Search Results (4,808)

Background/Objectives: Hypercapnic respiratory failure (HRF) is a serious complication of chronic obstructive pulmonary disease (COPD) and is associated with increased morbidity, mortality, and healthcare utilisation. National HRF trends among patients with COPD remain poorly characterised in Lithuania, and the knowledge of prehospital emergency-care professionals regarding oxygen therapy and hypercapnia has not been evaluated. Methods: This study comprised two components. First, a cross-sectional online survey assessed knowledge of COPD, hypercapnia, and oxygen therapy among prehospital emergency-care professionals (EMS physicians, emergency nurses, EMS paramedics, and paramedics); three questionnaire items whose designated correct answers could not be unambiguously supported were excluded from the knowledge score, and the original 10-item score was retained as a sensitivity analysis. Second, nationwide electronic health record data from the Lithuanian national health record system (ESPBI IS, 2020–2023) were analysed retrospectively: patients with COPD and concomitant chronic HRF were identified using ICD-10-AM diagnostic codes, and the number of patients with a recorded J96.11 diagnosis irrespective of underlying disease was obtained as a national denominator. Proportions are reported with 95% confidence intervals and temporal trends as absolute changes in percentage points; multivariable logistic regression was used to estimate odds ratios adjusted for age group and sex. Between-year differences were tested using the χ² test with Holm-adjusted pairwise comparisons, and the association between sex and chronic HRF was expressed as an odds ratio. All tests were two-sided, and p < 0.05 was considered significant. Results: Among the 65 prehospital emergency-care professionals surveyed, knowledge of hypercapnia was relatively high: 78.5% (95% CI 67.0–86.7) correctly defined it and 72.3% (95% CI 60.4–81.7) identified its symptoms, whereas 58.5% (95% CI 46.3–69.6) identified the recommended SpO₂ target range of 88–92%. Respondents answered a median of 5 of the 7 scored knowledge items correctly (IQR 4–6). Total knowledge scores differed by professional role (p = 0.034) but not by years of experience, sex, or frequency of COPD contact; the sensitivity analysis using the original 10-item score gave the same pattern (p = 0.006). In the national electronic health record data, the COPD population increased from 27,239 to 32,446 (+19.1%) between 2020 and 2023, while the number of COPD patients with a recorded chronic HRF diagnosis rose from 160 to 291 (+81.9%). The proportion rose from 0.59% (95% CI 0.50–0.69) to 0.90% (95% CI 0.80–1.01), an absolute increase of 0.31 percentage points (95% CI 0.17–0.45; risk ratio 1.53, 95% CI 1.26–1.85). Men had higher odds than women after adjustment for age (adjusted OR 1.55, 95% CI 1.28–1.88), and adjusted odds were lowest in patients aged 80 years or older. Across the four annual cross-sections, COPD accounted for 41.5% of patient-year observations with a recorded J96.11 diagnosis nationally. Conclusions: Knowledge of COPD, hypercapnia, and oxygen therapy varied among the prehospital emergency-care professionals surveyed, with one of the lowest proportions of correct responses observed for the recommended target oxygen saturation range. National electronic health record data showed an increase in the proportion of patients with COPD who had a recorded diagnosis of chronic HRF between 2020 and 2023. These components were analysed independently, and no relationship between professional knowledge and temporal trends in recorded diagnoses was assessed. The electronic health record findings support continued monitoring and recognition of chronic HRF in COPD, whereas the survey findings support further evaluation of targeted education on oxygen therapy in the prehospital setting. Full article

Background: Exercise is a cornerstone of axial spondyloarthritis (axSpA) management, yet real-world adherence to physical activity (PA) recommendations and patient preferences for exercise delivery remain insufficiently characterized. This study aimed to compare PA levels, World Health Organization (WHO) aerobic PA guideline compliance, and exercise preferences between patients with axSpA and age and sex-matched healthy controls. Methods: A total of 153 patients with axSpA and 153 age- and sex-matched healthy controls were recruited from a tertiary rheumatology clinic. PA was assessed using the International Physical Activity Questionnaire-Short Form. Compliance with WHO aerobic PA recommendations was defined as achieving ≥150 min/week of moderate-intensity PA including walking, ≥75 min/week of vigorous-intensity PA, or an equivalent combination. Disease activity, function, quality of life, kinesiophobia, fibromyalgia, neuropathic pain, psychological status, and exercise preferences (adapted from the Personalized Exercise Questionnaire) were also recorded, and logistic regression identified factors associated with compliance among axSpA patients. Results: Total IPAQ-SF MET-min/week scores were comparable between groups, but vigorous-intensity activity was lower in axSpA (p = 0.012). Fewer patients with axSpA met WHO aerobic PA recommendations than controls (60.1% vs. 71.2%, p = 0.041) and this gap was most evident among women (43.4% vs. 75.5%, p = 0.002) but not among men, with a significant axSpA status × sex interaction (p = 0.008). Among patients with axSpA, female sex and higher kinesiophobia scores were independently associated with lower odds of meeting the WHO aerobic PA recommendations. Patients with axSpA also showed distinct exercise preferences including greater preference for health-professional supervision, home-based exercise, and regular feedback. Conclusions: Patients with axSpA had lower adherence to WHO aerobic PA recommendations than healthy controls. Among patients with axSpA, female sex and higher kinesiophobia were associated with lower adherence. These findings highlight the importance of considering sex-related differences, kinesiophobia, and individual exercise preferences when developing personalized strategies to promote PA in axSpA. Full article

Background and Objectives: Rare diseases collectively affect large populations and require coordinated, patient- and caregiver-informed health and social support. This study had an overarching descriptive objective to characterize patient- and caregiver-reported experiences of living with rare diseases in Türkiye and a secondary exploratory objective to assess differences across broad disease categories. Materials and Methods: This cross-sectional, anonymous, voluntary non-probability online survey recruited affected individuals and relatives/caregivers through patient-organization networks. The 44-item questionnaire covered sociodemographic and caregiving context, diagnostic experiences, psychosocial support, healthcare access, and service-improvement priorities. Descriptive analyses, exploratory disease-group comparisons, Cramér’s V, and selected multivariable logistic regression models were used. Results: A total of 1642 responses were analyzed; 76.7% were completed by relatives/caregivers, and 66.4% concerned patients younger than 18 years. Among participants diagnosed after symptom onset (n = 1388), 34.4% reported an incorrect or alternative diagnosis and 64.0% sought at least one additional specialist opinion. Psychosocial support was needed by 74.2%, whereas 34.5% reported receiving professional support. Access to current treatment services was perceived as moderately adequate by 29.3% and adequate by 13.0%. The leading service-improvement priorities were increasing healthcare professionals’ knowledge (82.9%) and establishing specialized rare-disease centers (79.5%). Conclusions: This patient-organization-recruited survey provides a large descriptive account of the experiences and priorities reported by participating patients and caregivers. The findings identify perceived priorities, particularly clinician education and specialized centers, while not constituting nationally representative estimates. Full article

Objectives: To assess the knowledge, attitudes, and intended practices (KAP) of pulmonary tuberculosis (PTB) patients regarding the disease and home-based treatment. Methods: A cross-sectional study was conducted at the authors’ hospital from 1 September 2024 to 28 February 2025, using a self-designed KAP questionnaire. Differences in KAP scores across demographic subgroups were analyzed, and the associations among knowledge, attitude, and practice were examined. Results: A total of 509 valid responses were included (effective rate: 90.73%). Participants were predominantly male (56.6%) and rural residents (68.0%). Their mean (SD) knowledge, attitude, and intended practice scores were 26.20 (2.90) (possible range: 15–30), 32.09 (4.14) (possible range: 9–45), and 35.89 (5.57) (possible range: 8–40), respectively. Correlation analysis showed significant but relatively weak positive correlations between knowledge and attitude (r = 0.257, p < 0.001), knowledge and intended practice (r = 0.136, p = 0.002), and attitude and intended practice (r = 0.251, p < 0.001). Multivariate logistic regression revealed that knowledge score (OR = 1.098, p = 0.007) and attitude score (OR = 1.094, p < 0.001) were independently associated with better intended practice. Living in rural areas (OR = 0.633, p = 0.043) and being government/enterprise/public institution staff (OR = 0.386, p = 0.004) were independently associated with lower intended practice scores. Conclusions: These findings highlight that higher levels of knowledge among PTB patients are positively associated with more favorable attitudes and better anticipated self-management practices. These associative findings generate the hypothesis that targeted educational interventions, especially among populations with lower education levels or non-urban backgrounds, might improve expected home-based treatment adherence, which warrants validation in future longitudinal studies. Full article

Aims: International diabetes guidelines recommend inpatient glycaemic management protocols for bolus enteral feeding in people with diabetes to improve clinical outcomes. This study aims to evaluate before and after hospital-wide implementation of an inpatient bolus enteral feeding protocol: (1) the incidence of hyperglycaemia (>13.9 mmol/L) and hypoglycaemia (<4.0 mmol/L), (2) medication prescribing practices and capillary blood glucose monitoring and (3) health care professionals’ knowledge and confidence levels. Methods: We implemented an inpatient glycaemic management protocol for bolus enteral feeding developed by a multidisciplinary team of diabetes nurse educators and endocrinologists and approved by the institutional medical board in July 2024. This before-and-after quality improvement study was conducted over 3 months across eight inpatient wards. Adult inpatients were consecutively enrolled if they met the inclusion criteria: (1) a documented diagnosis of diabetes mellitus, (2) receiving bolus enteral feeding and (3) treatment with glucose-lowering medication. Patients listed as critically ill were excluded. Nurses working in the pilot wards were also recruited. Before implementing the protocol, diabetes nurse educators trained inpatient nurses on understanding and executing the protocol for administering capillary blood glucose monitoring and medications for patients with diabetes on enteral feeding. Nurses’ pre- and post-knowledge levels and perceived confidence were assessed using a structured questionnaire. Electronic medical records were reviewed to evaluate the incidence rates of hypoglycaemia and hyperglycaemia before and during the 3 months following protocol implementation. We also assessed adherence to protocol-recommended capillary blood glucose monitoring frequencies based on the diabetes medication regimen. Results: A total of 31 patients were observed during the 6-week baseline period and 28 patients following protocol implementation. A total of 192 clinical care episodes were audited, comprising 78 in the pre-intervention phase and 114 in the post-intervention phase. The incidence of hyperglycaemia decreased from 43.6% to 10.5%, while hypoglycaemia decreased from 3.8% to 2.6%. After adjusting for protocol adoption rates, protocol implementation was associated with significantly lower odds of hyperglycaemia (odds ratio [OR] 0.22, 95% CI [0.07, 0.65], p = 0.006). A significant increase in appropriate nursing practices was observed post-intervention (p < 0.001). Adoption of the protocol by nurses decreased the odds of hyperglycaemia by 70% (p = 0.014). Nurses’ knowledge scores improved significantly from baseline to 3 months post-implementation (p < 0.001). Conclusions: Implementation of a standardised inpatient glycaemic management protocol for PWD receiving bolus enteral feeding was associated with reduced rates of hyperglycaemia and hypoglycaemia. Larger-scale studies are warranted to evaluate the effectiveness and sustainability of wider implementation in improving clinical outcomes. Full article

Background/Objectives: Diet is a key modifiable determinant of mental health; however, the prospective association between dietary patterns and new-onset suicidal ideation remains poorly elucidated. Methods: We enrolled 7480 participants from demolition resettlement communities in Jining, Zoucheng, and Weifang in Shandong Province, China, during 2021–2023. Data were used from two waves (baseline and 1-year follow-up) in this study. Dietary patterns were determined using principal component analysis based on food frequency questionnaire data. Incident suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Multivariable logistic regression, stratified analysis, and sensitivity analysis were used to examine associations of different dietary patterns with the risk of incident suicidal ideation. Results: Among participants, 193 (2.58%) reported incident suicidal ideation. After full multivariable adjustment, the livestock–poultry–seafood dietary pattern was significantly inversely associated with incident suicidal ideation (Q3 vs. Q1; odds ratio = 0.67; 95% confidence interval: 0.45–0.97), whereas no significant association was identified when the pattern score was modelled continuously (OR = 0.92; 95% CI: 0.79–1.06; p = 0.239). Stratified analyses revealed stronger inverse associations among men, older adults, overweight individuals, and participants who did not use dietary supplements, but all interaction p-values exceeded 0.05, with no statistically confirmed subgroup disparities. After excluding participants with baseline depression, participants with baseline anxiety, and individuals with missing covariates in sensitivity analysis, the inverse association remained statistically stable. Conclusions: Our findings suggested a modest inverse association between higher adherence to the livestock–poultry–seafood dietary pattern and new-onset suicidal ideation in this observational cohort. Full article

Background/Objectives: This study examines gender differences in the relationship between multidimensional poverty and depression among single-parent families, drawing on the concepts of the feminization of poverty and dual vulnerability to inform gender-sensitive policy. Methods: Using a cross-sectional design, this study analyzed data from the 2024 Korean National Survey on Single-Parent Families, with a sample size of 3315 single-parent families. Multidimensional poverty was assessed across five domains: income, employment, housing, health, and social relations. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). Results: Poverty levels were highest in income, followed by housing, health, social relations, and employment. Female single parents experienced significantly higher poverty in income, employment, and social domains compared to males, while male single parents showed higher asset poverty. The proportion of respondents in the depressed group did not differ significantly by gender, though male and female single parents reached this similar overall level through partly different configurations of risk. Employment, health, and discrimination were common predictors of depression across genders, while lower education was an additional risk factor specific to female single parents. Depression scores rose in a linear, dose-dependent manner with the accumulation of multidimensional poverty for both genders, with a formal test indicating no significant overall difference in this pattern by gender. Conclusions: The findings suggest a critical need to shift policy from simple cash transfers to an integrated, multidimensional paradigm encompassing housing, employment, health, and stigma reduction. Policy interventions must prioritize gender-sensitive approaches tailored to the distinct risk configurations identified for male and female single parents. Full article

Background: Radiology and ultrasound technologists are exposed to sustained static postures, repetitive movements, equipment handling, and patient-positioning tasks that increase the risk of work-related musculoskeletal disorders (WRMSDs). During Ramadan, increased healthcare demand associated with Umrah may further increase occupational workload in Madinah. Objective: To estimate the 7-day prevalence of WRMSDs and identify occupational factors associated with pain intensity among radiology and ultrasound technologists working during Ramadan in Madinah. Methods: A cross-sectional online survey was conducted among 237 radiology and ultrasound technologists working in Madinah during Ramadan 1447/2026. Participants were recruited using online convenience and snowball sampling through professional networks and social-media platforms. The survey included the Nordic Musculoskeletal Questionnaire (NMQ), a 0–10 Numeric Pain Rating Scale (NPRS), and demographic and occupational variables. Bivariate analyses and multivariable linear regression with robust standard errors were used to examine factors associated with pain intensity. Results: Overall, 89.5% of participants reported WRMSDs during the preceding 7 days. The lower back (56.5%) and neck (40.5%) were the most affected regions. Mean pain intensity was 5.55 ± 2.28. Higher pain intensity was associated, after adjustment for the variables included in the model, with older age, working as an ultrasound technologist, managing 11–20 or more than 30 patients per shift, and frequent night-shifts, with the strongest association observed among participants working at least three-night-shifts per week (B = 3.27, 95% CI 2.43–4.10). BMI, sex, years of experience and shift duration were not independently associated with pain intensity after adjustment. Conclusions: WRMSDs were highly prevalent among radiology and ultrasound technologists working during Ramadan in Madinah. Night-shift frequency and very high patient workload showed the largest occupational associations with pain intensity. These findings identify workload distribution and night-shift scheduling as potential areas for occupational health evaluation during periods of increased healthcare demand. Because of the cross-sectional design, the findings should be interpreted as associations rather than causal effects. Full article

Background/Objectives: This study evaluated the real-world effectiveness and safety of intranasal esketamine plus oral antidepressants compared with venlafaxine-based oral antidepressant therapy in adults with moderate-to-severe treatment-resistant depression (TRD). Methods: This retrospective cohort study used electronic medical records from a mental health hospital between January 2023 and December 2025. Adults with moderately severe or severe major depressive disorder who had not responded adequately to at least two antidepressant trials received esketamine plus oral antidepressants or venlafaxine-based therapy. The outcomes were changes in the Patient Health Questionnaire-9 (PHQ-9) score, remission, response, minimal clinically important difference (MCID) without response or remission, and documented adverse events at 28 days, 3 months, and 6 months. Propensity score matching was used for continuous follow-up of the PHQ-9 outcomes. Results: The analytic baseline cohort included 82 patients treated with intranasal esketamine-based therapy and 87 treated with venlafaxine-based therapy. The esketamine group had greater baseline depression severity and more previous antidepressant failures. At 3 months, no patients who continued treatment in either group met the remission criterion, one esketamine-treated patient achieved a response, and 37/61 (60.7%) esketamine-treated patients and 23/72 (31.9%) venlafaxine-treated patients achieved MCID without response or remission. At 6 months, remission remained absent; 27/61 (44.3%) esketamine-treated patients and 9/72 (12.5%) venlafaxine-treated patients met the response criterion, whereas 34/61 (55.7%) and 63/72 (87.5%) achieved MCID without response or remission, respectively. In propensity score-matched analyses, follow-up PHQ-9 scores were 1.02 points lower at 3 months (average treatment effect [ATE], −1.02; 95% CI, −1.70 to −0.35; p = 0.003) and 1.94 points lower at 6 months (ATE, −1.94; 95% CI, −3.17 to −0.71; p = 0.002) in the esketamine group than in the venlafaxine group. Dissociation and dizziness were documented more often in the esketamine group, whereas sexual dysfunction was documented more often in the venlafaxine group. Conclusions: In this retrospective routine care cohort, esketamine was used in patients with more complex TRD and was associated with modestly lower matched follow-up PHQ-9 scores. The observational design, baseline imbalance, and attrition precluded causal conclusions. Full article

Background: Although nurses’ health-related quality of life (HRQoL) is critical for mitigating the growing intention to leave the profession, the association between nurse–patient mutuality and nurses’ HRQoL remains unexplored. Therefore, this study aims to examine the association between nurse–patient mutuality and nurses’ HRQoL. Methods: A cross-sectional, multicentre study was conducted across four tertiary hospitals in Italy. Data were collected from a sample of 726 nurses working in medical and surgical inpatient and outpatient wards. Mutuality was measured using the Nurse–patient Mutuality in Chronic Illness scale, comprising three dimensions: developing and going beyond, being a point of reference, deciding and sharing care; HRQoL was assessed via the Short Form-12 Health Status Questionnaire (SF-12), providing Physical (PCS) and Mental (MCS) Component Summaries. Two multiple linear regression models were conducted to evaluate the impact of mutuality dimensions on HRQoL components. Results: Among the 726 participants, none of the three mutuality dimensions were significantly associated with physical HRQoL (PCS). Conversely, two mutuality dimensions were significantly and positively associated with higher MCS scores: developing and going beyond (B = 0.54, 95% CI [0.14, 0.95], p = 0.009) and being a point of reference (B = 0.38, 95% CI [0.09, 0.68], p = 0.010). However, the overall regression model demonstrated a modest explanatory value for MCS (R² = 0.075). Among covariates, female sex (ref: male; B = −2.29, 95% CI [−4.10, −0.49], p = 0.013) and taking care of relatives (B = −2.07, 95% CI [−3.55, −0.60], p = 0.006) were associated with lower MCS, whereas older age (B = 0.17, 95% CI [0.01, 0.34], p = 0.039) was related to higher MCS. Regarding physical health (R² = 0.261), having chronic conditions (B = −5.08, 95% CI [−6.48, −3.69], p < 0.001), previous experience as a patient (B = −1.88, 95% CI [−3.07, −0.69], p = 0.002), and taking care of relatives (B = −1.49, 95% CI [−2.62, −0.36], p = 0.010) were significantly associated with lower PCS scores. Conclusions: The reciprocal nature of mutuality could be a potential relational resource for nurses’ mental HRQoL. Healthcare organizations should prioritize structural frameworks and interventions that allow nurses the time and resources to cultivate these essential clinical connections. Full article

Objective: Subcostal uniportal robot-assisted thoracic surgery (URATS) using the da Vinci Single-Port (SP) system avoids intercostal placement of the main robotic access. This prespecified secondary analysis of a prospective trial characterized chronic postsurgical pain and health-related quality of life (HRQOL) as primary patient-reported outcomes after subcostal URATS for early-stage lung cancer, with mid-term oncological outcomes as an exploratory endpoint. Methods: Patients from the parent trial (NCT05535712) undergoing subcostal URATS were assessed at 3, 6, and 12 months by structured telephone interviews. Chronic postsurgical pain was defined by the ICD-11 criterion (Numerical Rating Scale [NRS] > 0 on any of four activity-specific items). Neuropathic features were assessed with the painDETECT Questionnaire (PDQ), and HRQOL with EORTC QLQ-C30 summary score and selected domains. Results: In 33 patients, chronic postsurgical pain declined from 33.3% at 3 months to 6.1% at 12 months (p = 0.004), was mild among symptomatic patients (median NRS 1), and showed no PDQ-defined neuropathic features. Two patients received a 7-day course of gabapentin at 3 months. Baseline HRQOL (median QLQ-C30 summary score 91.5) increased at all postoperative time points (p < 0.001). At a median 40-month follow-up, one patient had bilateral pulmonary recurrence at 13 months, all remained alive, and no delayed hernia or other access-related complication was identified. Conclusions: Subcostal URATS was feasible in this prospective cohort. Chronic postsurgical pain was mild and decreased over time, HRQOL remained well preserved, although data on mid-term oncological outcomes were preliminary. Full article

Background: Depression is a major global health burden, requiring culturally appropriate assessment instruments, but no validated Kazakh-language version of the Patient Health Questionnaire-9 (PHQ-9) is available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Kazakh PHQ-9 in a community-based, non-clinical sample. Methods: This cross-sectional study included 503 Kazakh-speaking adults (mean age = 24.0 years, SD = 10.1; 51.3% women and 48.7% men) who completed the Kazakh PHQ-9 and Generalized Anxiety Disorder-7 (GAD-7) questionnaires. Internal consistency, structural validity, measurement invariance across genders, and convergent validity were assessed. Results: Internal consistency was excellent (Cronbach’s α = 0.91), and both one-factor and correlated two-factor models showed excellent fit (CFI = 0.998; TLI = 0.997–0.998; RMSEA = 0.046–0.048; SRMR = 0.050–0.052), with a slightly better fit for the latter. Measurement invariance across genders was supported, and PHQ-9 and GAD-7 scores were strongly correlated (r = 0.68, p < 0.001). Conclusions: The Kazakh PHQ-9 demonstrated excellent internal consistency and structural validity, measurement invariance across genders, and strong convergent validity in this non-clinical sample. These findings support its use for assessing depressive symptoms in Kazakh-speaking adults. Clinical validation is needed to establish diagnostic validity and screening performance. Full article

Background/Objectives: Burnout is an important occupational health concern among orthopedic and traumatology physicians. This study aimed to evaluate the individual dimensions of burnout and identify their demographic and occupational correlates among orthopedic and traumatology physicians practicing in Türkiye. Methods: This cross-sectional study used an anonymous online survey distributed through the Turkish Society of Orthopaedics and Traumatology electronic mailing group between October 2024 and June 2026. Burnout was assessed using the Turkish adaptation of the 22-item Maslach Burnout Inventory, comprising the Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales. Unadjusted group comparisons, Spearman correlation analyses, and separate multivariable linear regression models with HC3 heteroscedasticity-consistent standard errors were performed. Results: A total of 320 complete questionnaires were analyzed. The mean EE, DP, and PA scores were 20.17 ± 6.83, 7.40 ± 3.58, and 20.37 ± 4.19, respectively. The subscale scores were analyzed as continuous dimensions rather than classified using low-, moderate-, or high-burnout thresholds. In unadjusted comparisons, residents had higher EE and DP scores and lower PA scores than specialists. After adjustment, resident status remained associated with higher DP (B = 2.14, p = 0.010) and lower PA (B = −1.92, p = 0.018). Seeing more than 120 patients per day was associated with higher EE (B = 4.22, p = 0.023) and DP (B = 2.49, p = 0.018), while working more than 100 h per week was associated with higher EE (B = 4.47, p = 0.009). Individual predictor effect sizes and the explanatory power of the models were generally modest. Conclusions: Daily patient volume, weekly working hours, and professional status showed distinct associations with the individual dimensions of burnout. These findings suggest that workload organization and support for resident physicians warrant consideration. However, because of the cross-sectional design and voluntary non-probability sampling, the findings should not be interpreted as causal or nationally representative. Full article

Background/Objectives: Lifestyle modification is central to non-alcoholic fatty liver disease, now termed metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD), yet comparable health-promoting lifestyle (HPL) data for patients and family members are limited. This study compared two independent samples and examined psychosocial correlates. Methods: Two convenience samples recruited at one tertiary hospital were analyzed: 305 adults with NAFLD/MASLD and 299 adult family members of affected patients. A self-administered electronic questionnaire comprised the Health-Promoting Lifestyle Profile II (HPLP-II), the Self-Rated Abilities for Health Practices scale, autonomous-motivation items from the Treatment Self-Regulation Questionnaire, the Medical Outcomes Study Social Support Survey, and sociodemographic items. Group comparisons used parametric and non-parametric tests. HPL correlates were examined using complete-case regression, HC3 inference, and rank-based sensitivity analysis. Cross-sectional indirect-association decompositions used 5000 bootstrap resamples. Results: HPLP-II scores were 102.2 ± 17.5 in patients and 104.2 ± 17.4 in family members (p = 0.171; Mann–Whitney p = 0.166); the adjusted patient-minus-family difference was −1.14 (HC3 95% CI −3.89 to 1.60; p = 0.413). Physical activity was the lowest-scoring dimension. Self-efficacy was the most robust correlate in both samples; social support was associated in the primary models but weakened under rank transformation in family members. Group-by-correlate interactions were not significant. Exploratory indirect associations through self-efficacy were 0.355 (95% bootstrap CI 0.234–0.512) in patients and 0.163 (0.071–0.287) in family members; reverse-order models were also non-zero. Conclusions: The independent unmatched samples reported similar moderate, physically inactive lifestyles. The results identify associations, not shared-household effects or causal mechanisms; objectively characterized, dyad-matched longitudinal studies are needed. Full article

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that significantly impairs patients’ quality of life. Antispasmodics such as mebeverine and otilonium bromide (OB) are commonly used as first-line therapies; however, comparative evidence regarding their effectiveness and safety profile remains limited. This study aimed to compare short-term changes in health-related quality of life and the occurrence of adverse events among IBS patients receiving mebeverine or otilonium bromide. A prospective cohort study was conducted from December 2024 to July 2025 among 110 IBS patients meeting the Rome IV criteria who received either mebeverine 200 mg or OB 40 mg twice daily for 4 weeks. The IBS-specific quality-of-life questionnaire (IBS-QOL) was interviewer-administered at baseline and after treatment (week 4). Adverse drug events were documented and classified according to the Common Terminology Criteria for Adverse Events (CTCAE). After 4 weeks, significant within-group improvements in the overall IBS-QOL score and most domain scores were observed in both treatment groups. In the unadjusted between-group analysis, the mean improvement in the overall IBS-QOL score was greater in the mebeverine group than in the otilonium bromide group (20.31 ± 13.17 vs. 14.62 ± 14.61; p = 0.034). However, treatment group was not independently associated with change in the overall IBS-QOL score after multivariable adjustment (OB vs. mebeverine: B = −4.63, 95% CI −10.28 to 1.02; p = 0.107). Nominal differences in activity interference and health worry did not remain statistically significant after Holm correction for multiple domain-level comparisons. Adverse events occurred in 9 of 110 patients (8.2%), with no significant difference between the mebeverine and otilonium bromide groups (11.7% vs. 4.0%; Fisher’s exact p = 0.178). All reported events were mild. In this prospective observational cohort, both mebeverine and otilonium bromide use was associated with short-term improvement in health-related quality of life and low rates of mild adverse events. Although the unadjusted change in the overall IBS-QOL score favored mebeverine, the adjusted analysis did not establish an independent difference between the two treatments. Full article