National Study Research Articles

CTEPH is an uncommon complication of COVID-19: UK national surveillance and observational screening cohort studies.

Pulmonary embolism (PE) is a well-recognised complication of COVID-19 infection, and chronic thromboembolic pulmonary disease with and without pulmonary hypertension (CTEPD/CTEPH) are potential life-limiting consequences. At present the burden of CTEPD/CTEPH is unclear and optimal and cost-effective screening strategies yet to be established. We evaluated the CTEPD/CTEPH referral rate to the UK national multidisciplinary team (MDT) during the 2017-2022 period to establish the national incidence of CTEPD/CTEPH potentially attributable to COVID-19-associated PE with historical comparator years. All individual cases of suspected CTEPH were reviewed by the MDT for evidence of associated COVID-19. In a separate multicentre cohort, the risk of developing CTEPH following hospitalisation with COVID-19 was calculated using simple clinical parameters at a median of 5 months post hospital discharge according to existing risk scores using symptoms, ECG and NT pro-BNP. By the second year of the pandemic, CTEPH diagnoses had returned to the pre-pandemic baseline (23.1 versus 27.8 cases per month, p=0.252). Of 334 confirmed CTEPD/CTEPH cases, 4 (1.2%) patients were identified to have CTEPH potentially associated with COVID-19 PE, and a further 3 (0.9%) CTEPD without PH. Of 1094 patients (mean age 58 years, 60.4% male) hospitalised with COVID-19 screened across the UK, 11 (1.0%) were at high risk of CTEPH at follow-up, none of whom had a diagnosis of CTEPH made at the national MDT. A-priori risk of developing CTEPH following COVID-19-related hospitalisation is low. Simple risk scoring is a potentially effective way of screening patients for further investigation.

Family medicine viewed through the public lens: A national cross-sectional study in Lebanon

ABSTRACT Background: Family medicine (FM) is a medical specialty that provides continuing, comprehensive health care for the individual and the family. This study aimed to describe Lebanese citizens’ knowledge, attitudes, and practices toward FM as a specialty. Methods: This is a national cross-sectional phone-based survey targeting the knowledge of the public about FM and its scope of practice. Questions were asked whether participants had primary health care doctors and their specialties Results: A total of 373 participants were included, with a response rate of 85.2%. Two-thirds were aware of the specialty of FM, while only 16.6% of the participants had previously visited a family physician. Most participants (69.7%) had a doctor they regularly consulted. One-third of participants had a general practitioner as their regular doctor. More than 80% of the participants agreed that FM physicians treat all family members with common and chronic diseases. Around 60% to 75% of participants knew that family physicians provide medical care to children, treat patients with psychiatric impairments, and perform minor surgeries. There was a significant gap in the participants’ knowledge of FM physicians’ role in managing obstetric or gynecologic patients. Conclusion: Despite public awareness of FM, limited understanding and system challenges hinder its utilization in Lebanon. Educational campaigns, government-supported FM practices, and collaborations with public health initiatives are crucial to bridging the knowledge gap and establishing FM as the cornerstone of primary care. This knowledge gap challenges the specialty’s identity and necessitates promoting FM as the cornerstone of primary care, potentially requiring a system-wide endorsement.

Comparisons of cumulative live birth rates after embryo transfers at day-2/3 versus day-5/6: a French national study

Research QuestionAre there significant differences between cumulative live birth rates (CLBR) after short or extended embryo culture when comparisons are performed per cycle? DesignThis French national study included all IVF cycles performed from 01/2016 to 12/2019, with at least one cleaved embryo at day 2. The day-2/3 and day-5/6 groups were identified using the register from the national biomedicine Agency. Only the attempts in which the vitrification method was used, were included. The CLBR was assessed with 1 and 2 years of follow-up using logistic regression model. Over one year of follow-up, the evolution of CLBR per cycle was compared. ResultsIn total, 133,250 cycles met the inclusion criteria (70,528 and 62,722 in the day-2/3 and day-5/6 groups, respectively). In multivariate analysis taking into account several patients and cycle characteristics, per cycle, the CLBR was significantly lower in the day-5/6 group compared with the day-2/3 group. A significantly higher rate of fresh embryo transfer cancellation was observed in the day-5/6 group compared with the day-2/3 group. The evolution of the CLBR was significantly different in favour of day-2/3 group in cases with three or less day-2 embryos for patients, whatever their age, in their two first or more attempts. ConclusionsOverall, the nationwide results per cycle suggest that extended embryo culture until the blastocyst stage, even when used in combination with vitrification, could not improve live birth rates. Moreover, in cases where three or less day-2 embryos are obtained, it might be preferable to use the short embryo culture strategy.

Assessing attitudes toward mental health illnesses in Saudi Arabia: A national cross-sectional study.

The study aimed to assess the national attitudes toward individuals with mental health illnesses in Saudi Arabia, exploring the relationship between these attitudes and various sociodemographic factors. A cross-sectional design with computer-assisted telephone interviews was employed, covering all 13 administrative regions in Saudi Arabia. A total of 4,533 adults agreed to participate, and their attitudes toward people with mental illnesses (PWMI) were measured using an 11-item scale. The translation of the original English version of the PWMI to Arabic was validated and published previously. The scale used level of agreement on a 5-point Likert scale. The score varies from 11 to 55, where a higher score signifies higher stigma. The associations between total PWMI scores and sociodemographic variables were analyzed using linear regression. The mean age of participants was 35.92 ± 12.84, with equal distribution across regions. The linear regression model showed significant associations between total PWMI scores and gender, education level, marital status, living with, or being friends with someone diagnosed with a mental illness, and working in healthcare. No significant associations were found with age, income level, and previous mental health diagnosis. The study suggests that negative stereotypes about mental illness may be more prevalent in Saudi Arabia, while Saudi participants had a more optimistic view regarding the recovery and outcomes of mental illnesses. The study highlights the importance of assessing mental health stigma and its associations with sociodemographic factors in Saudi Arabia. The significant associations found point to the need for targeted interventions and public health campaigns to address misconceptions and stereotypes surrounding mental health, ultimately improving the societal acceptance and well-being of individuals with mental health illnesses.

Association of continuous subcutaneous insulin therapy and diabetic retinopathy in type 1 diabetes: A national cohort study

AimThis study aimed to investigate the short-and long-term effect on diabetic retinopathy (DR) in individuals with type 1 diabetes treated with continuous subcutaneous insulin injections (CSII) compared to those using multiple daily injections (MDI). MethodsWe conducted a register-based matched cohort study utilizing data from the Danish Registry of Diabetic Retinopathy as well as several other national Danish health registers. Our cohort consisted of all individuals with type 1 diabetes who attended the Danish screening program for DR from 2013 to 2022. We included individuals registered with CSII treatment, and compared them to individuals using MDI, matched by age, sex, and DR level. Cox regression analysis was performed to evaluate the outcomes. ResultsThe study included 674 individuals treated with CSII and 2006 matched MDI users. In our cohort 53.4 % were female and median age was 36 (IQR 27–47). Average follow-up risk-time was 4.8 years. There was no difference in the risk of DR worsening between the CSII group and MDI group (HR 1.05 [95%CI 0.91; 1.22], p = 0.49). However, an increased risk of focal photocoagulation was observed in the CSII group (HR 2.40 [95%CI 1.11; 5.19], p = 0.03). ConclusionsOur findings indicate that CSII treatment does not confer a significant difference in the overall short- and long-term risk of DR worsening or ocular intervention compared to MDI treatment. These results provide insights into the DR outcomes of CSII treatment in individuals with type 1 diabetes.

Association of opium use and tobacco smoking with α-, β-, and γ-human papillomavirus oral infection.

Head and neck squamous cell carcinomas (HNSCCs) are linked to tobacco smoking, opium use, and human papillomavirus (HPV) infection. However, little is known about the association of HPV infection with risk factors of HNSCCs, including opium and tobacco use. This cross-sectional analysis of a national multi-center case-control study in Iran included 498 HNSCC cases and 242 controls. We investigated the association of opium and tobacco use with α- (n = 21), β- (n = 46), and γ-HPV (n = 52) types in saliva samples using type-specific bead-based multiplex genotyping assays (TS-MPG). We found that α-HPV positivity was significantly associated with tobacco smoking (OR = 10.35; 95% CI = 1.15, 93; p = .03), but not with opium use (OR = 1.06; 95% CI = 0.41, 2.76; p = .89). Additionally, tobacco smoking correlated with an elevated risk of β-species 2 HPV infection (OR = 1.28; 95% CI = 1.04, 1.58; p = .020). Conversely, opium use showed a positive association with γ-species 12 HPV infection (OR = 5.67; 95% CI = 1.43, 22.44; p = .013). These findings indicate that tobacco and opium use may influence the risk of HPV infection in different ways depending on the HPV genus and species. Further studies are needed to replicate these findings in other populations.

Rehabilitation for spinal muscular atrophy patients in China: a national cross-sectional study

BackgroundThe management of Spinal Muscular Atrophy (SMA) requires a multidisciplinary treatment approach, wherein rehabilitation constitutes an integral element. In this study, we examined the effects of rehabilitation among Chinese SMA patients and assessed the real-world efficacy of rehabilitation interventions.MethodsWe conducted a cross-sectional online survey on SMA patients from June 9, 2023, to June 30, 2023, through the Meier Advocacy & Support Center using data from the Center’s database and electronic questionnaires. The rehabilitation situation of the participants over the past 14 months were investigated. Logistic binary regression was used to analyze the relationship between Pediatric Quality of Life Inventory(PedsQL™) scores and rehabilitation.ResultA total of 186 questionnaires were finally analyzed. Only 29 patients did not rehabilitated in the past 14 months. A significant correlation between age and type of rehabilitation, as well as between age and duration of rehabilitation. Patients receiving no rehabilitation or solely home-based rehabilitation exhibited a higher median age of 8.4 compared to those undergoing standard rehabilitation or a combination of standard and home-based rehabilitation, with a median age of 4.9 (z-score = -4.49, p-value < 0.001). In addition, long-term rehabilitation (OR = 0.314, 95%CI = 0.106–0.927, p = 0.04) were negatively correlated with lower PedsQL™ Neuromuscular Module scores, and PedsQL scores in the long-term rehabilitation group were higher than those in the short-term and no-rehabilitation groups (54.2 ± 15.1 vs. 45.9 ± 14.4 and 42.3 ± 14.3, p = 0.01), with the most significant difference observed in the physical function section (59.0 ± 15.8 vs. 46.8 ± 15.2 and 45.6 ± 15.9, p < 0.01). Mobility and exercise (OR = 0.26, 95%CI = 0.08–0.81, p = 0.02), as well as assistive technology (OR = 0.28, 95%CI = 0.10–0.82, p = 0.02), were independently associated with a lower score in a negative direction.ConclusionThe study found that long-term rehabilitation was linked to higher PedsQL scores in SMA patients, highlighting the need for standardized rehabilitation programs to enhance function and quality of life.

Heart failure in first- and second-generation immigrants aged 18-54years in Sweden: A national study.

We aimed at analysing the risk of congestive heart failure (CHF) among first- and second-generation immigrants in younger age groups. All individuals aged 18-54years, n=3973454 in the first-generation study and n=3817560 in the second-generation study, were included. CHF was defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2018. Cox regression analysis was used to estimate the relative risk [hazard ratios (HRs) with 99% confidence intervals (CIs)] of incident CHF with adjustments for age, co-morbidities and socio-demographics. In the first-generation study, a total of 85719 cases of CHF were registered, 54369 men and 31350 women, where fully adjusted models showed HRs for all foreign-born men of 1.12 (99% CI 1.06-1.17) and for women of 0.99 (0.92-1.05). Groups with higher risk included men from Eastern Europe, Central Europe, Africa and Asia and women from Africa and Asia, and a lower risk was found among Latin American women. In the second-generation study, a total of 88999 cases of CHF were registered, 58403 men and 30596 women, where fully adjusted models showed HRs for second-generation men of 1.04 (0.99-1.09) and women of 0.97 (0.90-1.04). The higher risk in some foreign-born groups needs to be paid attention to in clinical practice. The fact that almost all increased risks were attenuated and absent in second-generation immigrants suggests that lifestyle and environmental factors are more important than genetic differences in the risk of CHF.

Utilization of the Caprini risk assessment model(RAM) to predict venous thromboembolism after primary hip and knee arthroplasty: an analysis of the Healthcare Cost and Utilization Project(HCUP)

PurposeThis study aims to investigate the potential role of Caprini risk assessment model (RAM) in predicting the risk of venous thromboembolism (VTE) in patients undergoing total hip or knee arthroplasty (THA/TKA). No national study has investigated the role of Caprini RAM after primary THA/TKA.MethodsData from The National Sample of Healthcare Cost and Utilization Project (HCUP) in 2019 were utilized for this study. The dataset consisted of 229,134 patients who underwent primary THA/TKA. Deep vein thrombosis (DVT) and pulmonary embolism (PE) were considered as VTE. The incidence of thrombosis was calculated based on different Caprini scores, and the risk of the Caprini indicator for VTE events was evaluated using a forest plot.ResultsThe prevalence of VTE after primary THA/TKA in the U.S. population in 2019 was found to be 4.7 cases per 1000 patients. Age, body mass index (BMI), and Caprini score showed a positive association with the risk of VTE (P < 0.05). The receiver operating characteristic (ROC) curve analysis indicated that a Caprini score of 9.5 had a sensitivity of 47.2% and a specificity of 82.7%, with an area under the curve (AUC) of 0.693 (95% CI, 0.677−0.710). The highest Youden index was 0.299. Multivariate logistic regression analysis revealed that malignancy, varicose vein, positive blood test for thrombophilia, history of thrombosis, COPD, hip fracture, blood transfusion, and age were significant risk factors for VTE. Based on these findings, a new risk stratification system incorporating the Caprini score was proposed.ConclusionsAlthough the Caprini score does not seem to be a good predictive model for VTE after primary THA/TKA, new risk stratification for the Caprini score is proposed to increase its usefulness.

Association between homelessness and temperature-related health emergencies in the United States

Abstract Temperature-related illness (TRI) encompasses heat-related illness, such as heat exhaustion and heatstroke, and cold-related illness, such as frostbite and hypothermia. TRI is typically the result of exposure to ambient weather conditions; because of this, unhoused individuals are hypothesized to have higher risk of TRI. However, no national epidemiological studies have been completed to determine this risk. The objective of this study was to determine the association between homelessness and emergency department (ED) diagnosis of TRI in the United States. We conducted a cross-sectional study of adult ED visits in the U.S. from 2005 through 2020 using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative sample of non-federal ED patient visits. Housing status (housed vs. unhoused) was measured using NHAMCS patient residence category, with blank responses excluded. TRI was defined as ED clinician diagnosis of heat- or cold-related illness using ICD-9 and ICD-10 codes. Multivariable logistic regression was used to determine adjusted odds of TRI by housing status. There were 323,606 non-pediatric ED visits in the NHAMCS sample. TRI diagnosis was present in 288 (0.09%) visits. 4099 visits (0.9%) were categorized as unhoused. After adjusting for sex, mental health diagnosis, and alcohol or substance use or use disorder, the odds of TRI diagnosis in unhoused individuals was 4.08 (95% CI 2.09,7.95) compared to housed individuals. We found a higher adjusted odds of TRI diagnosis at an ED visit among unhoused individuals compared with housed individuals.

UK and US risk factors for hearing loss in neonatal intensive care unit infants.

Early detection and intervention of hearing loss may mitigate negative effects on children's development. Children who were admitted to the neonatal intensive care unit (NICU) as babies are particularly susceptible to hearing loss and risk factors are vital for surveillance. This single-centre retrospective cohort study included data from 142 inborn infants who had been admitted to the NICU in a tertiary regional referral centre. Data were recorded for 71 infants with confirmed permanent congenital hearing loss hearing loss. To determine impact of NICU admission independently of prematurity, babies were individually matched with 71 inborn infants on gestational age, birthweight, and sex. Neonatal indicators were recorded for all children with permanent congenital hearing loss. Presence of UK and US risk factors for hearing loss were collected on the neonatal population with hearing loss and for the matched controls. A fifth (21%) of babies with hearing loss had one or more UK risk factors whereas most (86%) had at least one US risk factor. False positives would be evident if US factors were used whereas the matched controls had no UK risk factors. Ten babies who at birth had no UK or US risk factors did not have any significant neonatal indicators identified in their records, one was ventilated for one day and two had a genetic anomaly. Current risk factors for hearing loss we identified for follow-up in this high-risk group are highly specific for congenital hearing loss. UK risk factors were highly specific for hearing loss but not sensitive and conversely, US risk factors are sensitive but not specific so false positives would be recorded. A national study of neonatal indicators could provide the utility to test which combinations of risk factors provide high sensitivity without losing specificity.

General practitioners and palliative care practices: a better knowledge of specific services is still needed

BackgroundFrance allows deep sedation for pain relief, but not for euthanasia. In anticipation of an increase in home-based palliative care, the role of general practitioners is central to the design of outpatient palliative care services. This study aimed to describe the knowledge, attitudes, and practices of general practitioners in mainland France regarding palliative and end of life care.MethodsThis was a national descriptive cross-sectional study within the Sentinelles network. Self-report questionnaires were distributed to general practitioners between November 2020 and November 2021. A descriptive analysis was carried out.ResultsOut of the 123 participating general practitioners, 84% had received academic training in palliative care (n = 104). While a significant majority (69%) expressed comfort in pain management, only a quarter (25%) declared that they were competent at indicating deep and continuous sedation for pain relief. Awareness of outpatient palliative care facilities close to their place of practice such as hospitalization at home was over 97% (n = 117/120). Awareness of hospital facilities, including identified palliative care beds on hospital wards and palliative care units, was lower (75% (n = 59/79) and 86% (n = 86/100), respectively).ConclusionsOur results suggest that French general practitioners are reasonably aware of palliative care resources available. However, there is room for improvement, particularly in understanding hospital-based facilities. Furthermore, a quarter of the general practitioners expressed discomfort with deep and continuous sedation for pain relief, highlighting the need for increased training in this specific aspect of palliative and end of life care.

Prenatal exposure to air pollutants and the risk of congenital heart disease: a Korean national health insurance database-based study

Air pollution and heavy metal exposure are emerging public health concerns. Prenatal exposure to air pollutants and heavy metals has been implicated in the development of congenital heart disease (CHD). However, the relationship between exposure to airborne heavy metals and CHD has not yet been investigated. Therefore, in this large population-based study, we investigated the association between air pollutants, including airborne heavy metals, and the risk of CHD using national health insurance claims data from South Korea. Data regarding 1,129,442 newborns and their mothers were matched with air pollutant levels during the first 8 weeks of gestation. In the five-air pollutant model, we found significant positive correlations between prenatal exposure to sulfur dioxide (SO2; odds ratio [OR] 6.843, 95% confidence interval [CI] 5.746–8.149) and cadmium (Cd; OR 1.513, 95% CI 1.187–1.930) and the risk of ventricular septal defects in newborns. This study highlights the association between prenatal exposure to air pollutants, including airborne heavy metals, and an elevated CHD risk. Further research is essential to validate and expand these findings, with the ultimate goal of enhancing public health outcomes.

Adolescent Substance Use, and Related Emergency Room Visits, and Continuum of Care

Abstract: Adolescence is a unique developmental period marked by biophysiological changes and psychosocial exploration. Risk-taking behaviors, including experimentation with psychoactive substances, are common during this period. Emergency room (ER) visits for adverse events related to adolescent substance use have increased over the last two decades. Without a continuum of care from the ER, significant opportunities to intervene are missed. The narrative review article aims to provide an overview of substance use during Adolescence in the United States, highlight related ER visits, and discuss extending care beyond the ER. A literature review was conducted to reveal historical and recent studies related to adolescent substance use trends, morbidity, and mortality patterns, as well as the much-needed continuum of care after the ER. Our approach prioritized capturing diverse perspectives and significant studies relevant to these themes, aiming for a thorough discussion without strict adherence to systematic review methodologies. The selection of studies involved a comprehensive search across multiple databases, including PubMed, Google Scholar, and relevant academic journals. Search terms were tailored to capture studies addressing adolescent substance abuse, ER visitation, and aftercare. Studies were screened based on title, abstract, and full-text review, with a focus on relevance and significance to the review's objectives. The strategy for this narrative review facilitated a detailed exploration of the selected themes while also allowing for flexibility in study selection and interpretation. National studies indicate an overall decline in the proportions of adolescents using substances compared to pre-COVID-19 levels. However, morbidity and mortality patterns have not mirrored this decline. Various factors, including gender, location, and specific mental health disorders, are associated with adolescent substance use presentations. Acute care providers in emergency settings, employing protocols like SBIRT, can significantly impact outcomes by facilitating appropriate screening and referral to aftercare treatment programs. Identification of barriers to care, such as stigma and social determinants of health, is important in formulating tailored interventions. While acute care provides an opportunity to intervene and initiate treatment, a continuum of care is essential to reduce morbidity and mortality patterns among adolescents with substance use.

Correction: Signs of Dysconscious Racism and Xenophobiaism in Knowledge Production and the Formation of Academic Researchers: A National Study

Correction: Signs of Dysconscious Racism and Xenophobiaism in Knowledge Production and the Formation of Academic Researchers: A National Study

Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected impacts of policy alternatives: A mathematical modeling study.

Tuberculosis incidence is increasing in Latin America, where the incarcerated population has nearly quadrupled since 1990. The full impact of incarceration on the tuberculosis epidemic, accounting for effects beyond prisons, has never been quantified. We calibrated dynamic compartmental transmission models to historical and contemporary data from Argentina, Brazil, Colombia, El Salvador, Mexico, and Peru, which comprise approximately 80% of the region's incarcerated population and tuberculosis burden. Using historical counterfactual scenarios, we estimated the transmission population attributable fraction (tPAF) for incarceration and the excess population-level burden attributable to increasing incarceration prevalence since 1990. We additionally projected the impact of alternative incarceration policies on future population tuberculosis incidence. Population tuberculosis incidence in 2019 was 29.4% (95% UI, 23.9-36.8) higher than expected without the rise in incarceration since 1990, corresponding to 34,393 (95% UI, 28,295-42,579) excess incident cases across countries. The incarceration tPAF in 2019 was 27.2% (95% UI, 20.9-35.8), exceeding estimates for other risk factors like HIV, alcohol use disorder, and undernutrition. Compared to a scenario where incarceration rates remain stable at current levels, a gradual 50% reduction in prison admissions and duration of incarceration by 2034 would reduce population tuberculosis incidence by over 10% in all countries except Mexico. The historical rise in incarceration in Latin America has resulted in a large excess tuberculosis burden that has been under-recognized to-date. International health agencies, ministries of justice, and national tuberculosis programs should collaborate to address this health crisis with comprehensive strategies, including decarceration. National Institutes of Health.

Emergency department utilization in Veterans with spinal cord injuries & disorders

ObjectiveTo determine frequency that ED visits are needed, and the most common chief complaints and medications prescribed to Veterans with spinal cord injuries and disorders (SCI/D). MethodsThe Veterans Health Administration (VHA) SCI and Disorders (SCI/D) Registry (VHA SCIDR) was used to identify Veterans with SCI/D over a five-year period (fiscal years 2018–2022). The primary outcome was the proportion of Veterans with SCI/D who had visits to the ED during the study period. Secondary outcomes included diagnostic codes and medications prescribed in the ED, and other healthcare encounters. ResultsOverall, 18,464 Veterans with SCI/D, including 80,661 patient-years were included. Of these Veterans, 10,234 (55.4%) had at least one ED visit and 8230 (44.6%) did not. ED visits were consistent, ranging from 33.5% to 36.4% annually. The number of in-person healthcare encounters decreased over the study period. The most common ED diagnostic codes were paraplegia or quadriplegia, discharge counseling, UTI, neuromuscular dysfunction of the bladder and low back pain. The most common medications prescribed in the ED were analgesics (e.g., acetaminophen, ketorolac), antimicrobials (e.g., ceftriaxone, vancomycin) and ondansetron. Antibiotics were among the most prescribed discharge medications, including ciprofloxacin, sulfamethoxazole/trimethoprim, cephalexin, and doxycycline. ConclusionThis national study of Veterans with SCI/D characterized ED healthcare utilization. Overall, more than half of Veterans with SCI/D required an ED visit during the five-year study period and over one third of Veterans in each fiscal year required an ED visit. Interventions to target prevention of ED visits and subsequent hospitalizations could focus on these areas.

Developing a Research Agenda for Resilient Systems and Innovative Practices in ODeL: Findings from a National Study

The Covid-19 pandemic exposed significant weaknesses in education systems globally, with many African countries, including Nigeria, struggling to respond swiftly to its impact. In Nigeria, the challenge was compounded by ongoing insurgency and insecurity, leading to extended school closures. To mitigate these disruptions, educational institutions adopted emergency remote teaching and learning methods, indirectly highlighting the potential of open, distance, and eLearning (ODeL). However, these initiatives often lacked proper ODeL design and pedagogical components. In response to these issues, a National Research Fund project, sponsored by the Tertiary Education Trust Fund (TETFund) titled "Setting an Agenda for Research into Open, Distance, and eLearning in the Global South: Nigeria as a Case Study" was initiated. The project aimed to identify gaps, high-priority areas, and research trends in ODeL to inform policy and guide practices amidst numerous challenges. This study aimed to investigate priority areas within ODeL that deserve more research attention and to offer insights into how this research could contribute to more resilient educational systems and promote innovative practices. The study employed a mixed-method approach, starting with an online survey of randomly selected 382 ODeL practitioners from Nigerian higher education institutions, followed by in-depth interviews with 26 purposefully selected ODeL experts. The findings revealed a consensus on key research areas, including learner support, technology, and instructional delivery. The study identified emerging research priorities specific to the African context. Addressing these key areas could significantly contribute to developing resilient education systems and promoting innovative educational practices in Nigeria and beyond.

Opioid misuse and mental health in college student populations: A national assessment

BackgroundDespite growing concern about opioid misuse and mental health of college students, little is known about this population who are at high risk of co-occurrence and unmet needs. This national study aims to estimate the prevalence of opioid misuse, examine correlates with anxiety and depression symptoms, and quantify help-seeking behaviors among U.S. college students. MethodsData come from students in the Healthy Minds Study between 2017 and 2020 (n = 176,191). Validated screening tools assessed mental health symptoms (PHQ-9, GAD-7). Marginal effects of logistic regression models estimate the effect of opioid misuse on mental health symptoms, help-seeking and academic performance. Results782 students indicated past month opioid misuse. Student opioid misuse was associated with 24.1 percentage point increase in the probability of screening positive for anxiety/depression (p < 0.001) and 3.6 percentage point increase in the probability of informal help-seeking (p = 0.017). Less than half of students with opioid misuse and a positive depression/anxiety screen received any treatment in the past year. LimitationsLimitations to this study include: possible non-response bias, as it is unknown whether students with opioid misuse may be differentially-likely to respond to the survey; differing time frame for opioid misuse and mental health questions; and data was collected prior to the COVID-19 pandemic. ConclusionsThis large, multi-campus study underlines the need for more partnership between substance use and mental health services on campus. It also highlights that college peers could receive training in ways to best help students who misuse opioids, directing them to on- or off-campus care.

Exposure to parental problem drinking during adolescence and symptoms of depression and anxiety in young adulthood: A Swedish national cohort study.

Previous research has shown associations between parental problem drinking and adverse mental health outcomes in children. However, while many studies assess parental alcohol problems based on clinical measures, longitudinal studies that investigate the impact of potentially less severe levels of parental alcohol problems are scarce. The aim of this study was to examine if the existence and severity of child-reported parental problem drinking in adolescence is associated with symptoms of depression and anxiety in young adult men and women. Data was obtained from the Swedish national cohort study Futura01, including 3143 participants born in 2001 who were surveyed in 2017 (age 15-16) and 2022 (age 20-21). Parental problem drinking was measured at age 15-16 with the short version of The Children of Alcoholics Screening Test. Depression and anxiety symptoms were measured at age 20-21 with the Patient Health Questionnaire-4. Registry information on gender, parental education and parental country of birth were included as covariates. The results demonstrated an exposure-response pattern, with greater severity of parental problem drinking associated with an increased probability of reporting depression and anxiety symptoms 5 years later. The association between parental problem drinking and subsequent depression symptoms was however present only in females. Adolescents exposed to parental problem drinking have elevated risks of long-term adverse mental health. These risks increase with greater severity of parental problem drinking. It is thus crucial with efforts preventing parental problem drinking and efforts promoting health among children and adolescents who are exposed.