Health Resources Research Articles

What will introducing and delivering new maternal vaccines cost in Ghana and Mozambique? A prospective analysis.

The maternal vaccine landscape is expanding, including the anticipated global rollout of the now approved respiratory syncytial virus maternal vaccine. Integrating maternal immunization (MI) into health systems in low-and middle-income countries (LMICs) will require adaptation to existing immunization delivery platforms and have cost implications. In this study, we project the cost of maternal vaccine introduction and delivery in Ghana and Mozambique to help inform introduction decisions and ensure financial sustainability of future MI interventions. We used an activity-based prospective cost projection approach to estimate MI introduction and delivery costs for a five-year period from a health system perspective. Country stakeholders informed the strategies for MI delivery. Interviews with key immunization and maternal health program representatives informed on the anticipated health system adaptation requirements, activities, and resource needs taken into account in the cost projections. Supplementary data from a sample of sub-national health administrative units, vaccine stores, and health facilities also informed the costing analysis. Financial and economic costs are estimated and presented in 2023 USD units. New maternal vaccines in both countries are anticipated to be delivered leveraging the existing maternal tetanus vaccine delivery practices. The non-vaccine cost of delivering one dose of maternal vaccine was estimated at $3.42 (financial) and $4.12 (economic) in Ghana, and $1.84 (financial) and $2.21 (economic) in Mozambique. Health worker training, communication and social mobilization, and program planning and coordination constitute the main cost drivers. Cost differences between countries are partly driven by the anticipated baseline coverage and baseline health system capacity gaps. Very few studies exist on the costs of delivering maternal vaccine in LMICs. This study begins to fill this gap. These MI cost projections are comparable to other new vaccine introduction costs in similar settings, providing insights for local and global stakeholders seeking to understand costs of MI delivery.

Differences in Social Support for Pregnant Women between Family Planning and Non-Family Planning

This study aims to analyze the differences in social support received by pregnant women who participate in the Family Planning (FP) program compared to pregnant women who do not participate in the program. The method used is a systematic literature review, which includes data collection and analysis from various studies related to social support for pregnant women. the results of the study indicate that pregnant women involved in the family planning program receive stronger social support from family, friends, and health workers. this support includes better emotional, informational, and instrumental aspects, which have a positive impact on their mental and physical health. in contrast, non-family planning pregnant women tend to experience social isolation and have limited access to health resources and information. the discussion in this study emphasizes the importance of social support in improving the welfare of pregnant women and the role of the family planning program as a platform to strengthen social support networks. the conclusion of this study shows that better social support in pregnant women who participate in the family planning program contributes to better mental health, lower stress levels, and increase their self-confidence during pregnancy. therefore, it is important to improve the integration of social support in the family planning program to create a more supportive environment for pregnant women, so that they can go through their pregnancy more healthily and optimally.

Dual sensory loss and cognitive impairment: A study in elderly users of gerontological centers in a Galician urban area.

Several studies indicate that dual sensory loss (DSL) is related to cognitive impairment. However, there are still no conclusive data on the role of each individual deficit on cognitive performance when both co-occur in the same person. This study aimed to analyze the possible association between sensory deficit and cognitive impairment in a sample of older adults and whether this association differs in subjects with DSL compared with those with single or no sensory impairment. Participants of this study were older adult users of gerontological centers in an urban area of Galicia (Spain). All subjects underwent visual and auditory screening tests to detect the presence of DSL. The Spanish version of the Mini-Mental State Examination test was used to identify cognitive impairment. Hearing loss was defined according to Ventry and Weinstein's criteria. Visual impairment was defined as a binocular presenting visual acuity <0.5 (20/40). The presence of DSL was established on the basis of the definitions of the single deficits. A total of 534 subjects were examined. Older adults with DSL had the worst results in the Mini-Mental test, and those without sensory impairment had the best. The likelihood of cognitive impairment was greater in older adults with DSL than in those without sensory impairment (odds ratio, 6.06 [3.14 to 11.65]). When only visual impairment was present, the likelihood of cognitive impairment was 3.73 times higher (0.95 to 3.09) than that of subjects with no sensory impairment. Hearing loss alone seems not to be significantly associated with a higher risk of cognitive impairment. The results of this study highlight the importance of continuing research in DSL for the prevention of cognitive impairment, the design of intervention plans, and the optimization of health resources.

The Effect of Health Fatalism and Health-Seeking Behaviors on the Frequency of Non-Medication Coping Strategy Use in Women with Urinary Incontinence in Türkiye.

Health-seeking behavior is habitual among people in a society, resulting from the interaction and balance between health needs, health resources, and socioeconomic factors. This study seeks to investigate the influence of health fatalism and health-seeking behaviors on the frequency of non-medication coping strategy use among women with urinary incontinence in Türkiye. This cross-sectional study was conducted between 8 August 2024, and 22 September 2024. A total of 354 women voluntarily participated in the study, which was disseminated via social media platforms and online forums. Data collection involved the use of a Personal Information Form, the Health Fatalism Scale (HFS), the Health-Seeking Behaviour Scale (HSBS), and the Non-Medication Coping Strategies for Urinary Incontinence Frequency of Use Scale (NMCS-UIFUS). The mean total HFS score was 50.39 ± 29.70, the mean total HSBS score was 38.76 ± 20.48, and the mean NMCS-UIFUS score was 35.69 ± 17.31. A statistically significant, strong negative correlation was found between health fatalism and health-seeking behavior, whereas a significant, strong positive correlation was observed between health fatalism and the frequency of non-medication coping strategy use for urinary incontinence (p < 0.001). Regression analysis revealed that health fatalism explained 37% of the variance in the frequency of non-medication coping strategy use for urinary incontinence, whereas health-seeking behavior accounted for 30% of the variance (p < 0.001). Our study demonstrated that women with urinary incontinence exhibit moderate levels of health fatalism, health-seeking behaviors, and the frequency of non-medication coping strategy use; further, as health fatalism increases, health-seeking behavior decreases, whereas the frequency of non-medication coping strategy use rises.

Nurse Practitioner Care Environments and Provider Shortages Among Patients With Multiple Chronic Conditions.

In health professional shortage areas (HPSAs), primary care providers face challenges due to high workloads and limited resources, impacting their ability to provide comprehensive care to patients with multiple chronic conditions (MCCs). In addition, patients in HPSA compared to non-HPSA settings experience poorer outcomes. Nurse practitioners (NPs) play a crucial role in meeting MCC patients' needs, but some work in unfavorable care environments (e.g., lacking teamwork, support, and autonomy) that hinder their capacity to manage complex chronic diseases. This study examines the effect of NP care environments on the relationship between HPSA status and hospitalizations or emergency department (ED) visits among patients with MCCs. We conducted a secondary analysis of merged Medicare claims, NP survey data, and Health Resources and Services Administration data. Our sample included 779 practices with 394,424 Medicare beneficiaries aged 65+ who had at least two of 15 chronic conditions. We used logistic regression to evaluate the impact of HPSA status and the NP care environment on ED visits or hospitalizations. NP care environments moderate the association between HPSA status and hospitalization (AOR 1.165, 95% CI [1.037-1.309], p = 0.010) but not ED use. Improved care environments are associated with lower odds of hospitalization in non-HPSAs (β = -0.148, 95% CI [-0.225, -0.072], p = 0.0001), while in HPSAs, improved care environments have no effect on hospitalization odds (β = 0.0047, 95% CI [-0.086, 0.096], p = 0.920). Addressing provider shortages in HPSAs may allow an improved NP care environment to produce maximal benefits for patients.

Dual sensory impairment: Global prevalence, future projections, and its association with cognitive decline.

There is rising public health concern surrounding dual sensory impairment (DSI), or comorbid hearing and vision impairments. Its global prevalence and the magnitude of its association with cognitive decline (CD) is unclear. Three databases were searched for epidemiological studies examining DSI prevalence or its association with CD. Independent reviewers selected studies, extracted data, and evaluated bias. Random-effects meta-analyses were performed. Projections were estimated using United Nations data. The population attributable fraction of DSI-associated CD was calculated. Among 43 studies with 5,246,796 participants, clinically assessed DSI prevalence was 5.50% (95% confidence interval [CI]=2.88%-10.26%), with regional/ethnic/age variations. DSI prevalence is projected to increase by 27.2% from 2025 to 2050. Approximately 59.83% (95%CI=41.03-76.12) of DSI patients had cognitive impairment. Baseline DSI was associated with incident CD (odds ratio [OR]=1.72, 95%CI=1.37-2.15). Globally, 3.81% (95%CI=1.05-10.55) of incident CD may be attributed to DSI. DSI is globally prevalent, growing, and associated with CD, highlighting the need for better health policy and resource allocation. HIGHLIGHTS: The global prevalence of DSI is 5.50%, with geographical, ethnical and age variations. The prevalence of DSI rises with age and is projected to increase by 27.2% by 2050. Approximately 60% of individuals with DSI may have measurable cognitive impairment. DSI was associated with a 72% greater longitudinal risk of incident CD. Globally, 3.81% of CD cases may be attributable to DSI.

Exploring the Association of Area of Deprivation Index (ADI) and cardiovascular risk factors in South Florida

IntroductionCardiovascular disease (CVD) is the leading cause of death in the United States. Major risk factors include hypertension, obesity, hyperlipidemia, and diabetes mellitus. While these cardiovascular risk factors are well-documented, further high-quality research is needed to examine their relationship with the Area Deprivation Index (ADI) in South Florida. As a measure of neighborhood socioeconomic disadvantage, ADI considers factors such as income, education, employment, and housing. This study investigates the association between ADI and cardiovascular risk factors in South Florida, a region characterized by unique health challenges and disparities.AimThis study aims to explore the odds ratio of having cardiovascular risk factors such as hypertension, obesity, hyperlipidemia, and diabetes mellitus in relation to neighborhood demographics in South Florida.MethodsA retrospective quantitative electronic health record review was conducted on patients who visited a primary care health system in South Florida from January 2022 to December 2022. The study population included 96,242 unique patients. Cardiovascular risk factors were identified using ICD-10 codes, and ADI was calculated using the patients' zip code plus four. Logistic regression, odds ratios, and Cochran-Armitage tests were used to evaluate the associations between ADI and the prevalence of cardiovascular risk factors.ResultsThe most common cardiovascular risk factor was obesity (64.24%), followed by hyperlipidemia (38.84%), hypertension (25.90%), and diabetes (10.04%). ADI was significantly higher in patients with obesity (Mean = 41.99), hypertension (Mean = 43.08), and diabetes (Mean = 44.99) compared to those without these conditions. Logistic regression analysis revealed that individuals in the highest ADI quartile were more likely to have obesity (OR = 1.16; 95% CI [1.16–1.20]), hypertension (OR = 1.47; 95% CI [1.40–1.54]), and diabetes (OR = 1.81; 95% CI [1.70–1.93]).ConclusionThis study highlights the significant association between higher ADI and the prevalence of obesity, hypertension, and diabetes in South Florida. The findings suggest that socioeconomically deprived neighborhoods are at higher risk for these cardiovascular conditions. These results underscore the need for community nurses and primary care providers to provide targeted public health interventions and resource allocation to address health disparities and improve cardiovascular health outcomes in socioeconomically disadvantaged communities.

Addressing Period Poverty: Evaluating a Free Period Product Program in a University Setting.

Period poverty, characterized by inadequate access to menstrual health resources and education, detrimentally affects school attendance, academic performance, and individual health. Recent studies have revealed nearly one-fifth of college-enrolled women experienced period poverty in the past year, highlighting the urgency of addressing this issue. Through our study at Purdue University, we evaluated the effectiveness of a free pad and tampon program aimed at reducing period poverty. Findings from our survey, which included responses from 766 university student participants, revealed many utilized the program due to not having products with them (43.2%). In contrast, others cited early or late periods (33.4%) and financial constraints (5.2%) as reasons for usage. In addition, 81.7% of respondents reported they were aware of the program's existence, indicating a need for more tailored promotional efforts to reach the entire student body. These insights contribute to a deeper understanding of the program's impact and provide actionable recommendations for improving accessibility and addressing the diverse needs of menstruating individuals within the university community. Leveraging these findings, university administrators can play a vital role in advancing menstrual equity initiatives and fostering supportive environments for all menstruators on campus.

Cyber Bullying, Psychological Distress and Quality of Life among Employees: A Correlational Study

This research was conducted to investigate the connection between cyber-bullying, psychological distress, and quality of life among employees. For this purpose, a cross-sectional correlational research design was used and a sample of 150 participants was selected through convenient sampling technique from various organizations in Faisalabad city. A demographic sheet, Cyber bully/Victim Scale, Kessler Psychological Distress Scale (K10), and Quality of Life Scale (QOLS) were used to collect the data. The data was analyzed using the Statistical Package for Social Science (SPSS). The results revealed a significant positive correlation between cyber-bullying and psychological distress and a weak negative correlation with quality of life. Further, the t-test analysis reported similar levels of cyber-bullying in both genders but female employees’ scores were higher on psychological distress and quality of life as compared to male employees. The findings emphasize the need for organizations to implement anti-cyber-bullying policies, accessible support services, and gender-sensitive mental health resources to foster a safer and healthier workplace culture. This study contributes valuable insights into the growing concern of workplace mental health in digitally connected environments.

Digitizing a Travel Health Resource: Lessons Learned From Implementing a User Experience Framework to Improve a Travel Health Website.

User experience (UX) is a key element in the design of effective public health websites. The Centers for Disease Control and Prevention (CDC) Yellow Book, a key travel health resource published by the U.S. CDC, adapted its print publication into a free companion website in the late 1990s to increase the resource's online reach and allow for more frequent updates of content. This process did not adopt a digital-first approach, leading to UX gaps such as barriers to finding relevant content, poor visual appeal, and inaccessibility on mobile devices. On May 10, 2023, the CDC Travelers' Health Branch implemented a UX update for the CDC Yellow Book 2024 website to improve the website's overall structure, content, and functionalities. This meant that the previous CDC Yellow Book 2020 website was replaced with the updated CDC Yellow Book 2024 website. Website metrics from Adobe Analytics were collected to show the outcomes of these updates. The CDC Yellow Book 2024 website received 5,726,545 page views for the year following the UX update, which was a 46% increase in web traffic compared to the CDC Yellow Book 2020 website the year prior to the update. In addition, there were 2,375,995 users who returned to the CDC Yellow Book 2024 website seven or more days after their first visit. This case study provides an overview of how the UX framework was used for the CDC Yellow Book 2024 website, which includes describing the lessons learned to inform future digitization efforts for health promotion tools.

Community Racial and Ethnic Representation Among Physicians in US Internal Medicine Residency Programs.

Increasing underrepresented in medicine (URIM) physicians among historically underserved communities helps reduce health disparities. The concordance of URIM physicians with their communities improves access to care, particularly for American Indian and Alaska Native, Black, and Hispanic or Latinx individuals. To explore county-level racial and ethnic representation of US internal medicine (IM) residents, examine racial and ethnic concordance between residents and their communities, and assess whether representation varies by presence of academic institutions or underserved settings. This retrospective cross-sectional study collected data from the Association of American Medical Colleges, Accreditation Council for Graduate Medical Education (ACGME), Area Health Resources Files, and US Department of Education data on ACGME-accredited US IM residency programs and their associated county populations. Self-reported racial and ethnic data from 2018 for 4848 residents in 393 IM programs in 205 counties were used. Data were analyzed between February 15 and September 20, 2024. County-level presence for academic health centers (AHCs), minority-serving institutions (MSIs), health professional shortage areas (HPSAs), and rurality. Main outcomes were representation quotients (RQs) or the ratio of the proportion of IM residents and their concordant county-level racial and ethnic populations. Quantile linear regression models on median representation were used to identify the association with URIM, Asian, and White residents by US Census division and county-level AHCs, MSIs, HPSAs, and rurality. Among 4848 residents, 4 (0.08%) self-identified as American Indian or Alaskan Native, 1709 (35.3%) as Asian, 289 (6.0%) as Black, 211 (4.4%) as Hispanic or Latinx, 2 (0.04%) as Native Hawaiian or Other Pacific Islander, and 2633 (54.3%) as White. A total of 761 (15.7%) were classified as URIM. Among URIM groups, American Indian and Alaska Native (mean [SE] RQ, 0.00 [0.04]), Black (mean [SE] RQ, 0.09 [0.20]), Hispanic and Latinx (mean [SE] RQ, 0.00 [0.04]), and Native Hawaiian and other Pacific Islander (mean [SE] RQ, 0.00 [0.26]) residents were grossly underrepresented compared with their training sites' county-level representation. Fifty-one of 205 counties (24.8%) with IM programs had no URIM residents. Black and Hispanic or Latinx residents had higher representation in counties with more MSIs (mean [SD] RQ, 0.19 [0.24]; P = .04; mean [SD] RQ, 0.15 [0.04]; P < .001, respectively), and Hispanic or Latinx residents were less represented in counties with more AHCs (mean [SD] RQ, 0.00 [0.06]; P < .001). Asian residents had lower RQs in counties with more MSIs (mean [SD] RQ, 6.00 [0.65]; P < .001), and White residents had higher representation in counties with greater presence of AHCs (mean [SD] RQ, 0.77 [0.04]; P = .007). In this cross-sectional study, URIM IM residents remained underrepresented compared with their program's county populations. These findings should inform racial and ethnic diversity policies to address the continuing underrepresentation among graduate medical education physicians, which adversely impacts the care of historically underserved communities.

Intention to utilize mental health and suicide prevention resources in a community sample during the first year of the COVID-19 pandemic

ObjectiveGiven the stressors experienced during the COVID-19 pandemic, it is critical to identify populations with elevated mental health needs during this crisis. This study investigated demographic correlates of reported intention to utilize mental health (MH) and suicide prevention (SP) resources in a community sample during the COVID-19 pandemic.MethodsA sample of 1,978 adults in the United States completed an anonymous online survey between June 2020 and February 2021.ResultsIntent to utilize MH resources was associated with younger age, single marital status, female gender, and Hispanic vs. White race/ethnicity. Intent to utilize SP resources was associated with younger age, single marital status, and was greater among Black and Hispanic vs. White race/ethnicity. Lower education was associated with MH and SP utilizers in bivariate analysis. Indirect effects of Suicide Crisis Syndrome (SCS) symptoms were found on the association of age, gender, and marital status with MH utilization and of age, marital status, and education with SP Utilization.ConclusionsSpecific demographic populations demonstrate greater interest in mental health care during the COVID-19 pandemic. These help-seeking patterns can be explained in part by an elevated level of SCS symptoms, suggesting greater levels of distress were driving expressed intention to utilize service referrals.

P-986. Integration of the National HIV Curriculum (NHC) into health professions programs: faculty and student/trainee reflections and perspectives

Abstract Background Targeted Access Knowledge and Education on HIV for Health Professions Programs (TAKE on HIV for Health Professions Programs) is a Health Resources and Services Administration (HRSA) funded effort to support National HIV Curriculum (NHC) integration into health professions programs (HPPs) to cultivate HIV prevention and care knowledge into student/trainee (learners) practice and build the HIV workforce. We report on faculty and learners perspectives within integrating HPPs. Methods Using mixed methodology, faculty and learners were asked about their NHC integration experience which was facilitated by the TAKE on HIV training and technical assistance (TTA) Team. Following an integration cycle, faculty participated in 1:1 structured interviews and a focus group to identify facilitators/challenges of integration and sustainment plans. Learners completed a digital survey about time to complete NHC lessons and ratings of HIV knowledge, confidence, and usability of the NHC platform (Likert scale: 1- strongly disagree to 5=strongly agree). Data were analyzed using rapid qualitative analyses, descriptive statistics and mean Likert scores. Results Nine participating faculty were from the following HPP disciplines: 3 from Pharmacy, 1 each from Physician Assistant and Family Medicine Residency, and 4 from Nursing. Integration facilitators included TTA support and guidance and NHC student tracking capability. A barrier was learner difficulty with navigating the platform and suggestion for improvement was providing additional visual learner resources for platform navigation. All faculty reported desire to sustain NHC integration with subsequent cohorts and additional NHC lessons. 46 learners completed the survey (13% response rate). 67% reported taking 15-30 minutes to complete an NHC lesson. Overall learners reported having improved HIV knowledge (mean=4.42), confidence in providing HIV care (mean=4.07), and ease of NHC platform navigation (mean=4.29). Conclusion NHC integration into HPPs is sustainable if sufficient resources are provided to faculty. TAKE on HIV effectively provides HPP faculty with free TTA resources to facilitate NHC integration and a framework for replicability. HIV knowledge gain amongst learners within integrating HPPs was demonstrated. Disclosures All Authors: No reported disclosures

P-584. Tailored telehealth behavioral health coaching demonstrates feasibility and potential in overcoming barriers to HIV treatment outcomes

Abstract Background People with HIV (PWH) face challenges, including behavioral health, stigma, financial constraints, homelessness and homophobia that negatively impact their HIV care. Unfortunately, limited, tailored programs exist to address these problems. Additionally, transportation and time constraints may hinder participation in available programs. Thus, Nebraska’s Specialty Care Center implemented the Intervention to Telehealth and Text to Improve Engagement in Care (i2TEC), a Health Resources and Services Administration (HRSA) HIV/AIDS Bureau-funded evidence-informed intervention aimed to address the intersection of mental health, substance use, and HIV. Here, we describe i2TEC program and its early impact on viral suppression (VS) among PWH in Nebraska. Methods Delivered by a licensed behavioral health therapist (BHT), participants receive 12 weekly behavioral health virtual coaching sessions. Participants could choose from various topics such as HIV care, mental health, relationships, sexuality, housing, and lifestyle. Then, they collaboratively work with the BHT to identify barriers to their HIV care and establish goals to overcome them. Participation in i2TEC requires being an HIV diagnosed adult not fully engaged in HIV care. Results Of the 50 participants enrolled in i2TEC, 84% were males, and 50% were non-Hispanic Whites. At baseline, 64% had a positive screen for substance use, 54% had a positive screen for depression or anxiety, and 71% did not have durable VS. Sixty percent had follow-up viral load labs, of which 97% had achieved VS within one-year post-enrollment. Participants' most identified discussion topics were lifestyle/health and socioeconomic needs (housing, food, and transportation). Overall, 95% would recommend the program, 86% agreed that i2TEC helped improve their mental health, and 76% reported that the program improved their medication adherence. Conclusion Preliminary findings from this tailored telehealth behavioral health program demonstrate feasibility and potential for improving HIV outcomes and overcoming individual barriers to VS. Through the delivery of i2TEC, we identified priority coaching needs among PWH. Future studies focusing on the topics identified by participants and the long-term impact of such programs are recommended. Disclosures Nada Fadul, MD, ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support

P-1886. Utilizing Artificial Intelligence to Predict Triage in Pediatric Outpatients with Prolonged and Recurrent Fever

Abstract Background Prolonged and recurrent fevers in pediatric outpatients often require specialist consultations, presenting a challenge in accurately triaging to the correct pediatric subspecialty. This study aims to develop an artificial intelligence (AI)-based model to accurately direct pediatric patients to appropriate subspecialties.Table 1.Patient characteristics and the department confirming the final diagnosis Table 1. Patient characteristics and the department confirming the final diagnosis Methods A retrospective study was conducted at the Mayo Clinic, Rochester, from December 1, 2020, to January 1, 2023, involving pediatric patients aged 0 to 18 referred for recurrent fever or fever of unknown origin. Six machine learning models, including gradient boosting, random forest, support vector machines (SVM), k-Nearest Neighbor (KNN), logistic regression (LR) and decision tree, were developed using 7 variables (demographics, chief complaints, referral sources, departments of same-day initial visit, and lab tests results within 30 days before initial visits). Data were extracted from external electronic health records (EHR) using Mayo Data Explorer and Lab Information Management Systems. Precision, Recall, F1 Score, and area under the curve (AUROC) were selected to measure the performance.Table 2.Performance of six machine learning models Table 2. Performance of six machine learning models Results The study evaluated 87 pediatric patients with a median age of 10.2 years (IQR: 4.6-13.8), including 43 (49%) females (Table 1). External provider referrals were noted in 40 (46%) patients. Musculoskeletal pain was the most common chief complaint, identified in 29 (33%) patients, in addition to prolonged or recurrent fever. Infectious disease and rheumatology divisions jointly saw 43 (49%) patients during the initial visit. Sub-optimal performance was observed in six machine learning models (Table 2). The random forest model showed the best results (Accuracy=0.39, Precision=0.34, Recall=0.39, F1 Score=0.35, AUROC=0.60) (Figure).Figure.ROC curves for various models Figure. ROC curves for various models Conclusion This study demonstrates the potential of AI-based models for outpatient triage prediction in pediatric patients with recurrent fever, using EHR data to optimize health resource utilization. This data serves as the groundwork to expand and refine this AI triage tool. Disclosures All Authors: No reported disclosures

Mental Health and Stress Management Among College Students: A Critical Analysis

- This study explores the mental health challenges faced by college students and the strategies they employ for stress management. Mental health issues, including anxiety, depression and stress, are prevalent among students due to academic pressures, social adjustment and other personal factors. Stress management techniques such as exercise, social support and mindfulness are commonly used but vary in effectiveness. Through a survey-based approach, this research aims to examine the relationship between mental health and coping mechanisms. The findings reveal a significant correlation between the use of effective stress management strategies and improved mental well-being. However, the study also highlights the challenges students face in accessing mental health resources. The importance of institutional support and peer networks in promoting mental well-being is emphasized. Key Words: Mental Health, Stress Management, College Students, Coping Strategies, Anxiety, Depression, Academic Stress

P-1981. MMCD score for predicting kidney replacement therapy in hospitalized patients with COVID-19 from 2020 to 2022

Abstract Background Acute kidney injury (AKI) requiring kidney replacement therapy (KRT) in its most severe forms is a significant complication of patients with COVID-19. The development of a risk score to predict KRT requirement could optimize health resource allocation. Thus, this study aimed to develop and validate a score to predict the KRT requirement in hospitalized patients with COVID-19 from 2020 to 2022. Area under the receiver operating characteristic curve for the 2021-2022 validation of MMCD score Methods This is a multicenter retrospective cohort of consecutive patients hospitalized for COVID-19, confirmed by laboratory tests, in 40 Brazilian hospitals, from March 2020 to July 2022. Patients under 18 years old, pregnant, in palliative care, or in dialysis therapy at admission were excluded from the study. Predictor variables were selected using generalized additive models (GAM) and the least absolute shrinkage and selection operator (LASSO) regression was used for score derivation. The score was developed in the period from March to July 2020, with temporal and geographic validation from July to September 2020 and new temporal validation from March 2021 to July 2022. The performance of the score was evaluated by the area under the receiver operating characteristic curve (AUROC, with a 95% confidence interval), graphical analysis with intercept and slope test, and Brier score. Calibration for the validation of MMCD score Results The study included 3,680 patients in the development sample, 1,532 in the 2020 temporal validation, 1,378 in the geographic validation, and 9,473 in the 2021-2022 temporal validation. Four predictors were identified: mechanical ventilation at any time during hospitalization, male sex, admission creatinine, and diabetes mellitus. The score named MMCD showed excellent performance in the derivation and validations cohorts (development AUROC 0.929, CI 0.918–0.939, Brier 0.057; 2020 temporal validation AUROC 0.927, CI 0.911–0.941, Brier 0.056; 2020 geographic validation AUROC 0.819, CI 0.792–0.845, Brier 0.122; 2021/2022 temporal validation AUROC 0.916, CI 0.909-0.924, Brier 0.057). Conclusion The MMCD showed excellent predictive ability for KRT in different phases of the pandemic, which can contribute to support more assertive decisions in the allocation of care resources, in addition to efficient clinical management. Disclosures All Authors: No reported disclosures

Unveiling climate extremes: A bibliometric odyssey through resilience, adaptation, and sustainable development goal synergies

Abstract In order to achieve sustainable development, it is critical to comprehend the intersectionality of severe events and the tactics used for their mitigation and adaptation as the effects of climate change become more widespread. This study explores the complex relationship between environmental challenges, climate change, and the Sustainable Development Goals (SDGs). It highlights the significant threat posed by environmental degradation, driven by both natural and anthropogenic factors, and its impact on global climate patterns. The study emphasizes the role of greenhouse gases in altering climate systems and the disproportionate effects on developing countries. It underscores the importance of sustainable development, as outlined in the 2030 Agenda for Sustainable Development, and the need for urgent action to combat climate change (SDG 13). The paper explores various theoretical perspectives on development, including the modernization theory and dependency theory, and their implications for environmental sustainability. It discusses the environmental Kuznets curve (EKC) hypothesis, which suggests a relationship between economic growth and environmental degradation, and presents contrasting views from contemporary research. The study also examines the socio-economic impacts of extreme environmental conditions and the importance of disaster risk reduction frameworks like the Sendai Framework. It highlights the ongoing challenges of climate change, such as increased greenhouse gas emissions and their effects on human health, agriculture, and water resources. Furthermore, the paper delves into the concept of sustainability and sustainable development, emphasizing the need for a balanced approach that integrates economic growth, environmental protection, and social equity. It reviews the historical evolution of sustainable development goals and the critical role of international cooperation in achieving these objectives. The findings of this paper provide valuable insights for policy makers, researchers, and practitioners working towards a more sustainable and resilient future. By addressing the complex interplay between climate change and sustainable development, the study aims to contribute to the global discourse on environmental sustainability and the achievement of the SDGs by 2030.

Global burden of burns among children and adolescents: a trend analysis from the global burden of disease study 2019

PreciseThis study investigates global trends in burns among children and adolescents using data from the Global Burden of Disease Study 2019. Analyzing incidence and YLD rates across 204 countries from 1990 to 2019 reveals a general decline in burn-related injuries, with age and sex influencing trends. Notably, in high-SDI regions, incidence rates initially increased before reversing. These findings highlight the need for targeted public health policies and resource allocation to reduce burn-related risks in vulnerable populations.BackgroundGiven the lack of long-term trend studies on global burns among children and adolescents, this study examined trends in the global burden of burns among children and adolescents.MethodsThe Global Burden of Disease (GBD) Study 2019 provided the statistical data. Sex, age, region, and SDI were used as stratification variables in the study to evaluate the prevalence of burns injuries among kids and teenagers across 204 nations and territories between 1990 and 2019. YLD rates per 100,000 people and incidence rates together with their respective average annual percentage changes (AAPC) were computed to evaluate burden trends. Furthermore, AAPC in YLD rates and incidence rates spanning various age cohorts were analyzed using the Joinpoint software.ResultsThe worldwide burns incidence and YLD rates of burns among kids and teenagers exhibited a general declining trend between 1990 and 2019. Concerning the general trend in new cases, incidence rates, and YLD rates, age was positively associated. In 2019, the incidence rate for females surpassed that of males, while YLD rates for females were consistently higher than those of males. New Zealand, Czechia, and Australia rank as the top three among the 204 countries studied. Interestingly, in the high SDI range, the expected values based on incidence rates reversed after first rising with the SDI.ConclusionOverall, the incidence and YLD rates of burns among children and adolescents have declined globally, though significant disparities exist across age groups, sexes, regions, and countries. These findings could help guide the development of more targeted strategies to reduce the burn burden in this population.

Mental Health Outcomes Among Female Ukrainian Refugees in Germany—A Mixed Method Approach Exploring Resources and Stressors

Background: Mental health outcomes among female refugees are complex and multifaceted. This study examines the mental health outcomes and coping resources of female Ukrainian refugees in Germany using a mixed methods approach with qualitative focus groups and quantitative assessments. Methods: This study employs a mixed methods approach, combining qualitative and quantitative methodologies. Three focus group discussions with fifteen participants were conducted in Hamburg in April 2023. A stepwise qualitative data analysis was done using a deductive coding technique. The quantitative analysis focused on descriptive statistics to summarize the data and provide an overview of participants’ mental health and well-being. Results: Our findings show that 43% of participants reported anxiety symptoms, and 21% showed signs of depression—many experienced isolation and disconnection and were struggling with cultural adaptation and the emotional toll of displacement. Despite challenges, participants utilized various coping strategies, such as staying active, volunteering, and seeking community support. However, significant barriers to accessing mental health services, especially for children, were identified. Conclusions: The study underscores the need for tailored interventions, including language support, accessible mental health resources, and community engagement, to foster resilience and well-being. It highlights the importance of comprehensive support systems for refugee populations in host countries, such as active lifestyles, social support, volunteer work, and successful integration.