Band 6, Heft 1

Polycystic ovary syndrome (PCOS) can negatively affect health and well-being. This study aimed to assess quality of life, use of self-management strategies, stress, anxiety, and depression in people with PCOS, and the effect of body mass index (BMI) on these factors. An online survey was distributed on PCOS social media sites and email listservs. Categorical data were analyzed as counts and percentages. Relationships between BMI and scores for PCOS quality of life (PCOSQ), use of diet and physical activity self-management strategies, perceived stress scale, and hospital anxiety and depression scale were analyzed using simple linear regression analyses. Significance was set at p < 0.05. The median BMI of participants ( n = 101) was 33.12 kg/m 2 . PCOSQ scores were similar across BMI groups for many domains. Linear regression analyses revealed that BMI predicted variation in weight and hirsutism scores. Self-management scores were low for all BMI groups. Linear regression analyses revealed no significant relationships between BMI and scores for self-management strategy categories. Most participants had moderate stress ( n = 55, 59.8%), abnormal anxiety ( n = 50, 56.2%), and normal depression ( n = 48, 53.9%) levels. Linear regression analyses revealed no significant relationships between BMI and these scores. Individuals of all body sizes with PCOS may experience quality of life disruptions and mental health concerns and may utilize dietary and physical activity self-management strategies at a low level. In PCOS, quality of life and mental health concerns should be assessed, in addition to metabolic impacts, and an individualized approach to increasing the use of self-management strategies should be implemented.

Diabetes mellitus is a metabolic, non-communicable disease characterized by elevated blood glucose levels resulting from defects in insulin function, secretion, or both. Nigeria has a National Guideline on the Prevention, Control, and Management of Diabetes Mellitus. The guideline was developed in 2021 for healthcare practitioners and facilities to enhance their standard of care for diabetic patients, thereby enhancing the management and control of diabetes in Nigeria. Diabetes accounts for 1.52% of the total deaths in Nigeria. Given the high prevalence of diabetes in the country, there is a need for a national policy on diabetes care. This study evaluates the challenges associated with the formulation and implementation of a diabetes care policy in Nigeria. Identified challenges include inadequate funding of the healthcare system, insufficient human resources, poor health infrastructure, corruption, and low socioeconomic status. This study highlights and alerts policymakers to the challenges associated with diabetes, including its economic burden, the specific obstacles in formulating and implementing diabetes healthcare policy in Nigeria, and how this policy could help ameliorate the rising cases of diabetes in Nigeria. The study recommends that the government prioritize increased healthcare funding, human resource development, and infrastructure improvement while addressing corruption and implementing targeted interventions to improve socioeconomic conditions.

Sleep is essential for the homeostasis of various brain and body functions. Timing, duration, and composition of sleep are controlled by internal oscillators. In modern society, sleep timing is largely dictated by environmental factors. There is increasing evidence that a severe mismatch between internal sleep needs and external demands leads to circadian misalignment, which is detrimental to physical and mental health. The aim of the present study was to examine relationships between the amount and timing of sleep/sleep stages on weekdays, body mass index (BMI), and psychosocial stress due to perceived workload in a relatively homogeneous cohort of young and lean healthy adults. We used longitudinal real-life Fitbit (Inspire) sleep data in combination with a questionnaire among first-year medical students ( n = 59) and conducted correlation-based network analysis. BMI was within the normal weight range in the sample. A stronger temporal alignment between rapid eye movement (REM) sleep and total sleep and a higher individual variability of sleep timing was associated with higher BMI, which was associated with lower subjective workload. Our data suggest an interaction between sleep timing, in general, and REM sleep timing, in particular, with metabolic homeostasis and resilience to psychosocial stress.

Introduction Practicing physical activity (PA) on a regular basis is an important support for people with type 1 diabetes (T1D). However, exercise may induce in them hypoglycaemic events during or after it. One major consequence of this is that, to limit this risk, many people with T1D tend to avoid performing PA. The availability of modern continuous glucose-monitoring (CGM) devices is potentially a great asset for reducing the chances of hypoglycaemia (HP) due to PA. Several algorithms have already been proposed to predict HP in subjects with T1D. However, not many of them are specifically focused on HP induced by exercise. Among those, many involve a large number of covariates making the applicability more difficult, and none uses CGM values available during the training session. Objectives We study the problem of predicting hypoglycaemia events in subjects with T1D during PA. The final aim is to produce algorithms enabling a person with T1D to perform a planned PA session without experiencing HP. Method One of the two algorithms we developed uses the CGM data in an initial part of a PA session. A parametric model is fitted to the data and then used to predict a possible HP during the remaining part of the session. Our second algorithm uses the CGM value at the start of a session. It also relies on statistical information about the average rate of decrease of the aforementioned model, as derived from a previously measured CGM data during PA. Then, the algorithm estimates the probability of HP during the planned PA session. Both algorithms have a very simple structure and therefore are of wide applicability. Results The application of the two algorithms to a very large dataset shows their very good ability to predict HP during PA in people with T1D.

Introduction Daytime sleepiness in the professional driving industry may affect the safety of drivers at work. Fatigue and obstructive sleep apnoea–hypopnoea syndrome are the most common causes that lead to daytime sleepiness. Purpose The aim of this study is to investigate daytime sleepiness as a possible cause of occupational accidents in professional drivers. Materials and methodology The Epworth Sleepiness Scale was used to measure sleepiness in 70 professional drivers of different ages, working on both national and international routes. Drivers answered a questionnaire exploring demographic data, as well as an Epworth Sleepiness Scale questionnaire. Data were analysed using the SPSS ® Statistical Data Editor 2019 statistical programme, with a 5% level of significance. Results Of the studied samples, 50% of the drivers operate on national routes and the other 50% operate on international routes. Nearly half of them (47.1%) work during lunch hours while they rest mostly in the evening. Eight percentage of the drivers suffer from a disease, and 38.6% have 10–15 years of experience. Drivers work an average of 6.91 h and sleep 6.34 h per day, with 37.1% reporting sleeping on the job. The study’s results suggest that there is no statistically significant correlation between sleepiness and the type of route they travel ( p -value = 0.142). Conclusions Daytime sleepiness is a common cause of road accidents, but this study does not confirm a correlation in specific routes. Although the work involves demanding schedules and routes, Greek professional drivers are perceived as being responsible, focused, and concentrated, which help them to stay alert.

Background and objectives Falls are a leading cause of death and disability for adults aged 65 and older, despite the availability of evidence-based interventions to decrease fall risk. We sought to assess public awareness of falls in the United States (US), including when falls are most likely to occur. Methods An online survey was distributed to US adults aged 18 or older. Results A total of 1,069 individuals agreed to be contacted for the study, and 966 (90.4%) of them participated in the study. The largest proportion of participants believed that falls are most likely to occur at night (41.2%). Most of the participants correctly identified falls as preventable (97.9%) and recognized homes as the primary location (94.8%). Participants understood the increased risk of subsequent falls after a single fall (97.4%) and the low rate of informing doctors after a fall (82.9%). However, many were unaware that falls are not a normal part of aging (58.8%), one in four older adults fall annually (58.0%), most falls do not cause injury (60.8%), or that $50 billion is the annual cost of falls (96.3%). Conclusions This study reveals gaps in public awareness of fall epidemiology and severity among older adults. Contrary to common belief, falls occur predominantly during morning and afternoon hours, not in the evening or at night. While most respondents correctly identified falls as preventable, many erroneously considered them an inevitable consequence of aging. Additionally, the actual medical costs of falls far exceed public estimates. These findings underscore the need for targeted public health interventions to address misconceptions and enhance the awareness of fall risks and prevention strategies.

Introduction This study addresses a gap in understanding psychological stress, perceptions as well as its determinants among urban poor populations during the Covid-19 pandemic in Sylhet, Bangladesh. Methodology Data were collected through structured questionnaires administered to a total of 408 respondents and focused on the participants’ perceptions of Covid-19 and their levels of psychological stress. Logistic regression analysis was employed to determine the factors contributing to elevated psychological stress levels among the urban poor. Results The survey revealed significant economic vulnerabilities among the urban poor. Specifically, unemployment rates were 18.45% in Sylhet, 18.45% in Moulvibazar, 16.67% in Habiganj, and 23.53% in Sunamganj. A substantial proportion reported very low monthly household incomes (less than 5,000 Tk): 25.24% in Sylhet, 23.30% in Moulvibazar, 10.78% in Habiganj, and 15.38% in Sunamganj. A majority reported having no alternative source of income: 71.84% in Sylhet, 66.02% in Moulvibazar, 63.73% in Habiganj, and 70.19% in Sunamganj. Regarding perceptions of Covid-19 mitigation, belief in the effectiveness of isolation and treatment of infected individuals varied across districts: 81.55% in Sylhet, 54.08% in Moulvibazar, 22.55% in Habiganj, and 35.58% in Sunamganj. The logistic regression analysis indicated that urban poor individuals without alternative income sources experienced significantly higher levels of psychological stress compared to those with alternative income. Conclusion The findings suggest that the absence of alternative income sources is a significant predictor of increased psychological stress and government interventions prioritize mental health support and economic safety nets for urban poor, focusing on addressing stress within this study group.

Background The coronavirus disease 2019 pandemic disproportionately impacted mental health and relationship satisfaction, particularly among individuals from lower socioeconomic status (SES) backgrounds. Aim The aim of this study is to examine the relationship between the pandemic and mental health outcomes (depression, anxiety, substance use, and psychological distress) using a mediated moderation analysis. Method Secondary data analysis was conducted using data from a state-wide screening, brief intervention, and referral to treatment project, with 1,718 participants throughout Rhode Island, United States. The Client Outcome Measures for Discretionary Programs tool was administered during interviews. A mediated moderation model assessed the pandemic’s impact (independent variable), relationship satisfaction (mediator), and SES (moderator) on five outcomes: alcohol use, cannabis use, anxiety, depression, and psychological distress. Generalized Linear Mixed Effects Models estimated associations, adjusting for participant and regional variations. Results While no significant total mediated effects were found ( p > 0.05), higher relationship satisfaction was associated with lower anxiety ( β = −0.13, p < 0.0001), depression ( β = −0.18, p < 0.0001), and psychological distress ( β = −0.16, p < 0.0001). A small positive association with alcohol use was found ( β = 0.04, p = 0.0938) with relationship satisfaction. SES moderated mental health outcomes, with low-income participants experiencing greater depression ( β = −0.09, p = 0.0015) and psychological distress ( β = −0.12, p = 0.0015). Conclusion Findings underscore the role of SES and relationship satisfaction in mental health during crises. Targeted interventions and policies addressing SES disparities, and relationship-based services are recommended.

Background Infertility is a significant global health issue, particularly in developing nations, where oocyte donation has become crucial for women facing poor oocyte quality. Understanding the psychological factors influencing Indian oocyte donors, including personality traits, emotions, and motivations, can provide insights into their experiences and behaviors. Aims This study aims to investigate the relationship between personality traits, emotions, and motivations of Indian oocyte donors, with a focus on identifying key predictors of their motivation and the impact of emotions on their donation experience. Methods A cross-sectional, interview-based study was conducted with 178 first-time oocyte donors from a private fertility clinic. Data were collected using the Big Five Inventory-10 to assess personality traits, the Positive and Negative Affect Schedule for emotions, and the Situational Motivation Scale to measure motivation types. Multiple regression analyses were used to determine predictors of motivation, and correlational analysis examined the relationships between emotions, personality traits, and motivation. Results Positive emotions correlated with intrinsic motivation ( r = 0.37, p < 0.01 ) and identified regulation ( r = 0.24, p < 0.01 ). Negative emotions correlated negatively with these motivations and positively with amotivation ( r = 0.31, p < 0.01 ). Conscientiousness was associated with identified regulation and amotivation. Positive emotions predicted intrinsic motivation ( B = 0.09, p < 0.01 ) and identified regulation ( B = 0.03, p < 0.05 ). Conclusions The study highlights the role of positive emotions and personality traits like conscientiousness in motivating oocyte donors. Understanding these factors can develop targeted support and counseling strategies to improve donor experiences and motivation. This research provides valuable insights into the psychological dynamics of Indian oocyte donors.

Background In 2023, Kenya recorded approximately 5,845 new cervical cancer cases and 3,591 deaths, primarily affecting women aged 30–49 due to persistent high-risk human papillomavirus (HPV) infections. This study aimed to assess the awareness of cervical cancer, its causes, risk factors, symptoms, and screening rates among women aged 18–46 seeking reproductive health care in eastern Kenya from 2018 to 2020. Objectives The aims of this study were to evaluate cervical cancer awareness, its causes, risk factors, and symptoms, and to explore the association between awareness and screening uptake among women in eastern Kenya. Methods A cross-sectional survey was conducted in Meru, Tharaka-Nithi, Kirinyaga, Embu, and Isiolo counties between 2018 and 2020. Stratified and simple random sampling was used to select participants, resulting in a total of 317 women aged 18–46 years. Data were collected through structured face-to-face interviews and analyzed using SPSS v25. Descriptive statistics summarized key variables, and logistic regression analysis assessed the association between awareness and screening uptake ( p < 0.05). Results The mean age of participants was 34.2 years (standard deviation ± 10.4). While 93.7% were aware of cervical cancer, only 24.7% identified HPV as its cause, and just 12.5% had undergone screening. Screening uptake was higher in Embu, among women under 30, and those with primary education. Hormonal contraceptive users were less likely to be screened (odd ratio: 0.48, confidence interval: 0.2–0.8). Conclusion Despite high awareness, knowledge gaps about cervical cancer’s cause and prevention remain. Targeted educational efforts are necessary to enhance screening uptake in underserved communities.

Most algorithms deployed in healthcare do not consider gender and sex despite the effect they have on individuals’ health differences. Missing these dimensions in healthcare information systems is a point of concern, as neglecting these aspects will inevitably perpetuate existing biases, produce far from optimal results, and may generate diagnosis errors. An often-overlooked community with distinct care values and needs is LGBTQ+ older adults, who have traditionally been under-surveyed in healthcare and technology design. This article investigates the implications of missing gender and sex considerations in distributed ledger technologies for LGBTQ+ older adults. By using the value sensitive design (VSD) methodology, our contribution shows that many value meanings dear to marginalized communities are not considered in the design of the blockchain, such as LGBTQ+ older adults’ interpretations of trust, privacy, and security. By highlighting the LGBTQ+ older population values, our contribution alerts us to the potential discriminatory implications of these technologies, which do not consider the gender and sex differences of marginalized, silent populations. Focusing on one community throughout, we emphasize the need for a holistic, VSD approach for the development of ledger technologies for healthcare, including the values of everyone within the healthcare ecosystem.

Background From 2018 to 2023, Human papillomavirus (HPV) vaccination coverage in the United States was shaped by both proactive immunization efforts and the disruptions caused by the COVID-19 pandemic, leading to the first national decline in nearly a decade. This study aimed to assess vaccination trends over time and across regions to identify coverage gaps and inform health policy best practices for achieving optimal HPV vaccination rates. Methods We used provider-verified data from the National Immunization Survey–Teen for adolescents aged 13–17, focusing on vaccine initiation (≥1 dose) and up-to-date (UTD) status, as defined by Centers for Disease Control and Prevention guidelines. We used Cochran-Armitage trend tests to assess changes across the pre-pandemic, pandemic, and post-pandemic periods. We stratified our analyses by sex, race/ethnicity, and state. Results Initiation increased from 68.1% in 2018 to 76.9% in 2021, then declined to 76.8% in 2023. UTD status rose from 51.1 to 62.6% by 2022 but fell to 61.4% in 2023. Females and Hispanic/Black adolescents consistently had higher coverage than males and White adolescents. Eighteen states, mainly in the Northeast and Upper Midwest, achieved ≥80% initiation by 2023, while Southern states lagged. Conclusion Best practices for improving HPV vaccination include: (1) strengthening vaccination infrastructure in low-performing Southern states, (2) targeting male and White adolescents, (3) maintaining robust delivery systems during crises, and (4) replicating high-performing regional models. These strategies can improve vaccine equity and contribute to achieving national targets over time and space.

Cell towers enable the dissemination and access to vaccine information through mobile networks. In developing regions where mobile device sharing is common, the benefits of cell tower connectivity extend beyond individual mobile device ownership. This study provides valuable insights into how access to these communication infrastructures affects vaccination coverage and empirically examines the extent to which it enhances vaccine uptake. Combining geocoded cell tower information with data from a nationally representative household survey in Côte d’Ivoire, we found that proximity to cell towers was associated with higher vaccine uptake. Every unit decrease in the distance to cell towers was associated with about two additional children vaccinated per 1,000 population. Using the instrumental variable to address endogeneity in cell tower distribution, the finding aligns with that obtained using OLS.

Analgesics are among the most frequently used drugs, but the analysis of their popularity is a tremendous challenge for the methods of classical epidemiology, hence the development of complementary infodemiological tools. Google Trends data from the years 2004 to 2023 was obtained in order to explore global interest in painkillers. Special attention was paid to time trends and geographical patterns related to their popularity. Globally, Google users most frequently searched for information regarding “Acetaminophen” (2.00 [times more frequently than “Aspirin”]), followed by “Ibuprofen” (1.68), “Aspirin” (1.00), “Diclofenac” (0.86), and “Tramadol” (0.74). Interest in all analysed drugs fluctuated seasonally but overall increased over time, with the greatest rise for non-opioid analgesics. The popularity of painkillers was dependent on the geographical region: non-opioid drugs were most searched in Latin America, while opioid analgesics in Northern European and English-speaking countries.

Introduction Brain fog is an experiential phenomenon, often described by persons with chronic pain. The term “brain fog” emerged from discussions among persons with lived experiences (PWLE) and clinicians. Despite several patient-guided sources describing the profound impact of this experience, its legitimacy remains debated in the medical literature. Methods To explore the public understanding of this phenomenon, we performed a concept analysis of text-based postings on two popular social media platforms. Results were examined using descriptive content analysis. Findings A total of 247 social media posts were identified. Posts were primarily written by PWLE. Brain fog was described as a fluctuating experience, with some participants feeling cloudiness, mental heaviness, or dissociation. The antecedents of brain fog could be attributed to pain, cognitive overload, environmental factors, or random occurrences. Brain fog could cause cognitive (e.g., thinking and remembering) and bodily (e.g., exhaustion and emotional challenges) impacts that affect meaningful participation and perception of self. Challenges to managing symptoms included not knowing where to start, misleading information, or not feeling comfortable discussing brain fog with others. Conclusion The results of this study demonstrate the (1) impacts of brain fog on the well-being and perception of self in PWLE and (2) importance of bridging a possible disconnect between clinicians and PWLE of chronic pain.

Introduction Maternal mortality remains a pressing public health concern in Madagascar, with an estimated 408 deaths per 100,000 live births. This study examines whether regional variations in the intensity of multidimensional poverty are associated with the maternal mortality ratio (MMR). Methods We analyzed data from the Third General Population and Housing Census across 22 regions. A cross-sectional approach was used to assess household deprivation and MMRs. Multidimensional poverty was measured using nine indicators across three dimensions – education, health, and living conditions – following the Alkire-Foster method. A simple linear regression model was developed using R version 4.4.2 to test the association between the intensity of multidimensional poverty and MMR. Results A strong positive correlation was observed between the intensity of multidimensional poverty and MMR ( r = 0.642, p < 0.001), explaining 41.2% of the variation. Rural regions exhibited significantly higher multidimensional poverty index (MPI) and MMR values than urban ones. A one-point increase in MPI was associated with an average rise of 24 maternal deaths per 100,000 live births. Conclusion Multidimensional poverty intensity is strongly associated with maternal mortality in Madagascar. These findings underscore the need for targeted policies addressing structural deprivation to improve maternal health outcomes, particularly in high-poverty rural regions.

Drawing from Carol Bacchi’s “What is the problem represented to be?” framework, we analysed discourses within documents from five nongovernmental organizations (NGOs) that have influenced the debate around “COVID-19 misinformation.” Through Google Scholar, we identified documents published between 2020 and 2024, selecting 29 reports by the Center for Countering Digital Hate, First Draft, Meedan, Public Good Projects, and the EU Disinfo Lab, and 13 articles authored by their directors or research directors. Across the data, the proposed policy solutions consisted of tracking, managing, and suppressing any COVID-relevant expression perceived as undermining the official policy response. It followed that the “problem” was represented to be these expressions, or rather, individuals producing them, framed as threatening science, democracy, and even human survival. NGOs also positioned themselves as experts in an emerging scientific field, infodemiology, thus equipped to evaluate all forms of communication according to their own or similar experts’ standards. Notably, none of the documents engaged with the substance of opposing viewpoints or disconfirming evidence, dismissing them almost entirely via authority, ad populum, or ad hominem fallacies. We conclude that, rather than defending science, democracy, or human survival, these NGOs and their partners are undermining the open, respectful, and inclusive debate essential to support these values.

Introduction Smartphones are now an integral part of everyday life, and their wide use by employees has raised concerns regarding workplace safety and productivity. Issues like ‘nomophobia’ and ‘digital amnesia’ have been marked as challenges, especially during the peak of COVID-19 pandemic, which accelerated reliance on smartphones. Aim This study aims to assess the cognitive effects of smartphone use on employees, particularly regarding attention, error rates, and potential occupational implications. Methodology Survey-based research was conducted among employees ( n = 71) of a Greek University. An experimental design of Stroop tests was done to measure cognitive performance and error rates. Respondents answered questions such as work-related smartphone activities and productivity implications. This survey was analyzed through non-parametric statistical tests. Outcomes Results show that most of the participants use their smartphones on a regular basis while they are at work. Participants who used a smartphone immediately before the test required longer completion times (median 2.68 min [IQR 2.30–3.10] vs 1.81 min [1.60–2.20]; difference +0.87 min, 95% CI 0.52–1.23; p < 0.001) and committed more errors (median 6.45 [5–8] vs 4.25 [3–6]; difference +2.2 errors, 95% CI 1.1–3.2; p = 0.002) compared to non-users. Daily smartphone use was positively correlated with errors (Spearman’s ρ = 0.34, 95% CI 0.12–0.52, p = 0.01). No stratified or interaction analyses by age or gender reached statistical significance. Conclusion Immediate smartphone use is associated with slower cognitive performance and increased errors. These findings highlight the importance of promoting moderate smartphone use and raising awareness to support employee well-being and productivity.

Body dysmorphic disorder (BDD) is a pathological body dissatisfaction characterised by delusional beliefs of a flaw in appearance paired with obsessive-compulsive rituals. This disorder has a high prevalence in adolescence. This study examines the current state of treatment for BDD in adolescents in the UK to establish a baseline of current treatment, and to identify specific areas for further research. A systematic literature review of two databases was carried out and resultant papers were organised using an amended version of the current UK management standards. Six papers met the eligibility criteria and cognitive behavioural therapy was reported as the most effective current treatment. In drawing together the key findings, three areas for further research were highlighted that are of relevance to a broad range of clinicians working in BDD management in adolescence. These included inquiry into mental health professionals’ perspectives, a review of the rate of remission rates, and research into the extent to which schools can influence adolescents’ ideas about body image. The significance of BDD is not reflected in the current literature base. Education of professionals and the wider community is warranted, as is the drive for improved awareness and an increase in the availability of treatment.

Minimally invasive surgery (MIS) has revolutionized the field of surgery by offering reduced trauma, faster recovery times, and improved patient outcomes compared to traditional open procedures. However, the widespread adoption of MIS is not without challenges, and managing complications and limitations is essential for optimizing patient safety and surgical efficacy. This study provides a comprehensive overview of the strategies employed in the management of complications and limitations associated with MIS. Complications in MIS can arise from various factors, including anatomical variations, unexpected bleeding, or difficulties in instrument manipulation. Recognizing the potential for complications is crucial, and surgeons must be equipped to make real-time decisions, including the possibility of converting to open procedures when necessary. Patient selection plays a pivotal role, with thorough preoperative assessments helping identify individuals who may be at higher risk for complications. Limitations in MIS are diverse and can stem from anatomical challenges, such as restricted access in confined spaces or complex structures. While technological advancements, such as robotic-assisted surgery and advanced imaging, have mitigated some limitations, ongoing efforts are directed toward overcoming challenges related to limited range of motion and maneuverability in intricate anatomical locations. Strategies for the management of complications and limitations involve a multidisciplinary approach. Surgeon training and proficiency in MIS techniques are paramount, emphasizing the importance of ongoing education and simulation-based training. Thorough preoperative planning, including a comprehensive assessment of patient history and anatomical considerations, helps anticipate potential challenges. Additionally, advancements in technology, such as enhanced imaging and robotic-assisted systems, contribute to improved visualization and precision during MIS. Regular maintenance and calibration of equipment, along with an emphasis on team communication and collaboration, further enhance the safety and effectiveness of MIS. The management of complications and limitations in MIS requires a holistic approach, encompassing surgical expertise, technological innovations, and meticulous preoperative planning. By addressing these challenges, the field of MIS continues to evolve, offering patients minimally invasive options with enhanced safety and efficacy.

Background The scarcity of oncology specialists poses a significant challenge globally, particularly in regions with limited healthcare resources. This leads to delayed diagnoses and disparities in care. The shortage of oncology services disproportionately affects vulnerable populations, leading to delays in diagnosis, treatment, and poorer outcomes. Aim This study investigates the implications of oncology resource scarcity, focusing on South Africa’s Eastern Cape province, aiming to analyse challenges, interventions, and lessons from other countries. Method This review study employed a mixed-method research design encompassing an empirical literature review and case study approach. It drew on existing research and data to analyse the impact of oncology resource scarcity on patient care. Results Cancer-related mortality in the province remains considerable, with lung cancer emerging as a leading cause, underscoring the need for comprehensive cancer control strategies. Infrastructure disparities between urban and rural areas compound the challenges, with limited access to oncology facilities and specialists in remote regions. Conclusion Urgent action is needed to address oncology resource scarcity to improve cancer care outcomes, particularly in underserved regions. Targeted interventions and lessons from other countries can enhance access to quality oncology services and reduce disparities in care. Contribution This study’s findings have significant implications for South African health policy, particularly regarding the urgent scarcity of oncology resources. The critical shortage of oncology specialists in underserved areas like the Eastern Cape underscores the necessity for a comprehensive strategy to enhance cancer care.

Background Various dietary strategies have been proposed for irritable bowel syndrome (IBS) symptom relief; yet, long-term studies and comparative trials remain limited. The literature reports inconsistent findings regarding the nutritional adequacy and global variability of dietary intake in IBS populations, highlighting the need for a broader understanding of how cultural and emerging dietary factors influence symptom expression. Objective This narrative review aims to evaluate the effectiveness of predominant dietary interventions for IBS, provide an overview of emerging dietary trends, and examine cultural differences in dietary patterns among IBS populations. Methods A comprehensive search was conducted across Google Scholar, Wiley Online Library, PubMed, Elsevier, Scopus, and ScienceDirect for peer-reviewed, English-language articles published after 2000. Studies included clinical guidelines based on systematic reviews, analyses of dietary intakes in IBS populations adopting alternative dietary assessment methods, and reviews of dietary interventions. One hundred and ten studies were included following title, abstract, and full-text screening. Key findings Due to the heterogeneous nature of IBS, various dietary strategies are reported. Yet, it remains unclear which is superior, with the low-FODMAP diet being the most studied. Emerging dietary trends show promising potential, but current evidence is preliminary and requires long-term investigations. Internationally, dietary intake patterns vary, with some IBS populations meeting nutritional needs while others exhibit deficiencies, particularly in fibre, calcium, iron, and B vitamins. Conclusion Given the variability in IBS responses, tailored dietary management is essential. Furthermore, long-term, comparative, and cross-national studies are needed to address global nutritional gaps and inform standardised dietary guidelines for IBS.

Background Intimate partner violence (IPV) is a significant social and public health issue with far-reaching consequences for individuals, their families, workplaces, and society. Despite its impact, the effects of IPV on victims’ work environments remain underexplored. This study aimed to review empirical evidence on how IPV affects the health and wellbeing of employed men and women, their working lives, and their work environments, as well as the types of support employers provide in OECD countries. Methods A descriptive systematic review was conducted across PubMed/MEDLINE, Scopus, Web of Science, and PsycINFO to identify empirical studies examining the impact of IPV on employees’ health, working lives, and the workplace environment. Twenty-two empirical articles, published between 2014 and 2025, met the inclusion criteria. These criteria specified that the studies must address IPV experienced in the home and its effects on the victim’s working life, workplace environment, and overall health and wellbeing. Furthermore, the studies were required to consider the support and assistance provided by employers to employees affected by IPV. Conclusion The findings indicate that IPV is widespread, with a higher reported prevalence among female employees. Victims – both male and female – experienced various forms of abuse, including physical, psychological, sexual, and digital violence, resulting in injuries, stress, anxiety, depression, and post-traumatic stress disorder. IPV also had a detrimental impact on victims’ work environments, often leaving them emotionally exhausted and unable to sustain performance levels, which in turn led to the redistribution of their workload among colleagues. Moreover, IPV disrupted victims’ working lives by undermining career identity, damaging professional reputations, restricting opportunities for career advancement, and necessitating extended periods of sick leave – ultimately hindering their ability to establish robust employment careers, secure references, and maintain professional credibility. Support from employers varies both across and within countries, ranging from legal protections and workplace policies to human resources guidance, safety planning, counselling, and flexible working arrangements.

Adequate nutrition during pregnancy supports maternal and fetal health; however, a comprehensive or sophisticated understanding of nutrition literacy among pregnant women remains limited. This systematic review aimed to evaluate the current literature on nutrition literacy in pregnant women, with a focus on socioeconomic factors and nutrition education interventions. Databases including PubMed (MEDLINE), Web of Science, SCOPUS, CINAHL, and the Cochrane Database of Systematic Reviews were searched for publications that described nutrition literacy, and related concepts, in pregnant women. The search included studies published in English between January 2000 and May 23, 2025. While 1757 studies were identified, only 5 met the inclusion criteria. These studies explored nutrition literacy levels, the influence of socioeconomic factors, and/or the effectiveness of education interventions on nutrition literacy during pregnancy. Socioeconomic factors, such as income, education, and health insurance were strongly associated with nutrition literacy levels. Nutrition education interventions improved dietary quality and nutrition literacy. However, challenges remain in measuring nutrition literacy as there are various assessment tools which limited the ability to perform cross-study comparisons. Improving socioeconomic conditions and providing nutrition education programs during pregnancy are essential for improving nutrition literacy among pregnant women. Future research should focus on creating standardized, culturally adaptable assessment tools, as well as evaluate the long-term impacts of nutrition education programs during the prenatal period.

The coronavirus disease 2019 (COVID-19) pandemic seems to have been overcome and replaced by other issues that influence risk perception, communication, and behaviour. However, for some people, the aftereffects continue to reverberate, either because they suffer from “long COVID” or from side effects of the COVID-19 vaccination. The aim of this article is to examine the experiences of patients in Germany who attribute health problems to COVID-19 vaccination. A literature search was conducted using four search engines, but no publications were found that shed light on this topic. This indicates that there remains a gap in the research landscape. The discussion considers what factors might influence patient experience and what factors might contribute to the lack of research on this topic.

The efficacy of communication about medical research lies in the ability to relay medical jargon in scientific papers. When inaccurate terms are used in the medical literature, for example of diseases or conditions due to paraphrasing, then the impact of the text is reduced, while ambiguity may arise, thus reducing the effectiveness of communication, while possibly having a negative impact on documents related to heath policy. The colloquial term, “tortured phrases,” describes such instances of linguistically irregular scientific terms. In this study, Huntington’s disease (HD) is used as an example to show how established medical jargon can be linguistically modified, leading to the creation of inaccurate medical terms. A total of 16 cases of five forms of linguistic distortions of HD were discovered in January 2025: “Huntington’s ailment,” “Huntington’s illness,” “Huntington’s infection,” “Huntington’s malady,” and “Huntington’s sickness.” The most frequent “tortured phrase” (six cases) was “Huntington’s ailment.” To avoid the distribution – through citation – and use of these erroneous terms, including in health policy literature, distorted jargon in these papers should be corrected.