Evaluation of adherence to abiraterone therapy in prostate cancer patients based on a population pharmacokinetic model.

AIMS: Abiraterone treatment requires regular drug intake under fasting conditions due to pronounced food effect, which may impact patient adherence. The aim of this prospective study was to evaluate adherence to abiraterone treatment in patients with prostate cancer. To achieve this aim, an abiraterone population pharmacokinetic model was developed and patients' adherence has been estimated by comparison of measured levels of abiraterone with population model-based simulations. METHODS: A total of 1469 abiraterone plasma levels from 83 healthy volunteers collected in a bioequivalence study were analysed using a nonlinear mixed-effects model. Monte Carlo simulation was used to describe the theoretical distribution of abiraterone pharmacokinetic profiles at a dose of 1000 mg once daily. Adherence of 36 prostate cancer patients treated with abiraterone was then evaluated by comparing the real abiraterone concentration measured in each patient during follow-up visit with the theoretical distribution of profiles based on simulations. Patients whose abiraterone levels were ˂5th or ˃95th percentile of the distribution of simulated profiles were considered to be non-adherent. RESULTS: Based on this evaluation, 13 patients (36%) have been classified as non-adherent. We observed significant association (P = .0361) between richness of the breakfast and rate of non-adherence. Adherent patients reported significantly better overall condition in self-assessments (P = .0384). A trend towards a higher occurrence of adverse effects in non-adherent patients was observed. CONCLUSIONS: We developed an abiraterone population pharmacokinetic model and proposed an advanced approach to medical adherence evaluation. Due to the need for administration under fasting conditions, abiraterone therapy is associated with a relatively high rate of non-adherence.

Effects of motivational interviewing intervention on psychological status, compliance behavior and quality of life of patients with malignant tumor combined with diabetes mellitus.

Objective: To investigate the effects of motivational interview education on psychological status, compliance behavior and quality of life in patients with malignant tumors combined with diabetes mellitus. Methods: This is a retrospective study. Eighty patients with malignant tumors combined with diabetes mellitus admitted at The Fourth Hospital of Hebei Medical University from January 2021 to June 2022 were included as subjects and divided into observation group and control group according to the intervention measures. Patients in the control group were given routine health education intervention, while those in the observation group were given motivational interviewing intervention on the basis of the control group. We compared the prognosis, cognitive function, quality of life, relief of cancer pain before intervention and three months after the intervention of the two groups were compared. Results: At three months after the intervention, the total remission rate of cancer pain in the observation group was higher than that in the control group(p<0.05), while the levels of FBG and 2hPG in the observation group were significantly lower than those in the control group(p<0.05). Self-Rating Anxiety Scale(SAS) and Self-rating depression scale(SDS) scores decreased in both groups three months after the intervention, with the level of reduction in the observation group being higher than that in the control group(p<0.05). The overall compliance was higher in the observation group than in the control group(p<0.05). Conclusion: Motivational interviewing leads to alleviate negative emotions, improve the psychological status, enhance compliance behavior and improve quality of life in patients with malignant tumors combined with diabetes mellitus.

Factors affecting asthma control in pregnancy: A cross-sectional study.

Background and Objective: Asthma control in pregnant women remains of utmost importance; suboptimal control can have adverse repercussions on both fetal and maternal health. The objective was to identify the factors that affect asthma control in pregnant Pakistani women presenting to a tertiary care hospital. Methods: This descriptive, cross-sectional research was conducted at KRL General Hospital between 1st November 2022 to 30th April 2023. Non-probability technique was used to sample one hundred and forty-five pregnant women with confirmed bronchial asthma irrespective of their trimester presented. Data regarding demographics and factors affecting asthma control was collected. Results: The mean age was 30.39 ± 4.33 years, with two-thirds (65%) being multiparous. Approximately 48% of participants were non-compliant with treatment, and less than 40% achieved adequate asthma control. A chi-squared test applied showed that multiparity (p = 0.003), treatment compliance (p < 0.001), BMI (p < 0.001), and proper inhaler technique (p < 0.001) were statistically significant factors affecting asthma control in pregnant women while, the level of education and household income did not exhibit a significant association. Multiple regression analysis qualified higher BMI, multiparity, treatment compliance, and inhaler technique as significant predictors of asthma control amongst pregnant women. Conclusion: Ensuring asthma control during pregnancy is important. This study identified BMI, multiparity, inhaler technique, and treatment compliance as factors that affect asthma control in pregnant women. Addressing these factors through regular antenatal check-ups can significantly mitigate risks and promote the optimal health of both maternal and fetal lives.

[Translated article] Digital health for promoting adherence to antiretroviral treatment in patients with HIV/AIDS: A meta-review.

INTRODUCTION: Digital health or "e-health" is a set of applications based on information and communication technologies (ICTs) that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-health interventions to promote adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. METHODOLOGY: A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-health components to promote adherence to ART, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS: A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 RCTs with different e-health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load (VL) measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-learning. CONCLUSION: Evidence was found that supports that some e-health interventions are effective in promoting adherence to ART and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.

Factors influencing nurses' compliance related to the use of personal protective equipment during the COVID-19 pandemic: A descriptive cross-sectional study.

AIM: To determine how nurses' experiences with the coronavirus disease (COVID-19) pandemic affected their knowledge, awareness, and compliance related to the use of personal protective equipment (PPE) during the COVID-19 pandemic in South Korea. DESIGN: A descriptive cross-sectional study. METHODS: A total of 247 nurses in South Korea participated in this study between May 10 and 19, 2023. An online self-report questionnaire was used to collect data on demographic and occupational characteristics, COVID-19 experience, knowledge, awareness, and compliance related to the use of PPE. Factors affecting compliance were analysed using hierarchical multiple linear regression. RESULTS: Mean age of the nurses was 31.92, and 94.3% were women. Most had a bachelor's degree or higher and the mean clinical experience as a nurse was 6.45 years. Knowledge of the use of PPE was 8.45 out of 10, awareness was 3.52 out of 5, and compliance was 4.28 out of 5. Knowledge and awareness were correlated with compliance related to PPE use. Awareness (ß = 0.234, p < 0.001), knowledge (ß = 0.218, p < 0.001), experience caring for COVID-19 patients (ß = 0.234, p = 0.004), optional fourth dose vaccine (ß = 0.150, p = 0.017), clinical experience (ß = 0.140, p = 0.022), and COVID-19 infection control education (ß = 0.115, p = 0.037) were found to have a significant impact on compliance. CONCLUSION: During the COVID-19 pandemic, nurses' knowledge and awareness of PPE use was a crucial factor in compliance. factors such as clinical experience, experience in caring for COVID-19 patients, optional vaccination, and completion of COVID-19 education also influenced compliance. We hope that these factors can provide a basis for developing training programs for nurses to respond to future emerging infectious diseases.

The impact of ASEAN economic community, firm characteristics and macroeconomics on firm performance and firm value: An investigation of Shariah-compliant firms in Indonesia.

The ASEAN Economic Community (AEC) presents both opportunities and challenges to Shariah-compliant firms (SCF) that have particular rules concerning business activities and financial ratios following Islamic principles. The SCF has to maintain the ratio of interest-based debt to total assets as well as non-permissible income, where these restrictions may impact both firm performance and firm value, particularly in the AEC era. Therefore, the SCF has to utilize internal factors to strengthen the firm while also considering the external factor of macroeconomics. The purpose of this paper is to examine the internal factors-firm age, size and efficiency (FASE), financial leverage, foreign ownership- and macroeconomics affecting financial performance and firm value of SCFs, including the effects both pre- and post-AEC. This study applies structural equation modelling-partial least square (SEM-PLS) to analyze 103 non-financial firms that were continuously listed on the Islamic Shariah Stock Index (ISSI) from 2011 to 2020. The results showed that FASE and macroeconomics had a significant positive influence on firm performance. Moreover, financial leverage, foreign ownership and the AEC participation showed a negative effect on firm performance. In addition, there was a positive relationship between FASE and firm value, as well as firm performance and firm value of SCFs. Finally, the findings from this study may help stakeholders determine policies that involve both internal and macroeconomic situations, as well as the potential effect of the AEC on the enhancement of firm performance and firm value.

Barriers to ensuring and sustaining street food safety in a developing economy.

Street foods are one of the highest contributors to foodborne illness in most developing economies around the world. In Ghana, diarrhoeal diseases, which are usually food or waterborne, are among the top ten causes of death. Most street food safety risks are avoidable when all food safety regulations are complied with. This paper identified and examined the barriers to the implementation of street food safety regulations in Ghana. A qualitative research approach was adopted by collecting data from nine focus group discussion sessions involving a total of 94 participants and five key informant interviews. The research uncovered three broad but interconnected categories of challenges to ensuring and sustaining street food safety: street vendor anonymity as a central challenge; poor trust in the regulatory system as root challenges; and vendor practices that risk the safety of street foods as consequential challenges. These findings have tangible policy implications. To best serve their purpose, policymakers need to understand these food safety challenges and ensure that food safety policies are responsive to the challenges.

Compliance with spectacle wear among learners with hearing impairment in Ghana.

Background: Hearing-impaired learners with refractive problems require correction because poor vision hinders their development and educational pursuits. Objectives: To determine the level of compliance with spectacle wear in learners with hearing impairment in Ghana. Method: A descriptive cross-sectional study design was used to investigate the level of compliance with spectacle wear in hearing-impaired learners with uncorrected refractive errors (URE). The participants were from six schools for the hearing impaired, comprising three schools from each sector (Northern and Southern) of Ghana. Results: Of the 1914 learners screened, 69 (3.61% CI: 2.82-4.54%) had URE. Sixty-two (89.9%) learners with URE had myopia (-0.50 Dioptre Sphere (DS) to -2.00DS), and 7 (10.1%) had hyperopia (+2.00DS to +10.00DS). There were more females (53.6%) with URE than males, and their ages ranged from 8 to 35 years, with a mean of 17.35 ± 5.19 years. Many (56.5%) learners complied with spectacle wear after 3 months of reassessment, with females being more compliant than males, but the difference was not significant (p = 0.544). Learners who complied well with the spectacle wear were those with moderate visual impairment (VI), followed by mild VI, while those with no VI were the least compliant. A significant difference was observed between spectacle compliance and presenting VI (p = 0.023). Conclusion: The spectacle wear compliance level was high compared to a previous study (33.7%) in Ghana. Contribution: This study highlights the importance of addressing URE among learners with hearing impairment in Ghana and Africa.

Treatment non-adherence among methadone maintenance patients and associated factors: a multicenter, cross-sectional study in Vietnam.

OBJECTIVE: This multicenter, cross-sectional study was conducted to investigate the prevalence of treatment non-adherence and its associated factors among methadone maintenance patients in Vietnam. METHODS: This secondary data analysis was conducted using the data from a previous study. Six hundred patients were interviewed face-to-face to collect data on their demographic characteristics and social support. Information about the treatment characteristics and patients' non-adherence was gathered from medical records and books monitoring their treatment process. Treatment non-adherence was defined as missing at least one methadone dose in the last three months. RESULTS: The overall prevalence of non-adherence was 45.7%. The average social support score of patients who completely adhered to treatment was significantly higher than that of those who did not (p < 0.001). In the multivariate logistic regression model, for each one-unit increase in social support (one score), treatment time (a year), and patient's monthly income (one million Vietnam dongs), the odds of non-adherence decreased by 28% (aOR = 0.72, 95%CI 0.59-0.88, p = 0.002), 15% (aOR = 0.85, 95%CI 0.80-0.91, p < 0.001) and 9% (aOR = 0.91, 95%CI 0.85-0.97, p = 0.004), respectively. Patients living in Son La (a mountainous province) were 1.72 times (95%CI 1.09-2.71) more likely to be non-adherent as compared to those in other areas (p = 0.020). As per univariate analyses, other associated factors could be age, education level, family monthly income, occupation, and opioid relapse (p < 0.001). CONCLUSIONS: A high non-adherence rate was found among Vietnamese methadone maintenance patients. Interventions involving social support, occupation, income, and education are needed to improve their treatment adherence.

Intracranial pulse pressure amplitude as an indicator of intracranial compliance: observations in symptomatic children with Chiari malformation type I.

OBJECTIVE: Reduced intracranial compliance (ICC) may be an important factor in the pathophysiology of Chiari malformation type I (CM-I). However, direct measurement of ICC is controversial because of its invasiveness, particularly in children. Instead, ICC may be estimated from continuous measurements of intracranial pressure (ICP), where the metric mean wave amplitude (MWA) has been found to be more useful as a surrogate marker of ICC than mean ICP. This observational study investigated the distribution of MWA and mean ICP in symptomatic children with CM-I, as well as their association with clinical and radiological findings. METHODS: From a consecutive series of children treated for CM-I at a single institution between 2006 and 2023, the authors analyzed ICP scores in those who underwent an overnight preoperative ICP recording in which MWA was calculated. Clinical and radiological data were retrieved from the patient records. RESULTS: Thirty-seven children (mean age 12.4 ± 3.6 years) with symptomatic CM-I were identified. From the overnight ICP measurements, the average MWA was 5.2 ± 1.3 mm Hg: 56% of children had an abnormal MWA (> 5 mm Hg) and 33% had a borderline MWA (4-5 mm Hg). In contrast, the average mean ICP was 9.7 ± 4.1 mm Hg: 8% of children had an abnormal mean ICP (> 15 mm Hg) and 41% had a borderline mean ICP (10-15 mm Hg). Thus, more children were found to have an abnormal MWA than an abnormal mean ICP (p < 0.001). MWA was significantly higher in the subgroup of children with medullary compression in the foramen magnum, as seen on MRI, than in those without (5.6 ± 1.0 mm Hg vs 4.7 ± 1.4 mm Hg, p = 0.03), whereas a similar difference was not observed for mean ICP (9.9 ± 4.6 mm Hg vs 9.7 ± 3.7 mm Hg, p = 0.889). CONCLUSIONS: In this cohort of symptomatic children with CM-I, MWA was more frequently abnormal than mean ICP, with a clinically significant discrepancy in half of the patients. Moreover, MWA was significantly higher in patients with medullary compression. Based on these findings, the authors' interpretation is that in children with CM-I, the ICC may be reduced, as indicated by increased MWA, even though the mean ICP is within normal thresholds.

Packaging of disposable vaping products and e-liquids in England, Canada and the United States: A content analysis.

BACKGROUND AND AIMS: Vaping product packaging is varied and often features bright colours and novel designs, particularly among recently marketed disposable vapes. This study provides an overview of attributes found on the packaging of popular disposable vapes and e-liquid bottles in England, Canada and the United States (US) and assesses compliance with local packaging regulations. DESIGN: Content analysis. SETTING: Brick-and-mortar and online shops in England (London), Canada (Ontario) and the US (New Hampshire and South Carolina). CASES: 108 vaping products (including packaging) from 76 brands in a range of flavours and nicotine levels. Specifically, 48 disposable vapes (15 from England, 16 from Canada, 17 from the US) and 60 e-liquid bottles (20 per country). MEASUREMENTS: Textual and graphic branding and marketing elements, independently coded by two researchers and checked by a third. FINDINGS: Compliance with local packaging regulations varied across countries. Health warnings were present on the packaging of all but one nicotine-containing product, although 33% of disposables and 17% of e-liquids featuring the warning did not adhere to formatting requirements. Leaflets were seldom included with e-liquid bottles, even in England (45%) where mandatory, and omitted elsewhere. Labelling of nicotine type and batch numbers was inconsistent. Vaping product packaging featured claims relating to sensory perceptions (41%), most often flavours, and some (32%) featured youth-appealing content. Common graphic elements included stylised brand fonts (80%), brand logos (54%), product representations on the external packaging (47%) and abstract graphic elements (64%). Colours on packaging, disposable vapes and e-liquid bottles were associated with product flavour. CONCLUSIONS: In England, Canada and the United States, popular disposable vapes and e-liquid bottles appear to have varying compliance with local packaging regulations and inconsistent labelling of nicotine and product characteristics. The use of colourful designs, evocative descriptors and appealing graphics to promote flavours underscores the need for comprehensive packaging regulations and enforcement.

Regulatory compliance of PCDD/F emissions by a municipal solid waste incinerator. A case study in Sant Adrià de Besòs, Catalonia, Spain.

Despite incineration is an important emission source of toxic pollutants, such as heavy metals and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), it is still one of the most widely used methods for the management of municipal solid waste. The current paper summarizes the results of a 20-year follow-up study of the emissions of PCDD/Fs by a municipal solid waste incinerator (MSWI) in Sant Adrià de Besòs (Catalonia, Spain). Samples of ambient air, soils and herbage were periodically collected near the facility and the content of PCDD/Fs was analyzed. In the last (2017) survey, mean levels in soil were 3.60 ng WHO-TEQ/kg (range: 0.40-10.6), being considerably higher than the mean concentrations of PCDD/Fs in soil samples collected near other MSWIs in Catalonia. Moreover, air PCDD/F concentrations were even higher than those found in a previous (2014) survey, as they increased from 0.026 to 0.044 pg WHO-TEQ/m3. Ultimately, the PCDD/F exposure would be associated to a cancer risk (2.5 × 10-6) for the population living in the surrounding area. Globally, this information indicates that the MSWI of Sant Adrià de Besòs could have had a negative impact on the environment and potentially on public health, being an example of a possible inappropriate management for years. The application of Best Available Techniques to minimize the emission of PCDD/Fs and other chemicals is critical.

Changes in complacency to adherence to COVID-19 preventive behavioral measures and mental health after COVID-19 vaccination among medical and dental healthcare professionals.

Medical and dental professionals should continue to adhere to preventive measures after COVID-19 vaccination due to their increased risk of exposure to the virus, particularly as new variants emerge that may heighten their risk perception and susceptibility. Therefore, this study aimed to explore the effects of COVID-19 vaccination on complacency to adherence to COVID-19 preventive behavioral measures and mental health among medical and dental professionals. In this cross-sectional study 410 medical and dental professionals were recruited from different medical and dental hospitals in Islamabad, Pakistan. The data was collected using a valid and reliable questionnaire comprising of three sections (socio-demographic, information of preventive behaviors performance against COVID-19 after vaccination, mental health status). A chi-square test and ordinal logistic regression were used for analysis. Post COVID-19 vaccination there was decrease in the frequency of use of hand washing, sanitizers (70.2%), and social distancing (60.5%), however greeting with a handshake (58.8%) and use of public transport (45.9%) seen upward trend among participants. Only face mask usage post-vaccination was statistically significant (p < .05) in association with age, marital status, and years of working Experience. The greatest decrease in the usage of masks after COVID-19 vaccination was seen in age group of 10-30 (41.7%) and working experience group of 0-5 years (39.7%). All the preventive behaviors are statistically significant (p < .05) associated with the mental status of the participants except online shopping and use of public transport. These results indicate the presence of vaccination-induced complacency in adherence to COVID-19 preventive behavioral measures among healthcare professionals.

A review of moxidectin vs. other macrocyclic lactones for prevention of heartworm disease in dogs with an appraisal of two commercial formulations.

Macrocyclic lactones (MLs) are the only drug class currently licensed for heartworm disease prophylaxis. Macrocyclic lactones kill third- and fourth-stage larvae of Dirofilaria immitis, thus preventing the development of adult worms in dogs, which are responsible for heartworm disease, a potentially life-threatening condition. Despite considerable overlap in terms of endectocide spectrum, several important differences distinguish moxidectin from other MLs. Moxidectin has beneficial pharmacokinetic characteristics, such as a longer half-life and greater tissue distribution compared to ivermectin. Additionally, moxidectin has a greater margin of safety compared to ivermectin in dogs with ABCB1 (previously MDR1) gene-defect, which is commonly recognized in collies and other breeds. Multiple laboratory studies have shown that moxidectin is more effective than other commonly used heartworm preventives against resistant strains of D. immitis. This improved efficacy benefits individual dogs and helps reduce the risk of spreading resistant strains within the community. Despite the presence of proven resistant strains in the United States, non-compliance with preventive measures remains a major factor contributing to the diagnosis of heartworm disease in dogs. In retrospective analyses, the oral moxidectin combination product Simparica Trio® (sarolaner, moxidectin, and pyrantel) was associated with increased compliance, resulting in more time of protection compared to dogs receiving flea/tick and heartworm preventive products separately. Compliance with the extended-release moxidectin injectables ProHeart® 6 and ProHeart® 12 was higher than with monthly heartworm preventives, as they provide 6 months or a full year of protection with one single injection, respectively, and revenues remain in the veterinary clinics as injectable moxidectin cannot be sourced through online retailers.

Advancing elderly diabetes care: exploring the usability and acceptance of continuous glucose monitoring (CGM).

OBJECTIVES: This study aimed to evaluate the acceptability, usability, compliance, and satisfaction of Continuous Glucose Monitoring (CGM) among elderly diabetic patients. DESIGN: Utilizing a mixed-methods approach, the study involved 30 participants, averaging 74.79 years in age. Participants wore two CGM devices, and their experiences, along with survey data, were comprehensively analyzed to gauge the effectiveness of CGM in managing diabetes. RESULTS: The study demonstrated that -CGM- is highly usable and acceptable among elderly diabetic patients. Participants effectively utilized CGM to monitor and predict blood glucose trends, positively influencing their glucose control and lifestyle. The average adherence rate was found to be 81 %, indicating a substantial level of effective self-management and treatment decision-making. CONCLUSION: The study recommends developing CGM educational programs tailored for the elderly, educating healthcare professionals, expanding insurance coverage for CGM, and promoting real-time CGM technology to improve usability and acceptance among the elderly.

Impact of Evidence-Based Nursing on Self-Efficacy, Quality of Life and Treatment Compliance in Patients Undergoing Urological Surgery: Retrospective Study.

BACKGROUND: Urological surgery presents unique challenges to patients, necessitating specialised aftercare nursing. Evidence-based nursing has emerged as a strategy to improve patient outcomes through tailored education, self-management strategies and psychological support. However, its specific impact on post-operative outcomes in patients undergoing urological surgery has not been extensively explored. METHODS: This study assessed postoperative self-efficacy, quality of life, treatment compliance and nursing satisfaction. Self-compiled percentage of satisfaction scale was used to assess the degree of satisfaction with nursing work in both groups. Patients' self-care ability was evaluated using the Self-Care Ability Scale, and their quality of life scores were assessed with Short Form 36 Health Survey (SF-36). Patients' anxiety and depression levels were examined using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Statistical analysis was conducted using SPSS 29.0 statistical software. RESULTS: This retrospective study analysed 231 patients undergoing urological surgery and categorised them into a usual care group (n = 99) and an evidence-based nursing group (n = 132). Post-operative outcomes in the evidence-based nursing group included significantly higher self-care abilities (p < 0.001), improved quality of life scores (p < 0.001), lower anxiety and depression levels (p < 0.001) and higher treatment compliance rates (p < 0.05) compared with the usual care group. Additionally, nursing satisfaction was higher in the evidence-based nursing group (p = 0.001). CONCLUSIONS: The findings provide compelling evidence regarding the favourable impact of evidence-based nursing on various post-operative outcomes in patients undergoing urological surgery. Evidence-based nursing shows promise in enhancing patients' self-efficacy, well-being, treatment compliance and satisfaction. The results underscore the potential benefits of evidence-based nursing in optimising aftercare nursing and driving positive patient-centred outcomes in urological surgery setting.

Determinants of global cardiac implantable electrical device remote monitoring utilization - Results from an international survey.

Background: Despite near-global availability of remote monitoring (RM) in patients with cardiac implantable electronic devices (CIED), there is a high geographical variability in the uptake and use of RM. The underlying reasons for this geographic disparity remain largely unknown. Objectives: To study the determinants of worldwide RM utilization and identify locoregional barriers of RM uptake. Methods: An international survey was administered to all CIED clinic personnel using the Heart Rhythm Society global network collecting demographic information, as well as information on the use of RM, the organization of the CIED clinic, and details on local reimbursement and clinic funding. The most complete response from each center was included in the current analysis. Stepwise forward multivariate linear regression was performed to identify determinants of the percentage of patients with a CIED on RM. Results: A total of 302 responses from 47 different countries were included, 61.3% by physicians and 62.3% from hospital-based CIED clinics. The median percentage of CIED patients on RM was 80% (interquartile range, 40-90). Predictors of RM use were gross national income per capita (0.76% per US$1000, 95% CI 0.72-1.00, P < .001), office-based clinics (7.48%, 95% CI 1.53-13.44, P = .014), and presence of clinic funding (per-patient payment model 7.90% [95% CI 0.63-15.17, P = .033); global budget 3.56% (95% CI -6.14 to 13.25, P = .471]). Conclusion: The high variability in RM utilization can partly be explained by economic and structural barriers that may warrant specific efforts by all stakeholders to increase RM utilization.

Factors Affecting Patients' Atttendance for Periodontal Follow-up Visits after Crown Lengthening Surgery.

PURPOSE: To assess adherence to follow-up maintenance visits among patients who had previously undergone crown-lengthening surgery and investigate the different factors impacting their compliance. MATERIALS AND METHODS: A total of 314 patients were identified for follow-up appointments. Based on their responses, participants were categorised into four groups: attendees, non-attendees, refusals, and unreachable. Furthermore, data on sociodemographic factors (age, sex, nationality, marital status, education, occupation, and residential area), medical history, dental history (including missing teeth, implants, or orthodontic treatment history), and past appointment attendance (average yearly appointments, missed appointment percentage, and last appointment date) were collected and analysed to understand their influence on patient compliance. RESULTS: In a sample of 314 patients, 102 (32.5%) attended the appointments successfully. Improved attendance rates were significantly associated with being female, Saudi Arabian, married, and employed (p < 0.05). Moreover, patients with a high frequency of annual appointments and a recent history of appointments exhibited better compliance. None of the analysed dental factors affected the attendance rates. CONCLUSION: About one-third of patients who had undergone crown lengthening surgery were compliant with the follow-up visits. Different factors influenced this compliance pattern to varying extents, with more efforts needed to enhance patients' commitment to these visits.

Would you bet on the vet? Influences on dairy farmers' vaccination choices, with a spotlight on the Veterinarian impact.

Ensuring effective vaccination is crucial for epidemic control, particularly in voluntary vaccination scenarios. Though highly important for planning voluntary vaccination programs, we lack insights into the effectiveness of veterinarian communication and the impact of disease-specific traits on farmer vaccination intentions. To fill this void, our study compared five diseases affecting Israeli dairy cattle (Botulism, Bovine Ephemeral Fever (BEF), Brucellosis, Lumpy Skin Disease (LSD), and Rabies). Using questionnaires grounded in the theory of planned behavior, we surveyed 340 Israeli dairy farmers to understand their vaccination intentions for each disease.Simultaneously, veterinarians overseeing these farms provided insights into their opinions and perceived influence on vaccination decisions. Results revealed varying levels of farmer vaccination intention, with Botulism showing the highest and BEF the lowest. Social pressure significantly influenced farmers' vaccination intentions, with distinct patterns across diseases. Veterinarian opinions had the highest influence only for LSD, while other factors played crucial roles in different diseases. Intriguingly, there was no correlation between veterinarians' recommendations and farmers' perceptions of these recommendations. In conclusion, the optimization of voluntary vaccination programs necessitates tailoring interventions to the unique characteristics of each disease. Additionally, improving communication between veterinarians and farmers is essential, with an emphasis on effective risk communication training.