Conformity to masculine norms and its association with drinking behaviors and alcohol-related consequences among adult men: A meta-analysis.

OBJECTIVES: Studies typically show that men are at higher risk for heavy alcohol use than women. Research linking conformity to masculine norms and drinking behaviors among adult males has grown steadily during the past 10 years. We conducted the first meta-analysis that examines (a) the strength of the associations between conformity to masculine norms and alcohol use outcomes, and (b) the extent to which the strength of these associations would be affected by the specific type of drinking behavior or methodological factors. METHODS: We included 35 studies (N=32,412) in this meta-analysis that examined the association between scores on the Conformity to Masculine Norms Inventory (CMNI) and alcohol use outcomes. RESULTS: Across all studies, the average correlation between conformity to masculine norms and alcohol variables was small (r = 0.17). The associations between conformity to masculine norms and specific alcohol variables were also modest: alcohol use composite score of frequency and quantity (r = 0.20), binge drinking frequency (r = 0.14), and alcohol-related consequences (r = 0.16). The mean correlation between each CMNI subscale and alcohol variables was also small (alcohol use composite, rs range from 0.07 to 0.22; alcohol-related consequences, rs range from 0.04 to 0.29; frequency of binge drinking, rs range from -0.06 to 0.22). There was a significant difference in effect size by specific type of drinking behavior (i.e., effect sizes for binge drinking were smaller than effect sizes for other alcohol variables). Methodological factors (i.e., CMNI version; sample type: university vs. adult vs. mixed samples; country where the study was conducted) did not affect the associations between masculine norms and the alcohol-outcome variables. CONCLUSIONS: Conformity to masculine norms is modestly associated with drinking behaviors and alcohol-related consequences. The effect sizes reported in this meta-analysis can assist in power analyses in future studies on conformity to masculine norms and specific drinking behaviors among adult males.

Implications of the decline in adolescent drinking on the experience of alcohol-related consequences in the Nordic countries: A study based on data from the ESPAD project.

Aims: The aim of this study was to investigate: (1) whether self-reported acute alcohol-related consequences among adolescents in the Nordic countries have declined in concert with the decline in alcohol consumption; (2) whether the relationship between alcohol consumption and alcohol-related consequences has strengthened; and (3) whether the decline in alcohol-related consequences can be attributed to the decline in alcohol consumption. Methods: Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional surveys in 2007, 2011 and 2015. Participants were students aged 15-16 years in 2007 (n = 16,035), 2011 (n = 14,765) and 2015 (n = 13,517). Alcohol consumption variables included lifetime and 12-month alcohol use, volume ethanol at last drinking occasion and heavy episodic drinking in the past 30 days. Self-reported acute alcohol-related consequences were measured as a sum index of experiencing the following at least once within the last 12 months: (1) an accident or injury; (2) being victimised by robbery or theft; or (3) had trouble with the police. Results: For all alcohol indicators, adolescent alcohol use decreased between 2007 and 2015. The highest prevalence estimates were found in Denmark, and here only the number of current drinkers decreased significantly. In addition, a decreasing trend in self-reported acute alcohol-related consequences was observed. We did not find a strengthening of the alcohol consumption consequences association from 2007 to 2015, except in Iceland. When all surveys were combined, the decrease in alcohol-related consequences could be explained by a decrease in alcohol consumption. Conclusions: Overall, adolescents aged 15-16 years exhibited decreasing trends in both alcohol consumption, less markedly in Denmark, and in our sum index of alcohol-related consequences between 2007 and 2015. Except for Iceland, we found no support for a strengthening of the alcohol-consequences association with declining drinking among adolescents.

Reconfiguration of uncertainty: Introducing AI for prediction of mortality at the emergency department.

The promise behind many advanced digital technologies in healthcare is to provide novel and accurate information, aiding medical experts to navigate and, ultimately, decrease uncertainty in their clinical work. However, sociological studies have started to show that these technologies are not producing straightforward objective knowledge, but instead often become associated with new uncertainties arising in unanticipated places and situations. This study contributes to the body of work by presenting a qualitative study of an Artificial Intelligence (AI) algorithm designed to predict the risk of mortality in patients discharged to home from the emergency department (ED). Through in-depth interviews with physicians working at the ED of a Swedish hospital, we demonstrate that while the AI algorithm can reduce targeted uncertainty, it simultaneously introduces three new forms of uncertainty into clinical practice: epistemic uncertainty, actionable uncertainty and ethical uncertainty. These new uncertainties require deliberate management and control, marking a shift from the physicians' accustomed comfort with uncertainty in mortality prediction. Our study advances the understanding of the recursive nature and temporal dynamics of uncertainty in medical work, showing how new uncertainties emerge from attempts to manage existing ones. It also reveals that physicians' attitudes towards, and management of, uncertainty vary depending on its form and underscores the intertwined role of digital technology in this process. By examining AI in emergency care, we provide valuable insights into how this epistemic technology reconfigures clinical uncertainty, offering significant theoretical and practical implications for the integration of AI in healthcare.

Adaptation and Validation of the Psychological Consequences of Screening Questionnaire (PCQ) for Cognitive Screening in Primary Care.

BACKGROUND: Context-specific measures with adequate external validity are needed to appropriately determine psychosocial effects related to screening for cognitive impairment. METHODS: Two-hundred adults aged ≥65 y recently completing routine, standardized cognitive screening as part of their Medicare annual wellness visit were administered an adapted version of the Psychological Consequences of Screening Questionnaire (PCQ), composed of negative (PCQ-Neg) and positive (PCQ-Pos) scales. Measure distribution, acceptability, internal consistency, factor structure, and external validity (construct, discriminative, criterion) were analyzed. RESULTS: Participants had a mean age of 73.3 y and were primarily female and socioeconomically advantaged. Most had a normal cognitive screening result (99.5%, n = 199). Overall PCQ scores were low (PCQ-Neg: x¯= 1.27, possible range 0-36; PCQ-Pos: x¯ = 7.63, possible range 0-30). Both scales demonstrated floor effects. Acceptability was satisfactory, although the PCQ-Pos had slightly more item missingness. Both scales had Cronbach alphas >0.80 and a single-factor structure. Spearman correlations between the PCQ-Neg with general measures of psychological distress (Impacts of Events Scale-Revised, Perceived Stress Scale, Kessler Distress Scale) ranged from 0.26 to 0.37 (P's < 0.001); the correlation with the World Health Organization-Five Well-Being Index was -0.19 (P < 0.01). The PCQ-Neg discriminated between those with and without a self-reported subjective cognitive complaint (x¯ = 2.73 v. 0.89, P < 0.001) and was associated with medical visit satisfaction (r = -0.24, P < 0.001) on the Patient Satisfaction Questionnaire. The PCQ-Pos predicted self-reported willingness to engage in future screening (x¯ = 8.00 v. 3.00, P = 0.03). CONCLUSIONS: The adapted PCQ-Neg is an overall valid measure of negative psychological consequences of cognitive screening; findings for the PCQ-Pos were more variable. Future studies should address measure performance among diverse samples and those with abnormal screening results. HIGHLIGHTS: The PCQ scale is an overall valid measure of psychological dysfunction related to cognitive screening in older adults receiving normal screen results.PCQ scale performance should be further validated in diverse populations and those with abnormal cognitive screening results.The adapted PCQ may be useful to both health research and policy stakeholders seeking improved assessment of psychological impacts of cognitive screening.

Examining the Impact of Simultaneous Alcohol and Cannabis Use on Alcohol Consumption and Consequences: Protocol for an Observational Ambulatory Assessment Study in Young Adults.

BACKGROUND: There is significant conflicting evidence as to how using cannabis while drinking alcohol (ie, simultaneous alcohol and cannabis use) impacts alcohol volume consumed, patterns of drinking, and alcohol-related consequences. The impact of simultaneous use on drinking outcomes may be influenced by several within-person (eg, contextual) and between-person (individual) factors. OBJECTIVE: This study was designed to examine naturalistic patterns of alcohol and cannabis use to understand how simultaneous use may impact drinking outcomes. The primary aims were to understand the following: (1) if simultaneous use is associated with increased alcohol consumption and riskier patterns of drinking, (2) if simultaneous use leads to increased alcohol consequences, and (3) how contextual circumstances moderate the impact of simultaneous use on consumption and consequences. METHODS: Data collection involves a 28-day ambulatory assessment protocol in which a sample of non-treatment-seeking young adults who report simultaneous use of alcohol and cannabis complete ecological momentary assessments (random, event-contingent, and time-contingent surveys) of alcohol and cannabis use, contexts, motives, and consequences on their personal smartphones while continuously wearing an alcohol biosensor bracelet. Participants also complete a baseline assessment, brief internet-based check-in on day 14, and a final session on day 28. Community-based recruitment strategies (eg, social media and flyers) were used to enroll 95 participants to obtain a target sample of 80, accounting for attrition. RESULTS: Recruitment and data collection began in May 2021 and continued through June 2024. Initial results for primary aims are expected in October 2024. As of March 2024, the project had recruited 118 eligible participants, of whom 94 (79.7%) completed the study, exceeding initial projections for the study time frame. Remaining recruitment will provide the capacity to probe cross-level interactions that were not initially statistically powered. Strengths of the project include rigorous data collection, good retention and compliance rates, faster-than-expected enrollment procedures, use of a novel alcohol biosensor, and successful adaptation of recruitment and data collection procedures during the COVID-19 pandemic. CONCLUSIONS: This is the first investigation to assess the key momentary predictors and outcomes of simultaneous use as well as self-reported and objective (via alcohol biosensor) measures of alcohol consumption and patterns. The results of this study will inform prevention efforts and studies of individuals who use cannabis who are engaged in alcohol treatment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58685.

The Code of Ethics for Chemists between Universal Moral Values and Local Reality.

In an increasingly globalized world, threatened by resource depletion, global warming and pollution, scientists in general and the chemists in particular are obliged to rapidly integrate ethical values into their work. This article shows that the codes of ethics are a valuable aid in this process. Two real life examples are highlighted. The first one concerns a misbehaviour situation from an academic, while the second one presents the entangled political, economic and legal implications brought about by the pollution by polychlorobiphenyls (PCBs) of the landfill La Pila, in the canton of Fribourg. Ultimately, the article underscores the collective responsibility of scientists, policy makers and economical players to uphold ethical excellence, for the benefit of the whole society and of everyone.

Translation and cultural adaptation of the COVID-19 Yorkshire Rehabilitation Scale into German.

Background: Experts estimate that in up to 10% of the infected, SARS-CoV-2 would cause persistent symptoms, activity limitations and reduced quality of life. Referred to as long COVID, these conditions might, in the future, specifically impact German-speaking countries due to their higher rates of unvaccinated people compared to other Western countries. Accurate measurement of symptom burden and its consequences is needed to manage conditions such as long COVID, and several tools have been developed to do so. However, no patient-reported instrument existed in the German language at the time of writing. Objective: This study, therefore, aimed to develop a German version of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS). Methods: We conducted a translation and qualitative evaluation, including cultural adaptation, of the C19-YRS and assessed its face validity. After creating a preliminary version, 26 individuals (14 women [53%]) participated in cognitive interviews (January 2022 to March 2022). Using cognitive debriefing interviews, we ensured the content's comprehensibility. The matrix-framework method guided the qualitative data analysis. Results: Compared to the original English version, adaptations were necessary, resulting in changes to the introductory text, while the items for recording persistent symptoms were hardly changed. Conclusion: The German version of the C19-YRS is expected to support standardized long COVID care.

Silent Screams: A Narrative Review of Cyberbullying Among Indian Adolescents.

Cyberbullying is bullying with the use of digital technologies, which can take place on social media, messaging platforms, gaming platforms, and mobile phones. It is repeated behavior aimed at scaring, angering, or shaming those who are targeted. India happens to be one of the rapidly improving countries in the cyber world and thus faces a lot of problems regarding cyber crimes, especially cyberbullying. This narrative review aims to provide a thorough assessment of the impact of cyberbullying among Indian adolescents. The database engines such as PubMed, Google Scholar, and PsycINFO were searched relevant to the Indian context, focused on cyberbullying and victimization among adolescents, and published within the last 10 years (2014-2024) were included. Around 19 articles were reviewed and analyzed. Cyberbullying in India is on the rise due to increased technology access, social media, and insufficient awareness and prevention measures, with significant gender differences in aggression patterns. The severe psychological and physiological effects on victims, including depression and stress-related health issues, highlight the need for accurate data and culturally tailored interventions. Studies show varying prevalence rates, emphasizing the urgent need for focused efforts to combat cyberbullying among Indian youth. The review encompasses various aspects, including prevalence, standard methods, forms, causes, consequences, and effects on mental health factors contributing to cyberbullying in India. Additionally, the review explores cyberbullying during COVID-19 and interventions for cyberbullying and highlights the evidence from cohort studies, mixed-method studies, and systematic reviews. A growing number of adolescents are experiencing cyberbullying, which has a severe impact on their lives and leads to unexpected deviances. Cyberbullying remains a growing threat, requiring stronger, coordinated action by the government to genuinely make a difference and safeguard adolescents in India.

Evaluating the consequences of critically ill patients with pediatric cancer at Aliasghar Children's Hospital.

Background: Despite significant progress in supportive care and advancements in chemotherapy treatments, cancer remains a leading cause of mortality in children. The objective of this study was to assess the potential correlation between various risk factors and the consequences of patients with pediatric cancer who were admitted to the pediatric intensive care unit (PICU). Methods: The present investigation is a retrospective cohort study that examined children with cancer who were between the ages of 1 month and 17 years and had been admitted to the PICU. Demographic and clinical information of all patients, including such as the age, type of cancer, sex, BMI, history of specific disease, PICU admission time, disease condition on PICU admission, patient's status at PICU admission, and number of organ failures, were extracted from each patient file. Results: The number of pediatric oncology patients admitted to the PICU was 127. The highest mortality rate was observed among children with heart problems (75%), followed by CNS involvement (54.2%) and sepsis (42.9%). The study found that various factors had a significant effect on the outcomes of patients who were admitted to the PICU, including but not limited to the primary type of malignancy, disease status, indications for hospital admission, patient's condition, inpatients' length of stay (LOS), tumor type, and the extent of organ failure at the time of admission to the PICU. Conclusion: Despite recent advancements in healthcare, the prognosis of patients admitted to the PICU in underdeveloped areas remains suboptimal in comparison to those in developed regions. Poor outcomes were found to be significantly associated with various factors, including the primary type of malignancy, disease status, the reason for admission to the PICU, patient's condition, LOS, tumor type, and the extent of organ failure, especially in cases involving hematological malignancies.

Unsettling trend: The alarming rise of human abuse of veterinary drugs and its consequences.

Veterinary practitioners often prescribe many controlled drugs to animals that may include sedatives, tranquilizers, and painkillers. Unfortunately, many of these drugs are drugs that can be abused by humans, especially among the pet owners. Adequate measures are required to prevent or detect the misuse of veterinary drugs. In this article, the phenomenon of the rising misuse of veterinary medications by humans and their potential health hazards which can accompany the unsettling trends in society has been highlighted. This article aims to shed light on the extent of issues, exploring reasons behind human abuse and its consequences.

[Bed confinement in old people-A literature review]. / Bettlägerigkeit bei alten Menschen ­ eine Literaturübersicht.

BACKGROUND: Particularly older people are affected by mobility restrictions and can go through the process of gradually becoming bedridden. This can potentially lead to extensive consequences for the individuals involved, which must be considered in their care. AIMS: To bundle nursing implications related to the phenomenon of being bedridden in the field of long-term care and to provide impulses for research in nursing science. METHODS: Research in relevant specialist databases (2003-2023) based on the criteria of a scoping review. RESULTS: In Germany there is a standard for maintaining and promoting mobility that addresses bed and local confinements but German language studies on these phenomena are rare. In the international context, these issues are researched more intensively, focussing on risk factors for the development of immobility and the negative consequences for those affected. The publications focus on the reduction of these factors, while less attention is paid to the organization of life in bed and the participation and involvement of those affected. DISCUSSION: The complexity of the phenomenon is not fully illustrated in current research. In order to develop a nursing perspective research projects that also include aspects of life in bed are a central aspect in order to take greater account of the reality of bedridden people's lives and their potential for participation and involvement.

It's Not Just What Parents Say, It's Why They Say It: Students' Perceptions of Parents' Motives for Alcohol Communication.

OBJECTIVE: Previous work has investigated parents' reports of motives for communicating with their young adults about alcohol. While parents' self-reported motives may predict intentions to communicate, young adults' perceptions of their parents' motives may be important for understanding young adults' responses to parent alcohol communication. The present study was conducted to explore college students' perceptions of their parents' motives for alcohol communication and to investigate whether perceptions of these motives predict changes in alcohol consumption and related consequences during the transition to college. METHOD: First-year college students (N = 306) participated in a longitudinal survey study. Baseline measures at pre-matriculation (T1) included assessments of student perceptions of their parents' motives for alcohol communication and covariates (e.g., perceived peer descriptive drinking norms, parental modeling and alcohol communication, and drinking and consequences). At a 1-month follow-up (T2), students reported on their alcohol use and consequences. RESULTS: Controlling for other predictors of college student drinking, results indicate that for each one-unit increase in perceived parental reactive communication motives, the incidence rate of typical weekly drinking increased by 9%, and heavy episodic drinking (HED) increased by 21%. Conversely, the incidence rate of HED decreased by 27% for each one-unit increase in perceived maternal family history communication motives. CONCLUSIONS: These findings suggest that college students' perceptions of their parents' motives for alcohol communication can significantly influence their drinking behavior during the transition to college.

Health consequences associated with poor diet and nutrition in persons with spinal cord injuries and disorders.

PURPOSE: To describe health consequences associated with poor diet in persons with spinal cord injuries and disorders (SCI/D). MATERIALS/METHODS: Descriptive qualitative design using in-depth interviews with SCI/D health providers. Audio-recorded and transcribed verbatim transcripts were coded and analyzed using thematic analysis. RESULTS: Participants (n = 12) were from 11 nationwide VA hospitals. Participants were male (75%), white (67%), 26-49 years of age, and most were dietitians (75%) and physiatrists (17%). Seven key themes identified consequences associated with poor diet in persons with SCI/D, including (1) Weight gain and body composition changes, (2) cardiometabolic conditions, (3) bowel dysfunction, (4) pressure injuries/wounds, (5) other SCI/D secondary conditions/complications (renal/kidney; immune function/susceptibility to infections; autonomic dysreflexia; bone health/osteoporosis; pain), (6) physical fatigue, and (7) poor mental health. CONCLUSIONS: Excess weight, cardiometabolic conditions, SCI/D secondary conditions/complications (e.g., bowel dysfunction, pressure injuries), and poor mental health were identified as health consequences of inadequate nutrition. Health providers should make individuals with SCI/D aware of the risks and health consequences to incentivize healthier dietary behaviors. Efforts to identify nutrition shortcomings and to develop interventions and tailored care plans are needed to improve a myriad of health consequences due to poor diet and nutrition in persons with SCI/D.

Individuals with spinal cord injuries and disorders (SCI/D) have a heightened risk for chronic conditions and SCI/D secondary complications that are impacted by diet and nutrition.Inadequate nutrition has been documented among individuals with SCI/D.Poor diet/nutrition is a preventable risk factor, which unlike exercise, may be a feasible approach to health improvement that can reach a wide range of individuals with SCI/D.Health providers are well-positioned to bring awareness of risks and health consequences of poor nutrition to individuals with SCI/D in the health care and rehabilitation setting to incentivize positive eating behavior changes.

Machine learning for environmental justice: Dissecting an algorithmic approach to predict drinking water quality in California.

The potential for machine learning to answer questions of environmental science, monitoring, and regulatory enforcement is evident, but there is cause for concern regarding potential embedded bias: algorithms can codify discrimination and exacerbate systematic gaps. This paper, organized into two halves, underscores the importance of vetting algorithms for bias when used for questions of environmental science and justice. In the first half, we present a case study of using machine learning for environmental justice-motivated research: prediction of drinking water quality. While performance varied across models and contaminants, some performed well. Multiple models had overall accuracy rates at or above 90 % and F2 scores above 0.60 on their respective test sets. In the second half, we dissect this algorithmic approach to examine how modeling decisions affect modeling outcomes - and not only how these decisions change whether the model is correct or incorrect, but for whom. We find that multiple decision points in the modeling process can lead to different predictive outcomes. More importantly, we find that these choices can result in significant differences in demographic characteristics of false negatives. We conclude by proposing a set of practices for researchers and policy makers to follow (and improve upon) when applying machine learning to questions of environmental science, management, and justice.

Alcohol Protective Behavioral Strategy use and Negative Consequences Across Heavy Alcohol Users and Risky Drinkers.

This study investigated differences in alcohol protective behavioral strategy (PBSA) use and negative consequences (ARNC) experienced among heavy alcohol users and non-heavy alcohol users, and risky and non-risky drinkers. Participants were from 12 universities in the United States (n = 2,163 college students, Mage = 19.47), predominantly identified as White (74%), and female (68.7%), who completed measures of typical weekly drinking, risky drinking, ARNC, and PBSA use. ANOVAs revealed that the heavy alcohol users and risky drinkers reported significantly fewer total PBSA, subtype strategy use, and greater negative consequences than their counterparts. Harm reduction interventions may benefit from identifying and targeting college students who are engaging in heavy alcohol use and risky drinking regardless of sex.

The Unintended Consequences of Telehealth in Australia: Critical Interpretive Synthesis.

BACKGROUND: Despite more than 2 decades of telehealth use in Australia and the rapid uptake during the COVID-19 pandemic, little is known about its unintended consequences beyond its planned and intended outcomes. OBJECTIVE: The aim of this review was to synthesize evidence on the unintended consequences of telehealth use in Australia to clarify its impact beyond its planned and intended outcomes. METHODS: We conducted a search of 4 electronic databases: Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, and Scopus. A critical interpretive synthesis approach was adopted for its flexibility and interpretive nature. We extracted data about study characteristics and the types and models of telehealth services. The extracted unintended consequences were coded and mapped into the domains and dimensions of the Australian Health Performance Framework. RESULTS: Of the 4241 records identified by the search, 94 (2.22%) studies were eligible for data extraction and analysis. Of these 94 studies, 23 (24%) reported largely positive unintended consequences of telehealth associated with health status, while 6 (6%) noted a potential negative impact of telehealth on socioeconomic status. The findings of 4 (4%) of the 94 studies highlighted societal and financial consequences of telehealth beyond the health system. Almost all studies (93/94, 99%) reported unintended consequences under the 5 dimensions of the Australian Health Performance Framework. CONCLUSIONS: Our synthesis offers a framework for understanding the unintended consequences of the use of telehealth as an alternative to in-person care in Australia. While we have documented many unintended benefits of telehealth use, our findings also shed light on many challenges of delivering care via telehealth across different domains and dimensions. These findings hold significant practice and policy-making implications for ensuring safe and high-quality care delivery via telehealth.

Assessing prevalence, factors and health consequences and academic performance of undergraduate students with breakfast skipping during COVID-19 using statistical modeling: a cross-sectional study.

The study was conducted in order to study breakfast skipping (BKS) frequency, factors associated with, health consequence and undergraduate students academic performance during Covid-19 pandemic as earliest studies focusing on this area. A cross-sectional study was carried out among 2225 of undergraduate students. The study was carried between the period of 15/1/2020 to 3/4/2020 using an online self-report Breakfast Eating Habit Survey (BEHS). The BEHS survey was divided into two sections. The first sections included sociodemographic information (gender, BMI, age, smoking, residency, parental education, family income, studying system and stage (public or private), and studying institution (university or institute) academic performance. The second part included questions regarding breakfast eating habits including frequency of skipping meals, factors related to BKS health consequences and types of snacks. Logistic regression is a common technique used for modeling outcomes that fall into the range of 1 and 0. For this purpose, a logistic regression was performed to find adjusted odds ratio and crude odds ratio. The results showed that the majority of participants were female (1238, 55.7%). Out of 2,224 students, 2059 are aged between 18 to 24 years. Most of the participants were from first level (26.5%), second level (32.8%), third level (17.6%) or the fourth level (21.3%). Over 92% of participants were single and about 68% came from families of medium income families. The statistical analysis showed that the odds of BKS is reduced among students who live in accommodation by 54% (odds ratio = 54%, CI (41-71%), p value = 0.000). It seems that students with low income and normal or higher BMI are more likely to skip breakfast more regularly. The odds of skipping breakfast among students with BMI of 18-24.9 is reduced by 41% (odds ratio = 59%, CI (27%-93%), p value = 0.027) and the odds of BKS is reduced among students with BMI of 25-29.9 by 45% (odds ratio = 55%, CI (31-95%). Additionally, students with medium or high incomes are more likely to skip breakfast as much as twofold in comparison with students with low income (medium income (odds ratio = 1.85, CI (1.08-3.17), p-value = 0.024), high income (odds ratio = 1.98, CI (1.12-3.51), p-value = 0.019). The most common reasons for skipping breakfast included include time constraint, not hungry, breakfast is not ready, afraid to be overweight and lack of appetite. The consequences of skipping breakfast were feeling hungry throughout the day, feeling tired, and not paying attention in class and low academic performance. To concluded, BKS during Covid-19 is more common among students with higher BMI, higher income and living in accommodation. The main reason is time constraint and the most common health problems are being tired and luck of attention.

Evaluating Neurogenic Bladder Management in Palestinian Healthcare: A Qualitative Study.

BACKGROUND: Neurogenic bladder (NB) is a prevalent urologic condition significantly impacting the health and quality of life of affected individuals. The condition, often resulting from various etiologies such as spinal cord injuries and multiple sclerosis, leads to severe life problems, including pain and impaired physical, mental, social, and emotional functioning. This study aims to explore the medical practices of urologists in the diagnosis, management, and care of NB patients within the Palestinian healthcare context, highlighting the absence of a unified treatment protocol and the reliance on private clinics for care. METHODS: An exploratory qualitative study design was employed, adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Structured interviews were conducted with 14 urologists and two urology residents across eight different cities in Palestine, including 10 governmental hospitals, two private hospitals, one university hospital, and one charity hospital. Fourteen doctors had private outpatient clinics alongside their work in hospitals. A questionnaire developed by the authors was delivered to specialists and residents to understand the evaluation, management, follow-up practices, and challenges faced in treating NB patients. The study focused on the diagnostic processes, treatment modalities, complications management, and the impact of the lack of standardized protocols on patient care. Our qualitative study consists of six major themes, each theme consisting of multiple sub-themes and different participant responses: (1) diagnosis and follow-up of NB patients; (2) general issues in the management of NB; (3) evaluation and follow-up of upper and lower urinary system function in NB patients; (4) urinary tract infections associated with NB disease and how to deal with it; (5) opinions and future attitudes in the treatment of NB patients; (6) NB in patients with multiple sclerosis. RESULTS: The study found that urodynamic studies are crucial in NB diagnosis, yet there is no unified management protocol, leading to varied practices. Most participants preferred the American Urological Association (AUA) guidelines in the absence of Palestinian protocols. Six major themes emerged, including diagnosis and follow-up challenges, general issues in NB management, evaluation and follow-up of urinary system function, urinary tract infections management, opinions on future treatment directions, and specific considerations for NB patients with multiple sclerosis. CONCLUSIONS: The study highlights the need for a unified, standardized protocol for the management of NB patients in Palestine. The reliance on international guidelines, primarily the AUA protocols, underscores the gap in local healthcare policies. The findings call for the establishment of national guidelines and enhanced resources for the effective management of NB, aiming to improve patient outcomes and quality of life.