for proactive approaches to equip health leaders to detect early signs of burnout in healthcare workers and intervene effectively is more pressing than ever. Health leaders are beginning to acknowledge the significant role that trauma plays in impacting workers' propensity to experience burnout, leading to the growing recognition of trauma-informed best practices in healthcare management. This article will introduce the CARES model, a leadership competency framework that underscores the connections between leadership competencies and employee-leader engagement to detect early signs of burnout in primary care workers. The model, along with the proposed CARES toolkit, strongly emphasizes trauma-informed best practices and will enable health managers to better proactively prevent burnout through appropriate, empathetic, and efficient interventions.

MalenoCare - Skin Cancer Detection and Prescription using CNN and ML

Machine learning (ML) and convolutional neural networks (CNNs) have driven significant advancements in healthcare, particularly in dermatology, by enabling the automation of diagnostic processes for skin cancer. Skin cancer, being one of the most common types of cancer, requires early detection and accurate classification to improve patient outcomes and reduce mortality rates. This review paper explores various studies and CNN-based tools that enhance skin cancer detection and support preventive care through image analysis. The paper also discusses the effectiveness of different CNN architectures, including VGG16, ResNet, and Inception, in achieving high accuracy rates in skin lesion classification. A combination of recent research findings, model evaluation metrics, and graphical data highlights the accuracy, interpretability, and real-world applications of ML models, offering insights into their potential for integration into clinical practice.

Exploring participants’ characteristics and self-assessed readiness to conduct clinical trials in general practice – baseline analysis of the RaPHaeL practice-based research network

Background Primary care is integral to healthcare systems extending beyond traditional illness management to include preventive care, chronic disease management, and health promotion. Practice-based research networks (PBRNs) have emerged as essential infrastructures for conducting clinical research in primary care. This study explores the establishment of the ‘Research-Practices Halle-Leipzig’ (RaPHaeL) PBRN in Germany, evaluating the characteristics and research readiness of participating practices. Methods A cross-sectional survey (MORNING II) was conducted among all general practitioners (GPs) joining the RaPHaeL PBRN, assessing socio-demographic characteristics, practice infrastructure, and research readiness. After a descriptive analysis, we compared data with a previous study (MORNING) to examine potential differences between PBRN participants and non-participants. We developed a research readiness score (RRS) to quantify practices’ ability to perform clinical research subtasks. Results The response rate was 97.1% and our participants were often male, involved in undergraduate education, generally interested in research or had previous research experiences. However, they differed widely in age and size, staff structure, and patient demographics of their practices. Initially, around two-thirds of the practices were not sufficiently prepared to conduct clinical trials (self-assessed feasibility of relevant subtasks). If further research and documentation tasks are required, patient recruitment estimations are lower than for patient identification and information. Conclusion This study highlights the variability in research readiness among GP practices and shows the need for targeted training. By systematically assessing and enhancing research capabilities of participating GPs, PBRNs can facilitate high-quality clinical research in primary care to improve patient outcomes and healthcare delivery.

Abstract 4141457: Forms of Childhood Maltreatment and Subclinical Cardiovascular Disease Risk in Black men and women

Background: Exposure to specific forms of childhood maltreatment have been associated with cardiovascular disease (CVD) risk factors and CVD events in adulthood. Heterogenous experiences of childhood maltreatment across race and sex exist, yet there is little evidence regarding these relationships and CVD risk in Black populations. Aims: To investigate the association between various forms of childhood maltreatment (emotional, general, physical, and sexual abuse) and surrogate markers of vascular dysfunction and test whether sex modify these associations. Methods: Forms of childhood maltreatment and indices of vascular function were assessed in a cohort of healthy Black adults without known CVD (n=404) from a large metropolitan southeastern city. Childhood maltreatment was assessed using the Early Trauma Inventory short form (ETISR-SF) consisting of physical, sexual, emotional, and general domains. A trauma severity index score was calculated by summing the indexes for each of the four domains. Higher scores are indicative of higher traumatic life events before age 18 years. Outcomes of central augmentation index (cAIx) corrected for a heart rate of 75 bpm and carotid femoral pulse wave velocity (CfPWV) were measured as indices of wave reflections and arterial stiffness using applanation tonometry (Sphygmocor Inc.), and central pulse pressure (CPP) was calculated as the difference between the aortic systolic and diastolic blood pressures. Associations between each domain and outcomes were assessed using multivariate-adjusted and sex-stratified linear regression models. Results: Mean age of the cohort was 53 + 10.3 years, 61% women. Exposure to emotional [ b = -1.5%, 95%CI: -2.7,-0.3] and physical abuse [ b = -1.3%, 95%CI: -2.5,-0.2] was associated with cAIx overall but not CPP or CfPWV after adjusting for sociodemographic, clinical factors, health behaviors, and depressive symptoms. Significant emotional abuseXsex ( P= 0.014) and physical abuseXsex ( P=&lt; 0.001) interactions were identified for cAIx. Among women, physical abuse was associated with higher cAIx [ b =1.5%, 95%CI: 0.6, 2.4] and among men emotional [ b =-1.6%, 95%CI: -3.2, -0.0] and physical [ b =-1.7%, 95%CI: -3.1, -0.3] abuse was associated with lower cAIx. Conclusions: Exposure to emotional and physical abuse as children was associated with vascular dysfunction; moreover, exposure to physical abuse among women and not men have adverse clinical implications for CVD risk and prospects for enhanced preventive care.

Improving Access and Timeliness of Employee Annual Exams.

Access to preventive healthcare improves health outcomes and reduces risk of chronic disease. Annual examinations were integrated into an underutilized clinic at the University of Utah to improve access to preventive care. Nurse practitioners conducted these examinations, which included history, physical examination, age-based screenings, and immunizations. The service was part of a wellness program offering health premium discounts for participants. With employee permission, visit documentation was shared with primary care providers (PCPs) or used to help establish a PCP. Human resources received monthly reports of participating employees identification numbers, validating participation in order to receive premium discount. In 2023, 373 examinations were performed, including 719 preventive services and screenings, with 143 referrals for specialty and primary care. Patient satisfaction remained high throughout implementation. This initiative effectively increased access to preventive care for employees, demonstrating the feasibility of offering annual examinations in worksite clinics. The program addresses common barriers to preventive care such as long wait times, PCP shortages, and travel time to appointments.

Abstract Su705: Predictive Model and Factors for Out-of-Hospital Cardiac Arrest in Geriatric Patients with insomnia: A Longitudinal Study

Background: Previous studies have shown that geriatric insomnia can impact the quality of life and lead to various health risks and comorbidities, which may further result in out-of-hospital cardiac arrest (OHCA). Therefore, assessing the risk of OHCA in elderly patients with insomnia is crucial. Hypothesis: We hypothesized that a predictive model incorporating demographic, clinical, and treatment adherence factors can effectively estimate the risk of OHCA among geriatric patients with insomnia. Aim: This study aimed to develop and validate a predictive model for OHCA in geriatric patients with insomnia using a large-scale population-based analysis. Method: A retrospective cohort study was conducted using data from Taiwan's Health and Welfare Data Science Center spanning from 2011 to 2020. The study included elderly patients diagnosed with insomnia who received medication. Predictors of OHCA, such as age, sex, comorbidities, medication adherence, and psychotherapy, were analyzed using multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) with both internal and temporal validation. Results: Among 438,147 eligible elderly patients with insomnia, 7,666 experienced OHCA. Using data from 2011 to 2018 for model development, the AUROC for predicting OHCA within 7 days, 30 days, and 90 days ranged from 0.749 to 0.762 in the training set and 0.768 to 0.784 in the validation set. Key predictors included older age, male sex, prior medical resource use, hemodialysis, pre-existing comorbidities, medication possession ratio, medication changes, and recent psychotherapy (Figure 1). The model was also tested in 2019 and 2020 dataset (began of the COVID-19 in Taiwan), respectively, demonstrating consistent predictive performance (Figure 2). Specifically, the 7-day model in 2019 showed a sensitivity of 0.776, specificity of 0.632, and accuracy of 0.632, with a positive likelihood ratio (PLR) of 2.11, and negative likelihood ratio (NLR) of 0.36. In 2020, it achieved a sensitivity of 0.739, specificity of 0.661, accuracy of 0.661, PLR of 2.18, NLR of 0.40. Conclusion: The study developed a reliable predictive model for OHCA in geriatric patients with insomnia, highlighting significant predictors such as age, comorbidities, medication adherence, and recent psychotherapy. This model can aid clinicians in identifying high-risk patients and improving preventative care strategies.

Oral Health and Systemic Disease: A Systematic Review of the Impact of Dental Care on Overall Health

Oral health is increasingly recognized as a critical component of overall health, with research highlighting its potential impact on various systemic diseases. This systematic review examines the current evidence on the association between oral health, particularly dental care, and systemic conditions such as cardiovascular disease, diabetes, respiratory illnesses, and adverse pregnancy outcomes. A comprehensive literature search was conducted across multiple databases, focusing on studies published from 2016 onward. Studies indicate that periodontal disease and other oral health issues may contribute to systemic inflammation, a common factor in many chronic conditions. Specifically, findings suggest that managing oral health can have beneficial effects on cardiovascular health, glycemic control in diabetic patients, and respiratory function, as well as reduce risks for adverse pregnancy outcomes. However, while associations are evident, causality remains difficult to establish, and further longitudinal research is needed to clarify these relationships. This review underscores the importance of incorporating dental care into holistic health approaches, advocating for greater collaboration between dental and medical professionals. Public health initiatives promoting regular dental check-ups and preventive care may play a crucial role in improving overall health outcomes.

Integrating Nursing and Family Medicine: A Comprehensive Review of Interdisciplinary Approaches in Patient-Centered Care

This review explores the integration of nursing and family medicine in promoting patient-centered care through interdisciplinary approaches. Family medicine and nursing play complementary roles in primary healthcare, with nurses increasingly involved in collaborative efforts to address complex patient needs. This article examines current models of interdisciplinary collaboration, including team-based care and the Patient-Centered Medical Home (PCMH), and their impact on patient outcomes, cost-efficiency, and holistic care delivery. Additionally, the review highlights barriers to integration, such as role ambiguity, communication challenges, and institutional constraints, and offers strategies for overcoming these obstacles, including interdisciplinary training, supportive policies, and integrated health IT systems. Case studies of successful integration are presented, underscoring the practical benefits of collaborative care. The review concludes with implications for practice, suggesting that integrating nursing into family medicine enhances patient-centered care, especially in managing chronic conditions and preventive care. Further research is encouraged to establish best practices and policies that support effective interdisciplinary collaboration in primary care