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Telehealth Policy Interactions Across the Buprenorphine Care Cascade: A System Mapping Analysis.

OBJECTIVE: The COVID-19 Public Health Emergency prompted multiple policies that expanded telehealth care, including buprenorphine treatment for opioid use disorder (OUD). Prior research has reviewed these policies, but not their structural relationships. We used a system mapping approach to visualize how those policies interacted to influence care delivery. METHOD: We developed a diagram based on system dynamics conventions to capture patient status and care transitions and provider capacity change, telehealth adoption, and attrition, informed respectively by the cascade-of-care framework and

The deepest well: longitudinal association of adverse childhood experiences with subjective life expectancy in later life.

OBJECTIVES: The aim of this study was to investigate the longitudinal association between adverse childhood experiences (ACEs) and subjective life expectancy (SLE) among middle-aged and older adults in China, as well as to assess whether socioeconomic position (SEP) and individual health serve as moderators of this association. METHODS: Data were drawn from five waves (2011, 2013, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study (CHARLS), which surveyed adults aged 45 years and older. The final analytical sample included 17,407 respondents. Hierarchical linear model

"I called people to carry me to the latrine": Podoconiosis patients' access to water, sanitation, and hygiene in Butaro, Rwanda.

Podoconiosis is a preventable Neglected Tropical Disease (NTD) that results in significant lower limb swelling and chronic disability. Its management can be done at home by regularly washing feet with clean water and soap and using protective footwear. This study aimed to explore podoconiosis patients' experiences with access to water, sanitation, and hygiene (WASH) and to identify barriers and facilitators of home-based management (HBM). In this qualitative phenomenological study, participants were recruited following a screening conducted in Butaro Sector (Rwanda) to identify individuals wit

Optimizing Diabetes Management During Type 1 Diabetes Pregnancy with Automated Insulin Delivery Therapy: Clinical Impact and Economic Consequences in Spain.

BACKGROUND AND AIM: The CamAPS FX automated insulin delivery (AID) system is extensively evaluated and uniquely tailored for T1D pregnancies. This study evaluated the clinical and economic implications of improving glycemia with CamAPS FX AID compared with the current standard of care (SoC). METHODS: A cost-consequence model was built leveraging data from the AiDAPT study and was adapted to the Spanish health care perspective, using local costs obtained from the literature or hospital databases. As observed in AiDAPT, women treated with AID began with an average glycated hemoglobin (HbA1c) of

Disaster risk management and SME resilience in low- and middle-income countries: A systematic review and evidence map.

UNLABELLED: Small and medium-sized enterprises (SMEs) play an important role in employment creation and local economic stability, yet they are highly vulnerable to disasters and operational disruptions. This study synthesises existing evidence on risk management frameworks used by SMEs in low- and middle-income countries and examines how these approaches contribute to disaster risk reduction and business continuity. A PRISMA-guided systematic review was conducted using major academic databases and selected grey literature covering the period 2000 to 2025. Eligible studies examined the applicat

Medicare Reimbursement Trends in Sleep Surgery: A 2 Decade Analysis of the Most Billed Codes.

OBJECTIVES: The prevalence of sleep-disordered breathing, including obstructive sleep apnea, has driven the rapid growth of sleep surgery as a subspecialty. Medicare reimbursement plays a pivotal role in the economic viability of sleep surgery, but trends remain understudied. This study analyzes reimbursement trends for commonly performed sleep surgery procedures from 2000 to 2024, assessing inflation-adjusted changes in facility-based professional reimbursement. METHODS: The 11 most frequently billed sleep surgery procedures at a single institution in 2024 were identified. Medicare data on f

Understanding how to maintain paramedic simulation-based education quality: a qualitative study.

BACKGROUND: Simulation-Based Education (SBE) is an essential component of paramedic training, offering a structured environment for students to develop clinical skills and decision-making capabilities. Despite the existence of SBE quality standards, such as those from the Association for Simulated Practice in Healthcare (ASPiH) and the International Nursing Association for Clinical Simulation and Learning (INACSL), the application of these standards in maintaining paramedic SBE quality remains inconsistent. This study explores paramedic educators’ perceptions of SBE quality, the challenges in

The relationship between food insecurity and tobacco or alcohol use in Great Britain: A representative population-based survey.

INTRODUCTION: Tobacco and alcohol use are linked to health disparities. In recent years, food insecurity, an indicator of disparities, has increased in Great Britain. This study examined the associations between food insecurity and tobacco or alcohol use. METHODS: Data were drawn from a representative cross-sectional study of people aged ≥16 years in Great Britain (N = 4,056), conducted in January‒February 2025. Food insecurity was measured with the 6-item Household Food Security Scale, divided into high/marginal, low, or very low food security. Logistic regression models with food insecurity

Ассоциация гинекологов-преподавателей в области медицинского образования - обзор скопирования.

Экзамен по фону Pelvic является ядром, но в то же время вызывающим тревогу, клиническим навыком в высшем медицинском образовании. Традиционные подходы к преподаванию - зачастую оппортунистические или основанные на моделировании - подвергались критике за лишение технических навыков от реляционной и этической практики. В качестве альтернативной модели появились специально подготовленные педагоги, которые используют свои собственные тела для обучения и предоставления олицетворенной обратной связи. Цель этого аналитического обзора состояла в том, чтобы составить карту того, что известно о ПГС, чьи

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… Funding This project was supported through Newcastle University Careers Service Student Employment on Campus funding, which provided financial support for the student researchers (C.K., E.B.). Conflicts of Interest The authors declare no conflicts of interest. …

Factors Associated With Antiseizure Medication Adherence in Patients With Epilepsy: A Systematic Review.

INTRODUCTION: Epilepsy is one of the most common chronic neurological disorders worldwide, and adherence to antiseizure medication (ASM) therapy is essential for seizure control and improved quality of life. Poor adherence has been associated with increased morbidity, mortality, and healthcare burden. This systematic review aimed to examine factors associated with ASM adherence among patients with epilepsy across different sociocultural and clinical settings. METHODS: Systematic searches were conducted in PubMed, Scopus, Web of Science, and Google Scholar databases. A total of 5736 records we

Current non-pharmacological practices for cancer-related fatigue in oncology rehabilitation: results of a national provider survey.

PURPOSE: Cancer-related fatigue (CRF) is one of the most common side effects of cancer treatment, yet there is little consensus on best non-pharmacologic practices to manage this debilitating side effect. The purpose of this study was to describe current non-pharmacologic practice patterns for managing CRF and barriers to rehabilitation. METHODS: An electronic survey, developed by the authors using the CHERRIES checklist, was piloted via REDCap™ by nine participants. Data collected included demographics, clinical experience, frequency (none of the time, some of the time, and all of the time)

Stage-Specific Morphofunctional Evaluation of Idiopathic Macular Holes Using En Face OCT Imaging.

PURPOSE: To evaluate stage-specific morphofunctional relationships in idiopathic macular holes (IMHs) and determine whether stage 2‑specific features could be explained by hole size alone. DESIGN: Retrospective observational study. PARTICIPANTS: A total of 105 eyes with IMHs and available 3-month postoperative follow-up data. METHODS: Eyes were stratified by Gass stage into stage 2 and stage 3 to 4 groups and by International Vitreomacular Traction Study size criteria into small and medium-to-large groups. Associations between preoperative optical coherence tomography (OCT) parameters and b

'Whole person' caregiver assessment: Insights from heart failure and stroke caregivers.

Caregivers of persons with heart failure and stroke describe increased responsibilities after hospitalization. To better characterize the needs of caregivers who self-selected into the intervention, we conducted a convergent parallel mixed methods secondary analysis from our pilot study of The Heart Failure and Stroke Resilience Intervention for Caregivers (HEROIC) program. Using transcriptions of Visit 1, coders analyzed pre-defined domains of caregiving for features of perceived strength, neutrality, or challenge. The domains included a) Values (not rated); b) Caregiving Intensity; c) Dyadic

Determinants of cervical screening in Ghana: a systematic review.

BACKGROUND: Cervical cancer remains a leading cause of morbidity and mortality among women in Ghana, yet screening coverage is extremely low and organised national programmes are limited. Although several studies have examined determinants of screening, no comprehensive synthesis has summarised the evidence to guide effective policy and intervention design. OBJECTIVE: To synthesise existing evidence on determinants of cervical screening in Ghana and identify opportunities to strengthen national screening strategies. DESIGN: This is a systematic review conducted following Aromataris and Pears

Development and psychometric validation of the family resource scale for parents of children with developmental delay.

PURPOSE: This study developed the family resource scale for parents of children with developmental delay (FRS-DD) and evaluated its validity and reliability. METHODS: Based on qualitative research, 42 items were drafted and evaluated through a pilot study and exploratory factor analysis (EFA) to verify factor structure and item composition. The World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used to assess scale convergent validity. RESULTS: An expert review suggested removing nine items; the item-level content validity index ranged from 0.80 to 1, and the scale con

Physicians' Knowledge, Attitudes, and Barriers Toward Clinical Trial Participation in Türkiye: A Cross-Sectional Survey and Implications for Oncology Research Capacity.

BACKGROUND: Physicians influence clinical trial conduct and patient referral, yet country-specific evidence regarding their knowledge, attitudes, and perceived barriers in Türkiye remains limited. This evidence gap is especially relevant to oncology, where clinical trials are closely linked to therapeutic innovation and access to novel treatments. OBJECTIVE: This study evaluated physicians' clinical trial knowledge, experience, attitudes, perceived barriers, and motivational factors, and identified variables associated with positive attitudes toward clinical research. METHODS: A cross-sectio

Documenting Clinical Complexity: A Model for Improving Documentation and Billing in Transplant Infectious Diseases.

BACKGROUND: Transplant infectious diseases (TID) clinicians provide complex, high-acuity cognitive care that is frequently undervalued due to inconsistent documentation and underutilization of appropriate evaluation and management (E/M) and billing codes. Limited published data describe billing practices or educational approaches within TID. We evaluated a documentation and coding education model aimed at improving billing accuracy and recognition of TID clinical complexity. METHODS: We performed a retrospective analysis of administrative billing data from a tertiary-care academic institution

Improving placement of central venous catheters in 22 hospitals in China: a best practice implementation project.

INTRODUCTION: Correct central venous catheter (CVC) placement is important, as inappropriate practices can lead to central line-associated bloodstream infections (CLABSIs), which increase the risk of death as well as imposing a heavy financial burden. OBJECTIVES: This multi-site project was conducted across 22 hospitals in China, and aimed to improve compliance with evidence-based bundles for the placement of CVCs among doctors, anesthetists, and operating room specialized nurses to reduce the rate of CLABSIs. METHODS: This project was guided by the JBI Model of Evidence-based Healthcare and

Mental Health Stressors and Barriers to Support Among Rural Farmers: A Qualitative Study of Agricultural Communities in the East South-Central United States.

Introduction: Suicide rates among individuals working in agriculture remain disproportionately high in the United States. Although farming-related stressors and coping strategies are documented, gaps remain in understanding how farmers sustain themselves psychologically amid chronic stress and why elevated suicide risk persists despite apparent resilience. Purpose: This study sought to explore the major stressors of farming, coping strategies used by farmers, and their barriers to help-seeking, with the goal of informing suicide prevention and mental health interventions. Methods: Fourteen sem

Carbon tunnel vision and sustainable meat production in the West: A disproportionate focus on dietary greenhouse gas emissions?

Livestock systems represent a considerable environmental challenge. In response, various scientists, non-governmental organisations, and policy makers claim that Western populations in particular need to sharply reduce meat consumption. Given people's attachment to meat, many of these actors favour hard policy interventions based on a range of systemic financial and legal reforms that would go beyond mere nudging and the formulation of recommendations, including the top-down imposition of meat taxes and bans, as well as herd size reductions, which would lead to sharply higher prices. However,