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Harms from Other People's Gambling: Associations with an Individual's Own Gambling Behaviours, Health Risk Behaviours, Financial Problems, General Health, and Mental Wellbeing.

This study aimed to explore relationships between being an 'affected other' (AO) and an individual's own gambling, health risk behaviours, financial problems, poor general health, and low mental wellbeing. A cross-sectional survey using representative and supplementary convenience samples was undertaken with 1234 residents of a British Island aged 16 + years. Being an AO was measured as having a partner or relative who has been gambling regularly in the past 12 months. PGSI was used to assess gambling severity. Health risk behaviours included: poor diet, low physical activity, daily smoking, a

Financial stress as a mediator of the association between maternal childhood adversity and infant birth weight, gestational age, and NICU admission.

BACKGROUND: To examine whether financial stress during pregnancy mediates the association between maternal exposure to adverse childhood experiences (ACEs) and three birth outcomes (i.e., gestational age, birth weight, and admission to the neonatal intensive care unit [NICU]). METHODS: Data were obtained from a prospective cohort study of pregnant women and their infants in Florida and North Carolina. Mothers (n = 531; Mage at delivery = 29.8 years; 38% Black; 22% Hispanic) self-reported their exposure to childhood adversity and financial stress during pregnancy. Data on infant gestational ag

Optimising hospital pharmacy inventory for high-value, intermittent-demand drugs using a machine-learning approach with LightGBM-Tweedie regression: a single-centre, retrospective study.

OBJECTIVE: Hospital pharmacies operate under a persistent dilemma: ensuring uninterrupted access to essential medicines while minimising capital tied up in inventory. This challenge is most acute for drugs with lumpy or erratic demand, where traditional manual ordering often fails because of limited forecasting capability. Therefore, this study aimed to develop and evaluate a LightGBM-Tweedie regression model for forecasting weekly demand of high-value intermittent-demand drugs. METHODS: We conducted a retrospective machine learning-based study using weekly pharmacy usage data from a large te

Profile-associated financial and access-related framing in LLM-generated pediatric asthma referral plans: a factorial audit of seven large language models.

BACKGROUND: Large language models (LLMs) are increasingly considered for clinical documentation, referral support, and patient-facing communication. Biomedical accuracy alone may be insufficient for safe deployment if generated plans vary in access navigation, financial-access language, referral specificity, or tone across socially meaningful patient cues. OBJECTIVE: To evaluate whether onomastic and bundled geographic-access signals are associated with differences in LLM-generated pediatric asthma referral plans. METHODS: We conducted a cross-sectional 2 × 2 factorial audit of seven commerc

Implementation strategies to increase smoking cessation treatment provision in primary care: a systematic review of observational studies.

BACKGROUND: Internationally, there is an 'evidence-practice gap' in the rate healthcare professionals assess tobacco use and offer cessation support in clinical practice, including primary care. Evidence is needed for implementation strategies enacted in the 'real-world'. AIM: To identify implementation strategies aiming to increase smoking cessation treatment provision in primary care, their effectiveness, cost-effectiveness and any perceived facilitators and barriers for effectiveness. METHODS: 'Embase', 'Medline', 'PsycINFO', 'CINAHL', 'Global Health', 'Social Policy & Practice', 'ASSIA A

Cost-sensitive random forest with adaptive threshold optimization for imbalanced financial fraud detection.

BACKGROUND: Financial transaction fraud detection is a challenging binary classification problem characterized by severe class imbalance, rare fraudulent cases, and asymmetric misclassification costs. In real-world banking systems, failing to detect fraudulent transactions can lead to substantial financial losses, whereas false alarms mainly increase operational review costs. Therefore, fraud detection models should not be optimized only for overall accuracy, as accuracy-oriented classifiers may favor the majority non-fraud class and fail to identify minority fraud cases effectively. To addres

Cost Analysis of Outpatient Ophthalmic Procedures.

OBJECTIVE OR PURPOSE: To evaluate the financial feasibility of various ophthalmic procedures performed at outpatient facilities, including ambulatory surgical centers (ASCs) and hospital outpatient departments (HOPDs), relative to Medicare facility reimbursement in 2025 and beyond. DESIGN: Cost-efficiency analysis. SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: Outpatient facilities in San Diego, California. METHODS, INTERVENTION, OR TESTING: In this study, we propose a novel framework to analyze ASCs and HOPDs based on the maximum intraoperative time to maintain financial neutrality. Common opht

Financial Toxicity, Psychological Well-Being, and Quality of Life in Hematopoietic Stem Cell Transplantation.

BACKGROUND: Financial toxicity is a well-documented consequence of cancer care and may disproportionately impact patients with hematologic malignancies due to the high cost and intensity of hematopoietic stem cell transplant (HSCT). This population is particularly vulnerable to the psychological consequences of financial toxicity; however, the longitudinal relationship between financial toxicity and psychological well-being-particularly positive psychological well-being-remains understudied. OBJECTIVE: To assess longitudinal associations between financial toxicity and patient-reported psychol

The Impact of Dementia Caregiving on the Health of the Spousal Caregiver.

Dementia caregiving represents a major public health challenge, with spousal caregivers assuming the greatest burden. Spouses, themselves typically older adults, provide high intensity, long-term, and largely unpaid care across all stages of cognitive decline. Despite their central role in dementia care, the health consequences experienced by spousal caregivers remain insufficiently characterized in the literature and inadequately addressed in clinical and public health practice. This structured narrative review synthesizes current evidence on the multidimensional impact of dementia caregiving

Patient-Reported Social Impact of Molecularly Confirmed Retinitis Pigmentosa.

Objectives: To evaluate the patient-reported impact of retinitis pigmentosa (RP) in a large patient cohort to identify relevant disease-related disadvantages as key aspects for the improvement of ophthalmic and social care. Methods: Consecutive patients with molecularly confirmed RP older than 18 years of age were identified in two tertiary care centers in Germany. Patients were contacted to participate in an anonymized patient query regarding the impact of RP on their vocational training, professional career, and social, familial, and personal life, as well as their experience with ophthalmol

Utilization, satisfaction, and perceived maternal health benefits of group antenatal care in Karu LGA, North Central, Nigeria.

INTRODUCTION: Group Antenatal Care (G-ANC) has emerged as an innovative model for improving maternal health service delivery in low- and mid … tudies showing high satisfaction with G-ANC but call for system-level interventions. Integration of financial support schemes, community engagement, male involvement, and improved infrastructure are necessary for broader impact. CONCLUSION: G-ANC presents a promising strategy to enhance maternal health outcomes in LMICs. Strategic scale-up, system-wide support, an …

Explanation of chronic stressors in older women with uterine fibroids-a qualitative study.

INTRODUCTION: Older women with uterine fibroids experience complex challenges that extend beyond physical symptoms to include emotional stressors and other stressors. This study aimed to explain the chronic stressors faced by older women with uterine fibroids, with a focus on their effects on physical health, emotional well-being and daily functioning. METHODS: This qualitative study employed semi-structured, in-depth interviews with 28 women aged 60 years or older diagnosed with uterine fibroids, conducted between 2023 and 2024 in China. Participants were purposively sampled to ensure divers

The migrant Hazara Shias of Pakistan and their social determinants for PTSD, mental disorders and life satisfaction.

BACKGROUND: Ensuring safety and wellbeing of all the minority populations of Pakistan is essential for collective national growth. The Pakistani Hazara Shias are a marginalized non-combative migrant population who face targeted violence in Pakistan, and suffer from great challenges which compromise their life satisfaction and mental health. In this study, we aim to identify the determinants of life satisfaction and mental health disorders in Hazara Shias and ascertain which socio-demographic characteristics are associated with post-traumatic stress disorder (PTSD). METHODS: We used a cross-se

Bolivia programme evaluation of a package to reach an underserved population: Community-based maternal and newborn care economic analysis.

To address inequitable access to health services of indigenous communities in the Bolivian highlands, the Bolivian Ministry of Health, with the support of Save the Children-Saving Newborn Lives, conducted operational research to identify, implement and test a package of maternal and newborn interventions using locally recruited, volunteer Community Health Workers (vCHW) between 2008 and 2010. The additional annual economic and financial costs of the intervention were estimated from the perspective of the Bolivian Ministry of Health in two municipalities. The cost of intervention-stimulated inc

Giving care to people with symptoms of AIDS in rural sub-Saharan Africa.

In rural sub-Saharan Africa, most care for patients with AIDS is provided at home by relatives. Caring for those with AIDS is assumed to be a substantial burden, but little is known from the perspectives of those who provide the care. In this paper we use interviews with caregivers, supplemented with survey data from a larger study in rural Malawi, to investigate this issue. We focus on the caregivers' diagnoses of the illness of their patients, the type and duration of the care they provided, the support they received from relatives and other members of the community, and the extent to which

Defining the Clinical, Emotional, Social, and Financial Burden of Congenital Athymia.

INTRODUCTION: Characterize the burden of illness in pediatric patients with congen̄ital athymia who were receiving supportive care. METHODS: This cross-sectional study of adult caregivers of patients with congenital athymia used both a quantitative survey and qualitative interviews. Caregivers of patients currently receiving supportive care responded to questions about the past 12 months and completed the parent proxy version of the Pediatric Quality of Life Inventory Generic instrument (PedsQL) for patients aged 2-4 years. For caregivers of patients who had received supportive care in the pa

Healthy patients who perceive poor health: why are they worried sick?

OBJECTIVE: To explore characteristics of patients who are physically healthy but who perceive poor health by investigating the hypothesis that mental health problems, financial strain, and deficiencies in social support underlie why these patients are "worried sick." METHODS: Three hundred forty-eight continuity patients in 2 rural primary care practices were administered the PRIME-MD, the MOS SF-36, a health-related worry (1-item, 5-point) scale, the MOS social support survey, and perceived economic strain instruments. The patient's physician rated physical health on a 10-point scale. Health

Risk factors for not proceeding to reconstructive surgery after female genital mutilation: A cohort study of 220 women in a specialized referral center.

OBJECTIVE: This study identifies factors associated with not proceeding to clitoral reconstructive surgery among women with female genital m … ial vulnerability, specifically reliance on state welfare (OR 3.43, 95% CI 1.28-9.80; P = 0.017) or financial support from relatives/community (OR 6.18, 95% CI 1.40-28.9; P = 0.017), were independently associated with non-progression. Model discrimination was good (area under the curve 0.75). Bayesian analysis confirmed these findings (P[direction] >99%) and sugges …

Experiences of People With Long COVID Accessing Rehabilitation Services: A Qualitative Study.

PURPOSE: Long COVID is associated with a range of physical, cognitive, and/or psychological symptoms that significantly affect daily functioning. These individuals require rehabilitation services to address their limitations. This study explored the experiences of people with long COVID regarding access to and receipt of rehabilitation services. METHODS: This qualitative study recruited 12 individuals with long COVID from a population-based survey among the population of Laval (Quebec). Semistructured telephone interviews were conducted, recorded, transcribed verbatim, and analyzed using indu

Frail older adults' challenges in using telehealth services: A scoping review.

ObjectiveTelehealth is increasingly used to expand access to healthcare, but rapid digitalization risks exacerbating exclusion among frail older adults, who often face intersecting limitations related to health, resources, and digital competence. As this group frequently has complex care needs, mapping their experiences is essential to ensure equitable access to digital care. The aim was to map the challenges frail older adults experience when using telehealth services.MethodsThis scoping review followed Arksey and O'Malley's framework and PRISMA-ScR guidelines. PubMed, CINAHL, Scopus, and Web

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… Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Three authors, i.e., KÅ, AS, and MK, received financial support by FORTE- Forskningsrådet för hälsa, arbetsliv och välfärd (2024-01593). …