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High Economic Burden Yet Low Clinical Value: Why Is so Much Sucralfate Prescribed?

Sucralfate is a commonly prescribed medication in use for decades. Despite the availability of more effective medications for acid-dyspeptic conditions, including proton pump inhibitors and histamine H2-receptor antagonists, sucralfate continues to be utilized for upper gastrointestinal symptoms. We reviewed the limited evidence base supporting the approval and ongoing usage of sucralfate and performed a cost analysis using the ClinCalc database. The financial impact of sucralfate was comparable to famotidine, lansoprazole and ranitidine. We encourage further studies to accurately gauge the tr

Threatened Periviable Delivery and Abortion: Clinical Considerations.

Periviable delivery, or a pregnancy at risk of delivery between 20 0/7 and 25 6/7 weeks gestational, is an uncommon event with profound physical, psychological, and financial impact. Neonatal outcomes can be hard to predict and with the changing legal landscape around abortion access, management options may be compromised. Dynamic maternal and fetal factors make a cohesive and supportive care team critical for optimal care. Management of threatened periviable delivery in a post-Roe United States may prioritize fetal outcomes regardless of threat to maternal health due to legal restrictions.

Walking through mud; history of the Polish methadone maintenance treatment from its stakeholders' perspective.

This paper presents Polish methadone maintenance treatment (MMT) against the background of the dominant therapeutic community approach. The perspectives of various stakeholders-supporters and opponents-are examined as well as the barriers, facilitators, ideological conflicts, and financial interests influencing MMT policy and practice. In-depths interviews were carried out with 18 major stakeholders around 2012, almost two decades after the first MMT was launched. The interviews shed light on stakeholders' inter- and intragroup conflicts as well as on their official and hidden agendas, but the

Uncovering hidden patterns: How good governance and health outcomes are shaped by the public healthcare funding?

INTRODUCTION: This study aims to empirically investigate the relationships between governance quality and health outcomes, considering the mediating role of healthcare funding. METHODS: The Gaussian Graphical Models (GGM) and the Ward method (hierarchical clustering) were used to investigate the relationship between good governance and health status, considering health expenditure as a key pathway to bridge health outcomes. This study comprises panel data covering the period from 2008 to 2024. RESULTS: Good quality of public governance demonstrates a stronger positive impact on the health st

Barriers to medication adherence and health access among young people living with HIV in Kumasi, Ghana.

Young people living with HIV (YPLH) in Ghana aged 10-24 face elevated barriers to effective HIV management due to structural, social, and economic challenges. These barriers, including poverty, social stigma, gendered inequities, and limited social and household support, disrupt medication adherence and access to healthcare. Inadequate adherence contributes to increased viral loads, reduced HIV knowledge and acceptance, and ongoing transmission. Despite this vulnerability, the lived experiences of YPLH in Ghana and the strategies they use to navigate these barriers remain underexplored. Using

Barriers to care and intimate partner violence screen in orthopaedic trauma clinic.

OBJECTIVES: To evaluate the prevalence of barriers to care and IPV risk and assessed associations between economic hardship and violence. METHODS: A prospective, cross-sectional survey was performed recruiting adult orthopedic trauma patients presenting for clinical follow up at one Level 1 orthopaedic trauma center. Primary outcomes were SDoH domains and IPV risk. Associations between patient characteristics, barriers to care, and IPV risk were analyzed using Fisher's exact tests with false discovery rate control. RESULTS: Among 261 respondents, 50.6% reported difficulty paying for basic ne

Strategic Alignment: Driving Patient Satisfaction and Performance in Public Hospitals.

RATIONALE: Healthcare IT investments in Iranian public hospitals often fail to translate into better perioperative experiences when IT initiatives are not strategically aligned, leading to delays in diagnostics, scheduling, and discharge and, consequently, lower patient satisfaction. AIMS AND OBJECTIVES: Drawing on Dynamic Capabilities Theory, this study examines whether strategic alignment improves perceived organisational performance and patient satisfaction in perioperative care settings, assesses whether IT strategic orientation strengthens the alignment-satisfaction relationship, and tes

Efforts to mitigate the economic impact of the COVID-19 pandemic: potential entry points for neglected tropical diseases.

BACKGROUND: The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. … -19 pandemic. This paper should serve as a starting point for the NTD community to seek much needed financial support in order to sustain and revitalize control and elimination efforts pertaining to NTDs in LMICs.

[Knee school as a secondary preventive approach : The sustainable treatment of occupational gonarthrosis].

BACKGROUND: 2-6 months after successful medical rehabilitation in gonarthrosis, the positive effects remit without the implementation of ade … ile 178 employees voluntarily and locally continued their training in selected fitness centers with financial support (VG 1), and 38 employees opted for an individual home program (VG 2), 76 participants stopped all training (KG). RESULTS: After Phase 1, all groups showed significant improvements in the parameters mobility, as well as stretch ability and strength …

"'Not just a job": Organizational Culture and the Sustainability of the Peer and Lived Experience Workforce.

Peer recovery support specialists represent one of the most rapidly expanding sectors of the behavioral health care workforce, yet organizational conditions that support or undermine this workforce remain underexplored. To better understand the experience of providing peer support and identify organizational factors that facilitate or hinder effective and sustainable peer work, we conducted semi-structured qualitative interviews with a convenience sample of 17 peer workers in Connecticut. Interviews were recorded, transcribed, and thematically analyzed. We identified five themes, reflecting bo

Decision-Making Dilemmas Among Elderly Prostate Cancer Patients Receiving 177Lu-PSMA Therapy: A Qualitative Study.

OBJECTIVE: To explore the decision-making dilemmas experienced by elderly patients with advanced prostate cancer when considering 177Lu-PSMA therapy, and to provide evidence for the development of tailored decision-support strategies. METHODS: A qualitative descriptive design was adopted. Using purposive sampling, 20 elderly prostate cancer patients who had received 177Lu-PSMA therapy at a tertiary hospital in China between April and June 2025 were recruited for semi-structured interviews. Data were analyzed following Braun's style of thematic analysis. RESULTS: Three overarching themes and

Early Life Disadvantage and the Risk of Depressive Symptoms among Young Black Women.

OVERVIEW: We examined the association between early-life socioeconomic disadvantage and depressive symptoms in adulthood and assessed whether social factors in adulthood modify the association. METHODS: The 11-item Center for Epidemiologic Studies-Depression Scale (CES-D) assessed adult depressive symptoms among 1612 Black women and other participants with a uterus (hereafter participants) in the Study of Environment, Lifestyle and Fibroids. Baseline self-reported childhood factors (i.e., parents in the household, mother's educational attainment, food insecurity, neighborhood safety, childhoo

Community-based peer support significantly improves metabolic control in people with Type 2 diabetes in Yaoundé, Cameroon.

AIMS: To examine the effectiveness of a community-based multilevel peer support intervention in addition to usual diabetes care on improving glycaemic levels, blood pressure and lipids in patients with Type 2 diabetes in Yaoundé, Cameroon. METHODS: A total of 96 subjects with poorly controlled Type 2 diabetes (intervention group) and 96 age- and sex-matched controls were recruited and followed up over 6 months. The intervention subjects underwent a peer support intervention through peer-led group meetings, personal encounters and telephone calls. Both intervention subjects and controls contin

Lived Experiences for Supportive Care Needs of Women with Breast Cancer-Related Lymphedema: A Phenomenological Study.

This descriptive phenomenological study was conducted to explore the lived experiences for supportive care needs of women with breast cancer … m healthcare professionals, education and lifestyle advices, and access to healthcare sources), and financial supportive care needs. Women experience various SCNs in their daily lives. Provision of supportive care from both family members or others and healthcare professionals could ease the daily lives, improve physical, and psychosocial well-being.

Diversity in scarcity: financial scarcity uniquely impairs success-seeking beyond a universal surge in failure-avoidance.

PURPOSE: Social life is fundamentally shaped by how individuals perceive and respond to resource constraints. Although the "scarcity mindset theory" suggests a general cognitive cost of deprivation, research on how different contextual factors, especially time and financial scarcity, shape motivation structure remains limited. This study investigates the divergent effects of these two forms of scarcity on achievement motivation, specifically distinguishing between the motivation to pursue success (Ms) and the motivation to avoid failure (Mf). METHODS: We employed a multi-study approach across

Maternal age and psychological well-being in early pregnancy: a cross-sectional analysis.

BACKGROUND: Psychological well-being in early pregnancy may differ by maternal age and by sociodemographic, economic, and reproductive circumstances. This study examined the associations of maternal age and other participant characteristics with screen-positive anxiety symptoms, screen-positive depressive symptoms, perceived stress, and composite psychological distress during the first trimester. METHODS: A total of 1,282 women attending routine antenatal care at 10-12 weeks of gestation were included. Participants were classified into three maternal age categories: 18-29, 30-34, and ≥35 year

Optimizing Advanced Practice Provider Roles Through Standard Patient Contact Hours: Improving Patient Access and Workforce Sustainability.

OBJECTIVE: To assess changes in patient access, productivity, financial performance, and workforce outcomes before and after the implementation of standardized clinic workweek expectations for advanced practice providers (APPs), inclusive of physician assistants and nurse practitioners, in ambulatory specialty care. The initiative established 36 patient-facing hours per week for a full-time APP and included redesigning workflows and care team responsibilities. METHODS: A multidisciplinary team approach was used to optimize clinical operations and support APP sustainability. Interventions incl

Catastrophic costs and impoverishment among tuberculosis-affected households in Nepal: results from a national patient cost survey.

Tuberculosis (TB) poses a significant economic burden on affected households. Despite the provision of free diagnosis and treatment services, patients and their households experience substantial financial hardship. This study aimed to estimate the catastrophic costs faced by TB patients in Nepal and identify associated factors. We conducted the first national cross-sectional survey of 1000 patients enrolled within the National Tuberculosis Program (NTP). The sample consisted of 600 drug-susceptible (DS-TB) and 400 drug-resistant TB (DR-TB) patients. Data were collected through structured inter

Rural hospital philanthropy: community awareness and willingness to donate to the Georgia rural hospital tax credit program.

BACKGROUND: The Rural Hospital Tax Credit program, legislated by the Georgia General Assembly, provides financial support to rural hospitals by allowing Georgia taxpayers to contribute to eligible rural hospitals, receiving a 100% tax credit for their donation. While the policy aims to improve hospital financial stability, little is known about public awareness of the program or factors influencing willingness to donate. This study examines community members’ awareness of the Georgia rural hospital tax credit program and their willingness to donate to it to better understand donor perspectives…

Cross-Cultural Validation of the COmprehensive Score for Financial Toxicity (COST) Measure in an Australian Sample.

IntroductionThe COmprehensive Score for Financial Toxicity (COST) measure developed in the United States measures the financial impact resulting from cancer and its treatment. This paper reports on an Australian cross-cultural validation of the COST measure.MethodsParticipant eligibility criteria included individuals aged ≥ 18, undergoing or completed primary treatment for cancer. Immediate family members of patients were also eligible for Phase 1. Face and content validity were assessed through concurrent interviews and a brief survey (Phase 1). The subsequent revised version of COST was fiel

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… Not knowing about eligible financial support early in their cancer journey was also an issue, for example, “We had nothing to do with Centrelink [prior to cancer diagnosis], so it was quite hard to go through the process, not knowing exactly how we qualified, what we qualified for; we didn't even know …