Search Results (601)

Knowledge translation (KT) is an essential process in bridging the gap between research evidence and healthcare practice, particularly in community health and primary care settings. In Saudi Arabia, KT is gaining increasing importance as the healthcare system undergoes a major transformation under Saudi Vision 2030 and the new Saudi Model of Care. The new model of care emphasizes the importance of healthy communities and primary care as early elements of healthcare service delivery before reaching the secondary and tertiary healthcare levels. Additionally, healthcare transformation under Saudi Vision 2030 encourages the utilization of evidence and KT to improve healthcare services provided to individuals and enhance the standardization of healthcare delivery. Nonetheless, the application of KT principles in community health and primary care contexts has faced some challenges during the period preceding the establishment of the new Saudi Model of Care. While Saudi Arabia has achieved significant advances in health research and institutional capacity building, KT remains underutilized in local community health initiatives. This narrative review aims to provide a conceptual overview of KT and explore its implications within the contexts of community health and primary care in Saudi Arabia. Additionally, the review introduces the key components of KT—evidence synthesis, dissemination, exchange, and application—and examines how these can be implemented in community and primary care contexts. The review emphasizes the necessity of stakeholder engagement, community-based participatory research, and the integration of frameworks such as the knowledge to action and social–ecological models to ensure effective KT in community health settings. Future directions should focus on expanding KT training, promoting its integration across health institutions involved in primary care delivery, and sustaining community health through strong partnerships among academic, governmental, and community stakeholders. Full article

While often framed as historical or ‘post’colonial, the pervasive legacies of anti-Black racism, rooted in the afterlives of slavery and the dehumanization of African, Caribbean, and Black (ACB) voices, continues to shape the health experiences of young ACB women in Ontario, Canada. Using an intersectional framework, this qualitative study utilized focus groups (n = 24) to understand factors influencing access to sexual and reproductive health services for young ACB women in southern Ontario. The findings reveal that fostering ACB youth engagement in the design and facilitation of healthcare programs will be vital for creating more responsive spaces to fully express sexual health concerns. It also demonstrates that Eurocentric biomedical frameworks continue to obscure young ACB women’s needs, emphasizing the necessity for culturally relevant care. Lastly, the findings indicate that internalized colonial narratives around health practices perpetuate intergenerationally, further complicating young ACB women’s access to adequate sexual and reproductive healthcare. This examination illuminates the need to address the colonial legacies within healthcare systems that continue to pathologize and hypersexualize young ACB women’s bodies. The study concludes by advocating for intersectional, youth-centered, and culturally competent approaches to dismantling the barriers young ACB women face in accessing sexual and reproductive health services. Full article

Background/Objectives: Timely initiation of antenatal care (ANC) services is crucial for ensuring maternal and fetal well-being. Despite the importance of ANC, research regarding its initiation remains limited in the Jazan region of Saudi Arabia, an area with notable adverse birth outcomes. Therefore, this study aimed to assess pregnant women’s initiation of ANC and identify associated factors and significant barriers for timely initiation. Methods: A cross-sectional study was conducted among 369 Saudi pregnant women in their third trimester attending ANC clinics in the Jazan region in 2024. A structured questionnaire was used to collect data. Andersen’s behavioral model of healthcare utilization provided the framework for the study. Descriptive statistics, chi-square tests, and binary logistic regression were used to analyze the data. Results: The majority of women (78.9%) initiated ANC in the first trimester. Higher maternal education was positively associated with early ANC initiation (aOR = 2.369, 95% CI: 1.154–4.901), whereas higher paternal education was negatively associated with early ANC initiation (aOR = 0.350, 95% CI: 0.175–0.699). When modeled independently, the positive association of higher maternal education was attenuated but was not significant, while the negative association of higher husband’s education remained the same. Those living more than three km from health facilities (aOR = 0.510, 95% CI: 0.276–0.941) and seeking care for reasons other than routine follow-up were less likely to initiate ANC early. Most women received essential services, but only 37.1% had ultrasound tests. Conclusions: While ANC initiation in Jazan showed promising trends, factors like geographical accessibility remain a significant barrier. Targeted interventions should address these identified barriers, which fall within predisposing, enabling, need, and external environmental factors. Further investigations of pregnant women’s familial decision-making and low ultrasound test utilization in relation to ANC are recommended. Full article

Background: During COVID-19 Arab American and Arab/Middle Eastern (AME) international students faced disproportionately higher psychosocial stressors like other racial populations that may influence their mental health and help-seeking behaviors. Objective: This study examined and compared the prevalence of depression, anxiety, and loneliness among Arab American and AME international college students in addition to how loneliness is associated with perceived mental health need and the use of digital mental health (DMH) services. Methods: Data from the 2022–2024 Healthy Minds Study (HMS) comprised a final analytic sample of 3249 AME students (2662 Arab American; 587 AME international). Logistic regression and generalized structural equation modeling (GSEM) were used to examine associations and mediating pathways. Results: Depression and anxiety were prevalent among Arab American students (44.3% and 40.0%) compared to AME international students (40.9% and 37.0%). Rates of loneliness were similar (56.2% vs. 56.9%). Loneliness was bidirectionally associated with both depression and anxiety (p < 0.001). Perceived need for care emerged as a significant mediator linking psychological symptoms to DMH service use (OR = 2.56, p < 0.001), while loneliness did not directly predict DMH utilization. Only 10% of students reported using DMH services. Conclusions: Mental health disparities among AME students exist. Institutions should prioritize culturally responsive approaches to support the mental health needs of diverse student populations. Full article

Background: The agile Comprehensive Care (aCC) is a service that was developed in response to a detailed analysis of the most frequent attendees to Monash Health’s emergency departments (ED). Analyses revealed a group of clients with complex mental health issues who were receiving disintegrated care resulting in suboptimal clinical outcomes, high demand on resources and substantial costs. In a real-life setting, we sought to evaluate, through follow-up, the effectiveness of the aCC service, which aimed at stabilizing the system’s response to high utilizers by developing comprehensive service plans, modelled on the General Psychiatric Management Framework, to be utilized by all clinicians no matter where the person presents within the system of care. Methods: A single group pre/post study was undertaken involving the follow-up analysis of 27 patients discharged from the aCC clinic after intervention. A comparison of 12-month median pre-aCC and median post-aCC service utilization and service costs was undertaken using Wilcoxon signed rank tests with effect sizes reported as r. In addition, we received feedback from staff within the health service who received support from aCC for their complex clients. Results: ED presentations decreased significantly from the pre-intervention period to the post-intervention by a median of 15 visits to a median of four visits. Mental health ED presentations decreased from a median of nine visits to one visit. Median service costs decreased from AUS 64,921 to AUS 19,329. aCC support gave staff greater confidence in working with this complex group. Conclusions: agile Comprehensive Care, involving the development of a systems-wide treatment plan coupled with patient and clinician support, improved outcomes and reduced service usage and costs for a complex group of high utilizer patients. Full article

Background: The COVID-19 pandemic disrupted pediatric healthcare systems globally, altering infection dynamics, hospital admissions, and antimicrobial practices. This study aimed to evaluate temporal shifts in patient demographics, clinical aspects, and microbial pathogen profiles in a tertiary pediatric hospital in Western Romania, spanning pre-pandemic (2019), pandemic (2021), and post-pandemic (2023) periods. Methods: A retrospective observational study was conducted at the “Louis Țurcanu” Emergency Children’s Hospital, Timișoara. Pediatric patients (<18 years) with laboratory-confirmed bacterial infections were included. Data on demographics, hospital wards, sample types, and pathogen distribution were analyzed using Χ² tests, incidence rate ratios (IRR), and non-parametric statistical methods. Results: A total of 3530 patients and 6885 samples were analyzed. Pediatric admissions declined by nearly 50% during the pandemic. The Outpatient and Emergency department observed a decrease in cases, while the ICU and surgical ward cases increased proportionally. Nasal and pharyngeal samples declined during the pandemic, while catheter, blood, and conjunctival samples rose. The study identified a significant shift in pathogen prevalence, with Escherichia coli and Staphylococcus aureus as the most frequent isolates. ICU patients showed increased rates of Pseudomonas aeruginosa, Candida albicans, and Klebsiella pneumoniae. Group A Streptococcus resurged post-pandemic after a decline in 2021. Conclusions: The pandemic significantly impacted pediatric infection profiles, hospital service utilization, and sample collection patterns. Strengthening infection surveillance, ensuring consistent reporting standards, and adapting pediatric care to future crises are critical for improving child health outcomes. Full article

Introduction: This study examined the relationship between Indigenous identity, perceived stress, and healthcare utilization for Indigenous students on-campus. Methods: Potential participants included undergraduate and graduate Indigenous students from Tribal Nations within the United States. Participants were recruited through community partnerships and in person communication. This survey included the Perceived Stress Scale (PSS-10), the Multiethnic Identity Measure (MEIM), and university Campus Health Service Health and Wellness Survey. Results: 153 Indigenous students from United States-based Tribal Nations participated in this survey. While there appears to be a relationship between Indigenous identity, perceived stress, and Campus Health utilization, the results were not significant for the second tertile (OR: 1.1 (0.4, 2.7)) or third tertile (1.4 (0.5, 3.3)). Students who reported “Yes” or “Unsure” to questions on if their insurance needed them to go outside of the university were far less likely to use Campus Health (Yes OR: 0.2 (0.08–0.5)); (Unsure OR: 0.09 (0.03–0.3)) and CAPS (Yes OR: 0.2 (0.09–0.6)); (Unsure OR: 0.2 (0.04–0.4)). Discussion: This study saw a complex relationship between Indigenous identity, perceived stress, and campus health utilization; however, the findings are not statistically significant. There are distinctions in on campus health care usage when adjusting for undergraduate or graduate student status and health insurance literacy. Conclusion: The research findings offer many promising avenues for future work around Indigenous identity, affordability of healthcare, and importance of health literacy. Full article

States like Hawai‘i are decriminalizing psychedelics based on emerging evidence linking their use to improved psychological well-being. Yet, in many cultural contexts, stigma surrounding mental illness may lead individuals to pursue non-traditional forms of healing, including psychedelics, in place of formal care. This study examines how psychedelic use relates to mental health treatment-seeking behaviors among Asians and Native Hawaiians and Other Pacific Islanders (NHOPIs). Using the National Survey of Drug Use and Health (NSDUH) data from 2008 to 2019 (n = 458,372), the analysis compares Non-Hispanic Whites with Asian and NHOPI respondents to assess associations between MDMA and lifetime classic psychedelic use, psychological distress (K6 scale), and formal mental health service utilization. Nested logistic regression models conducted in Stata 18 indicate that psychedelic use among White individuals is associated with a lower likelihood of seeking formal treatment. In contrast, among NHOPI individuals, psychedelic use is associated with increased odds of accessing mental health care. These findings suggest that psychedelic use may serve culturally distinct roles in coping with distress, shaped by structural stigma and the perceived trustworthiness of formal treatment systems. Full article

The World Health Organization estimates that between 10% and 20% of young people worldwide suffer from mental health problems during adolescence, which is a crucial time for many youngsters. Adolescent mental health cases have increased by 31% as a result of the COVID-19 epidemic, which has made the issue much worse. Due to stigma, restricted access, and challenges in evaluating emotional states, traditional mental health care frequently faces challenges. The goal of this research is to create a chatbot system that uses machine learning and natural language processing (NLP) to identify emotional distress and mental health issues in teenagers at an early age. The study offers a safe environment for teenagers to express their emotions while examining chatbot interactions to find trends suggestive of mental health problems. To improve the efficacy of the chatbot, the methodology integrates quantitative and qualitative techniques, utilizing data from open datasets and mental health services. Sentiment analysis and emotion identification are important strategies that enable the chatbot to react sympathetically. By offering easily available support and highlighting the role of technology in addressing adolescent mental health issues, this project ultimately seeks to enhance youth mental health outcomes. Full article

Introduction: Eliminating mother-to-child transmission (EMTCT) of HIV is a global health priority to ensure that no child is born with HIV. When EMTCT services are underutilized, mothers and babies face greater risks, including the vertical transmission of HIV and higher rates of maternal and neonatal mortality. Despite ongoing efforts, many women worldwide still struggle to access and use these vital services. Objective: This study sought to explore barriers and facilitators to the elimination of mother-to-child transmission services among pregnant and breastfeeding women (PBFW) in Gauteng province, South Africa. Methods: A qualitative, explorative, and descriptive research design was used. Convenience and purposive sampling were used to select participants. The study population consisted of PBFW aged 18 years or above who were utilizing EMTCT services. Data was collected through in-depth face-to-face individual interviews with participants. A semi-structured interview guide was used to collect data until data saturation was reached after interviewing 25 participants. Data were analyzed using thematic analysis (Tesch’s open coding method). Trustworthiness and ethical principles were ensured. Results: Four main themes emerged from the data analyzed, namely, barriers associated with EMTCT service utilization, facility-based strategies to improve EMTCT service uptake, community support for enhancing EMTCT engagement, and the role of partner support in service utilization, each with linked sub-themes. This study found that health education about EMTCT, along with community awareness and involvement, encourages the target group to utilize these services. Conclusions: Increasing women’s use of EMTCT services is an important step toward eliminating MTCT and increasing the health and well-being of mothers and their children. Addressing numerous barriers to receiving these services, as well as implementing targeted measures, can help ensure that all women gain access to the care and support that they require to safeguard their families from HIV. Full article

Background: Work-Related Quality of Life (WRQoL) is an essential aspect of the sustainability of the healthcare workforce, intimately connected to employee well-being, job fulfillment, and the standard of patient care. This research sought to evaluate WRQoL among healthcare employees in Greek public hospitals, concentrating on the influence of demographic and work-related factors in a healthcare system affected by prolonged economic and public health crises. Methods: A cross-sectional study was conducted with 1022 staff members from 23 hospitals in the 1st Health Region of Attica, utilizing the validated Work-Related Quality of Life Scale (WRQoL). Data were analyzed using non-parametric tests, including Chi-square and Linear-by-Linear Association analyses. Results: The findings showed that 44.3% of employees experienced low WRQoL, with the lowest ratings found among younger workers, those on temporary contracts, and individuals working in pediatric hospitals. Holding a leadership position, being over 40 years old, and having a permanent job were linked to notably greater well-being and job satisfaction. A significant portion of participants viewed the working conditions and autonomy as insufficient, particularly in demanding institutional environments. Conclusions: These results emphasize the necessity for focused policy measures to enhance working conditions, guarantee job stability, and reinforce organizational support structures. Tackling structural shortcomings in the healthcare system is crucial for protecting workforce stability and the standard of public health services. Full article

Gene therapies that induce the body to produce therapeutic anti-vascular endothelial growth factor (anti-VEGF) proteins are an emerging topic related to neovascular age-related macular degeneration (nAMD). Continuous delivery of anti-VEGF protein directly to the target tissue offers the possibility of lifelong efficacy without the need for repeated and frequent eye injections. This novel approach could revolutionize patient management through optimizing clinical outcomes while simplifying service delivery. However, such gene therapies are anticipated to face unique challenges related to patients’ access and health technology assessment (HTA), and their integration into real-world eyecare practices. This article presents key elements raised at the European Access Academy (EAA) Fall convention (held in Rome in October 2024) regarding anticipated HTA challenges for gene therapies in nAMD. The important role of HTA and policymakers in ensuring that emerging gene therapies are accessible to all eligible patients is also highlighted. This article mainly focuses on the need for a fit-for-purpose EU HTA framework to address the widely varying utilization of standard of care in nAMD clinical practice, and to incorporate considerations about the long-term durability of gene therapies in nAMD. The importance of integrating real-world evidence (RWE) into the EU HTA framework is also discussed. Full article

Background/Objectives: With rapid population aging, concerns about cognitive health—especially mild cognitive impairment (MCI), a prodromal stage of dementia—are growing. Although MCI prevalence is rising, limited empirical evidence exists on changes in healthcare expenditures associated with its diagnosis. This study aimed to assess shifts in medical spending before and after MCI diagnosis and to identify factors influencing healthcare costs among Korean adults. Methods: We used data from the National Health Insurance Service–National Health Information Database (NHIS–NHID) from 2020 to 2022. This study analyzed 4162 Korean adults aged ≤84 who were newly diagnosed with MCI in 2021. Annual healthcare expenditures were tracked from 2020 to 2022. Generalized estimating equations (GEEs) were employed to examine changes over time, adjusting for sociodemographic characteristics, comorbidities, healthcare utilization, and long-term care insurance (LTCI) enrollment. Results: The average annual healthcare expenditure increased from 74,767 KRW before diagnosis to 87,902 KRW after diagnosis, reflecting a 12.51% rise. Regression analysis showed a significant decrease in costs in the year prior to diagnosis (β = −0.117, p < 0.01) and an increase in the year following diagnosis (β = 0.061, p < 0.01). Higher expenditures were associated with greater outpatient visits (β = 0.385, p < 0.01), longer hospital stays (β = 0.039, p < 0.01), LTCI enrollment (non-graded: β = 0.035, p = 0.02; graded: β = 0.027, p = 0.04) and higher comorbidity levels (CCI = 2: β = 0.088, p < 0.01, CCI ≥ 3: β = 0.192, p < 0.01). Conversely, older age (β = −0.003, p = 0.02) and female sex (β = −0.093, p < 0.01) were associated with lower costs. Sex-stratified analyses revealed consistent cost trends but different predictors for male and female patients. Conclusions: Healthcare expenditures rise significantly after MCI diagnosis. Early identification and interventions tailored to patient characteristics—such as age, sex, and comorbidity status—may help manage future costs and support equitable care for older adults. Full article

Telemedicine has transformed obstetrics and gynecology (OB/GYN), accelerated by the COVID-19 pandemic. This study aims to synthesize evidence on the adoption, effectiveness, barriers, and technological innovations of telemedicine in OB/GYN across diverse healthcare settings. This scoping review synthesized 63 peer-reviewed studies (2010–2023) using PRISMA-ScR guidelines to map global applications, outcomes, and challenges. Key modalities included synchronous consultations, remote monitoring, AI-assisted triage, tele-supervision, and asynchronous communication. Results demonstrated improved access to routine care and mental health support, with outcomes for low-risk pregnancies comparable to in-person services. Adoption surged >500% during pandemic peaks, stabilizing at 9–12% of services in high-income countries. However, significant disparities persisted: 43% of rural Sub-Saharan clinics lacked stable internet, while socioeconomic, linguistic, and cultural barriers disproportionately affected vulnerable populations (e.g., non-English-speaking, transgender, and refugee patients). Providers reported utility but also screen fatigue (41–68%) and diagnostic uncertainty. Critical barriers included fragmented policies, reimbursement variability, data privacy concerns, and limited evidence from conflict-affected regions. Sustainable integration requires equity-centered design, robust policy frameworks, rigorous longitudinal evaluation, and ethically validated AI to address clinical complexity and systemic gaps. Full article

Objective: This study aimed to investigate the impact of depression and anxiety disorders on mortality in women diagnosed with gynecologic cancers, utilizing nationwide retrospective cohort data. Methods: Data from the Korean National Health Insurance Service (NHIS) database, covering women diagnosed with cervical, endometrial, or ovarian cancers between 2007 and 2014, were analyzed. Women diagnosed with depression or anxiety disorders within one year after cancer diagnosis were identified and compared with a control group comprising patients with gynecologic cancers who did not develop either disorder during the same post-diagnosis period. Mortality was evaluated as the primary outcome. Results: Of 85,327 women analyzed, 784 (0.9%) were diagnosed with depression or anxiety disorders. Patients with depression or anxiety exhibited significantly higher mortality (38.4% vs. 29.9%; p < 0.001). Multivariate analysis indicated that depression significantly increased mortality risk (OR 1.46, 95% CI 1.27–1.66), whereas anxiety alone showed no significant effect (OR 0.97, 95% CI 0.74–1.27). Combined depression and anxiety showed the highest mortality risk (OR 1.47, 95% CI 1.31–1.65). Conclusions: Depression and anxiety disorders are significant predictors of increased mortality in women with gynecologic cancers, emphasizing the necessity for integrated mental health assessment and interventions in oncologic care to improve both survival and quality of life. Full article