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Hematopoietic stem cell transplantation (HSCT) during adolescence is complex and may compromise psychosocial development, mental health, and treatment adherence. Evidence remains limited on how adolescents experience HSCT and which interventions support coping and self-management. To describe interventions that strengthen coping strategies and promote compliance in adolescents, and to synthesize their transplant and posttransplant experiences. A mixed-method systematic review with a convergent integrated design was conducted (PROSPERO CRD42023405294) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles published between 2013 and 2023 were searched in major databases. Thirteen studies including adolescents aged 10-18 years were retained and appraised using established criteria, with assignment of levels of evidence. Adolescents reported negative impacts on mental health, isolation, life limitations, and insufficient posttransplant information, alongside gratitude and strengthened family ties. They mobilized positive coping strategies-social support, positive reframing, autonomy/self-management, self-transcendence, and reward by stage-counterbalanced by defense mechanisms. Five behavioral or e-health interventions were acceptable and feasible but yielded limited evidence for improving adherence or long-term outcomes. HSCT profoundly affects adolescent mental health and daily life. Spontaneous coping may support adjustment but does not appear sufficient to ensure adherence, while existing interventions remain insufficiently evaluated, particularly regarding adherence and long-term outcomes. Oncology nurses should routinely assess coping and mental health to guide early psychosocial and educational support. They should provide adolescent-specific preparation and post-HSCT education on the constraints and self-management demands of home-based care. Age-appropriate behavioral and e-health tools may support autonomy and motivation.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, disabling toxicity in children and adolescents with cancer. CIPN's impact on health-related quality of life (HRQoL) and self-care capability remains poorly understood. Guided by the Symptom Management Theory, this review examines these effects to inform improved CIPN management. To define how the CIPN symptom experience is conceptualized within the Symptom Management Theory and examine its impact on HRQoL and self-care capability in children and adolescents aged ≤19 years receiving chemotherapy. Four databases (CINAHL Ultimate, MEDLINE, Scopus, Web of Science Core Collection) and 1 register (Cochrane Central Register of Controlled Trials) were searched on February 14, 2025, from inception using predefined eligibility criteria. Data were extracted, tabulated, assessed for methodological quality, and synthesized narratively. Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. No studies reported qualitative experiences of CIPN, and symptom management strategies were rarely described. Most studies reported negative impacts on physical, emotional, and social domains of HRQoL, with caregiver proxy reports often indicating worse outcomes than survivors' self-reports. Despite consistent reporting of symptom outcomes, major evidence gaps persist, particularly the absence of qualitative research capturing the lived experiences of CIPN. Future work should incorporate rigorous qualitative and longitudinal approaches to fully characterize the symptom experience and inform supported self-management. Proactive assessment, education, and supportive self-management by nurses are essential to improving survivor HRQoL, particularly through addressing the impacts of CIPN and supporting ongoing symptom monitoring and management in survivorship.

Anaphylaxis is a time-critical, potentially fatal systemic hypersensitivity reaction. This narrative review summarizes recent advances in the diagnosis and management of anaphylaxis in children and adolescents, with emphasis on new diagnostic frameworks, improved self-management strategies, intranasal adrenaline, and disease-modifying therapies. A narrative review was conducted using PubMed and MEDLINE, focusing on articles and guidelines published between January 2020 and March 2026. Search terms included "anaphylaxis", "pediatric anaphylaxis", "adrenaline", "epinephrine", "autoinjector", "intranasal adrenaline", "food anaphylaxis", "omalizumab", and "oral immunotherapy". International guidelines, consensus documents, systematic reviews, pharmacokinetic studies, and pediatric studies were prioritized. Food remains the leading trigger in children, but drug, Hymenoptera venom, cofactor-dependent, and non-IgE-mediated mechanisms must be systematically considered. Adrenaline is underused in community settings despite being the only life-saving drug. Intranasal adrenaline represents the most visible delivery innovation: it may reduce needle-related barriers and simplify administration, but current evidence is largely based on pharmacokinetic/pharmacodynamic studies and limited pediatric clinical data. Omalizumab and oral immunotherapy are reshaping long-term risk reduction in food allergy but do not remove the need for emergency adrenaline.  The pragmatic management of anaphylaxis in children and adolescents entails self-management and hospital-based care. Intramuscular adrenaline is the first-line treatment when anaphylaxis is ongoing or recurrent, whereas adjunctive therapies should be considered on clinical grounds. Discharge recommendations should be individualized and include structured education, risk assessment, emergency planning and specialist follow-up. Intranasal adrenaline is a promising innovation, but its introduction requires clinical positioning, pharmacovigilance, cost-effectiveness evaluation, and continued emphasis on early treatment. • Intramuscular adrenaline is the first-line treatment for anaphylaxis and should not be delayed. • Food is the leading trigger in children, while drugs, venom, and cofactors become more relevant with age. • Intranasal adrenaline is a promising needle-free option, but pediatric evidence remains limited. • Omalizumab and oral immunotherapy may reduce risk but do not replace emergency preparedness.

This study examines the utilization of digital health resources among individuals with bipolar disorder (BD) in Germany, applying the Andersen Healthcare Utilization Model (AHUA) to this context for the first time. While resources such as health-related websites, social media and online forums, smartphone apps, digital devices such as wearables, and online interaction with health care professionals offer new opportunities for self-management, less is known about which factors systematically influence their use among individuals with BD. To address this gap, the AHUA, which classifies healthcare utilization through predisposing, enabling, and need factors, was adapted to investigate digital health resource utilization. An anonymous online cross-sectional survey of 213 individuals with a self-reported diagnosis of bipolar disorder collected data on demographics, illness history, digital literacy, and digital health resource utilization. Hierarchical multiple linear regression analysis was conducted to examine associations between predisposing, enabling, and need-related factors with digital health resources. The final model explained 30.6% of the variance in digital health resource utilization. Among predisposing factors, female gender was associated with higher utilization. Among enabling factors, wearable ownership was the strongest and most significant factor associated with higher utilization. Among need factors, earlier age of diagnosis and lower health-related quality of life were significantly associated with greater utilization. In contrast, smartphone ownership, digital health literacy, subjective health status, concentration difficulties, and the interaction between cognition and wearable ownership were not significantly associated with utilization. These findings highlight that digital health resource utilization in individuals with BD is primarily driven by enabling factors and objective health-related need rather than subjective health perceptions or cognitive functioning. The results underscore the importance of device access and clinical characteristics in influencing engagement with digital health tools. Targeting wearable-based interventions and tailoring digital health solutions to individuals with greater clinical need may enhance adoption and improve self-management in BD.

With the aging of the global population of people living with HIV (PLWH), cognitive impairment has emerged as an important public health concern. Older adults with HIV frequently experience multimorbidity, which may further increase the risk of mild cognitive impairment (MCI). However, studies exploring predictors of MCI among older adults living with HIV and multimorbidity remain limited. To investigate the prevalence and factors associated with screening-defined mild cognitive impairment (MCI) among older adults living with HIV and multimorbidity, and to explore the potential predictive value of logistic regression and decision tree models. A cross-sectional study was conducted among 327 older adults (aged &#x2265;50&#x202f;years) living with HIV and at least one comorbid chronic condition. Sociodemographic characteristics, clinical information, self-management ability, and social support were collected through structured questionnaires. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and dementia was excluded using the Mini-Mental State Examination (MMSE). Univariate analysis and multivariable logistic regression were performed to identify factors associated with MCI. A CHAID decision tree model with 10-fold cross-validation was constructed to explore hierarchical relationships among predictors. Receiver operating characteristic (ROC) curves were used to assess model performance. Among the 327 participants, the prevalence of screening-defined MCI was 48.9%. Multivariable logistic regression analysis showed that older age, female sex, hypertension, monthly income of 3,001-5,999 RMB, and a higher number of comorbidities were significantly associated with an increased risk of cognitive impairment (p&#x202f;<&#x202f;0.05). In contrast, higher education level, HIV knowledge learning experience, greater social support, and better daily living management ability were protective factors (p&#x202f;<&#x202f;0.05). The decision tree model identified five key predictors, including number of comorbidities, education level, age, hypertension, and HIV knowledge learning experience, with number of comorbidities being the most important splitting variable. The area under the ROC curve (AUC) of the logistic regression model was 0.961, which was significantly higher than that of the decision tree model (0.916; p&#x202f;<&#x202f;0.01). Screening-defined cognitive impairment is highly prevalent among older adults living with HIV and multimorbidity. Factors including the number of comorbidities, age, education level, HIV knowledge learning experience, and hypertension were identified as important correlates of cognitive impairment, with consistent findings across logistic regression and decision tree analyses. Both models demonstrated acceptable discriminatory ability within the study sample; however, these findings should be interpreted as exploratory given the lack of external validation. Overall, the results may contribute to the early identification of individuals at higher risk of cognitive impairment and provide a basis for developing targeted interventions. Further studies with rigorous validation are warranted to confirm the generalizability of these findings.

Disease modifying therapies for progressive fibrotic interstitial lung diseases (F-ILDs) slow physiological decline but have not consistently shown to improve patient-reported symptoms or health-related quality of life. Patients with F-ILD experience a substantial symptom burden that necessitates comprehensive supportive care alongside antifibrotic treatment. This review summarises the current evidence for management strategies for F-ILD to be considered in conjunction with disease-modifying therapies. Dyspnoea, chronic cough, fatigue, anxiety and depression are highly prevalent in F-ILD and significantly impair daily functioning. Dyspnoea management includes non-pharmacological interventions, personalised self-management strategies and selective use of low dose opioids in advanced disease though overall benefit may be modest. Chronic cough may be addressed through behavioural and speech therapy, treatment of contributing comorbidities such as gastro-oesophageal reflux disease and antitussive therapies, including neuromodulators and low dose opioids for refractory symptoms. Fatigue and psychological distress require routine screening, evaluation of modifiable factors and targeted interventions. Oxygen therapy remains a standard of care for patients with resting or exertional hypoxaemia. While it improves oxygenation, its effect on dyspnoea and symptoms is variable, underscoring the importance of individualised assessment and patient-centred decision making. Pulmonary rehabilitation provides evidence-based improvements in exercise capacity, symptom burden and health-related quality of life. It also offers important psychological benefits and should be integrated early and maintained as feasible throughout the disease course. Given the unpredictable trajectory of F-ILD, early integration of palliative care is essential. Discussions regarding prognosis, advance care planning and end of life preferences, supported by a multidisciplinary care model, enable holistic, goal concordant care across the progressive disease trajectory. A multidisciplinary care model is beneficial for providing individualised, holistic care throughout the patient's progressive disease trajectory.

Virtual nursing is an evolving care delivery model in which registered nurses use secure telehealth technology to provide remote clinical support that compliments bedside care. Although initially adopted to address workforce shortages and workflow inefficiencies, virtual nursing has emerged as a promising strategy for delivering patient education. Patient education is a core nursing responsibility essential to medication adherence, chronic disease self-management, and continuity of care, yet it is often hindered by time constraints, interruptions in clinical settings, and health literacy. This paper examines virtual nurse-led education as an effective approach to improve patient understanding, engagement, and health outcomes. Virtual education models, delivered through fully remote or hybrid approaches, provide standardized yet personalized instruction, protected teaching time, and continuity of care beyond discharge. Despite challenges related to digital access and health equity, well designed virtual nursing programs offer a scalable, patient centered strategy to enhance education, reduce preventable readmissions, and support public health goals.

This study aimed to explore the manifestations of posttraumatic growth (PTG) and its influencing factors among ovarian cancer patients undergoing chemotherapy. A descriptive qualitative study was employed. Between May 2023 and June 2024, 12 patients undergoing chemotherapy for ovarian cancer were recruited from a tertiary hospital in Hangzhou, China. Data were collected through semi-structured interviews and analyzed using conventional content analysis. Three major themes and nine subthemes emerged: (1) Manifestations of PTG, including adopting healthy lifestyles, enhancing self-management awareness, maintaining a positive psychological state, and developing harmonious interpersonal relationships; (2) Facilitators of PTG, including medical resource accessibility, family support, and an optimistic personality; (3) Barriers to PTG, including family burden and conflict, and negative illness perception. PTG among ovarian cancer patients undergoing chemotherapy manifests as an integrated process of behavioral, psychological, and social adaptation. Family support and illness perception may modulate the degree of PTG. Future research should adopt multi-center and longitudinal designs to validate and extend these findings.

Hypertension is the main risk factor for cardiovascular-related morbidities and mortalities. Nurses play a pivotal role in hypertension care, encompassing screening, detection, management, patient education and self-management counselling. This study assessed nurses' knowledge of hypertension care and associated factors in the Northern Region of Ghana. Tamale Metropolis of the Northern Region of Ghana. A descriptive cross-sectional study was conducted among nurses. Using a census approach, 410 eligible nurses working in hypertension care across the study hospitals were invited to participate. Of these, 266 consented and completed a self-reported validated questionnaire. The IBM Statistical Package for the Social Sciences programme version 30 was used to process the data and perform descriptive and inferential statistics. The mean hypertension care knowledge score was 51.47% &#xb1; 11.76%. About 4% had good knowledge, 57.1% average knowledge, and 38.7% had poor knowledge. While nurses demonstrated good knowledge of accurate blood pressure measurement (82.4%), their knowledge of hypertension diagnosis (35.1%) and management (48.8%) was poor. The following were significantly associated with overall knowledge of hypertension care: hospital of practice (p = 0.021), age (p = 0.007), nursing category (p = 0.002), qualification (p = 0.001), years of practice in the present unit (p = 0.021) and hypertension in-service training (p = 0.027). This study revealed significant gaps in nurses' knowledge of hypertension care and highlighted the need for continuous professional development to bridge knowledge gaps and sustain clinical competence. The study provided evidence on nurses' knowledge of hypertension care in Ghana, which can inform the development of tailored interventions to improve management and patient outcomes.

Low back pain (LBP) is increasingly reported among school-aged children, a population vulnerable to musculoskeletal strain as a result of growth-related changes, developing spinal structures and school demands such as heavy backpacks and prolonged sitting. Although international evidence highlights these risk factors, data from African contexts, particularly Botswana, remain limited. This study investigated associations between school backpack loading, sitting time and the prevalence and intensity of LBP among 10-12-year-old schoolchildren. Primary schools in Gaborone, Botswana. A cross-sectional study was conducted among 521 children (46% boys; mean age = 11.1 &#xb1; 0.7 years). Backpack and body mass were measured using calibrated scales, and sitting time was self-reported using the International Physical Activity Questionnaire - Short Form (IPAQ-SF). Low back pain frequency and intensity were assessed using the Young Spine Questionnaire (YSQ). Chi-square tests examined associations between LBP outcomes and independent variables, and Cram&#xe9;r's V interpreted effect sizes. Approximately 43% carried backpacks exceeding 10% of body mass; 34% reported frequent LBP and 14% moderate-to-severe intensity. Heavier loads were weakly but significantly associated with more frequent LBP (&#x3c7;2 = 4.05; p = 0.044; &#x3a6; = 0.09). No associations were found with sitting time, age or sex. Heavier backpack loads were associated with higher LBP frequency among Gaborone schoolchildren, although the effect size was small. These findings highlight the importance of addressing modifiable ergonomic factors, particularly load management, in school health strategies. This study highlights modifiable ergonomic risk factors for LBP in Botswana and supports the inclusion of load management and posture education in school health programmes.

Emergency department (ED) care should be guided according to patient needs and demand. Age and gender influence consultation and care patterns. This study aims to analyze these factors as well as upstream care pathways in order to reduce misallocation and improve quality of care. Between March and November 2024, standardized patient surveys were conducted in 5&#xa0;Berlin and 18&#xa0;Bavarian emergency departments (n&#x202f;=&#x2009;10,040). Data collected included sociodemographic characteristics, presenting complaints, subjective urgency, physician contacts, and awareness of the 116117 hotline. Influencing factors were analyzed using logistic regression; only cases indicating "male" or "female" were included. A&#xa0;total of 9835 questionnaires were analyzed (49.6% female); patients were predominantly from older age groups. Reasons for presentation differed by gender: for example, women more frequently reported pain as well as neurological or abdominal complaints, whereas men more often presented with injuries. Health-related anxiety was a&#xa0;key motive for seeking care in about 37.8% of cases and was more common among women. A&#xa0;prior attempt to contact ambulatory care was reported by 48.7% of women and 44.2% of men (p&#x202f;<&#x2009;0.001). Direct ED visits were more frequent in cases of higher urgency and injuries. Awareness of the 116117 hotline was 67.0% among women and 60.3% among men and decreased with age; willingness to use digital self-assessment tools was higher among younger individuals. Age and gender influence both utilization patterns and the steerability of emergency care. Target group-specific, low-threshold, and digital interventions may help reduce misallocation and improve quality of care. EINLEITUNG: Die Versorgung in Notaufnahmen sollte patienten- und bedarfsgerecht gesteuert werden. Alter und Geschlecht beeinflussen Konsultations- und Versorgungsmuster. Ziel der Studie ist die Analyse dieser Faktoren sowie vorgelagerter Versorgungspfade zur Reduktion von Fehlsteuerungen und Verbesserung der Versorgungsqualit&#xe4;t. Zwischen M&#xe4;rz und November 2024 wurden standardisierte Patientenbefragungen in 5&#xa0;Berliner und 18&#xa0;bayerischen Notaufnahmen durchgef&#xfc;hrt (n&#x202f;=&#x2009;10.040). Erfasst wurden Soziodemografie, Beschwerden, subjektive Dringlichkeit, Arztkontakte und die Bekanntheit der 116117. Einflussfaktoren wurden mittels logistischer Regression analysiert; ber&#xfc;cksichtigt wurden nur F&#xe4;lle mit Angabe &#x201e;m&#xe4;nnlich&#x201c; oder &#x201e;weiblich&#x201c;. Insgesamt konnten 9835 Frageb&#xf6;gen ausgewertet werden (49,6&#x202f;% Frauen); die Patient:innen geh&#xf6;rten &#xfc;berwiegend &#xe4;lteren Altersgruppen an. Die Vorstellungsgr&#xfc;nde unterschieden sich nach Geschlecht: Frauen nannten h&#xe4;ufiger Schmerzen sowie neurologische oder abdominale Beschwerden, M&#xe4;nner eher Verletzungen. Gesundheitsbezogene &#xc4;ngste waren f&#xfc;r rund 37,8&#x202f;% ein zentrales Inanspruchnahmemotiv, h&#xe4;ufiger bei Frauen. Einen vorherigen Kontaktversuch zur vertrags&#xe4;rztlichen Versorgung gaben 48,7&#x202f;% der Frauen und 44,2&#x202f;% der M&#xe4;nner an (p&#x202f;<&#x2009;0,001). Direkte Notaufnahmebesuche waren h&#xe4;ufiger bei h&#xf6;herer Dringlichkeit und Verletzungen. Die Bekanntheit der 116117 lag bei 67,0&#x202f;% der Frauen und 60,3&#x202f;% der M&#xe4;nner und nahm mit dem Alter ab; die Bereitschaft zur digitalen Selbsteinsch&#xe4;tzung war bei J&#xfc;ngeren h&#xf6;her. Alter und Geschlecht beeinflussen Inanspruchnahme und Steuerbarkeit der Notfallversorgung. Zielgruppensensible, niedrigschwellige und digitale Angebote k&#xf6;nnen Fehlsteuerungen reduzieren und die Versorgungsqualit&#xe4;t verbessern.

Despite increased integration of digital technologies in higher education, nursing students face major barriers in resource-limited settings. The study investigated the utilisation of digital educational technologies amongst undergraduate nursing students in the Western Cape. The study was conducted at the school of nursing at a higher education institution in the Western Cape. A descriptive cross-sectional survey design with a self-administered questionnaire was used to collect data from a sample of 253 participants. Descriptive analysis was conducted to determine the frequencies and percentages; the mean score and Chi-square test were conducted to determine the association between the variables. Nearly 90% of participants had experience in the use of digital educational technology, 94.5%, learning management system and Facebook, and 93.7% used PowerPoint, communication and collaboration tools. The gender differences in technology use are consistent with the literature. The results suggest female respondents' frequent use of social networks. Male respondents reported more frequent use of bibliographic and web conferencing technologies. Although overall use was very low, gender remains an important factor in understanding technology use. In contrast, blogs, discussion forums and immersive technologies were amongst the least utilised educational technologies. Most nursing students use basic digital tools like learning management systems, Facebook and PowerPoint, but advanced tools such as blogs, forums and immersive technologies are underused, revealing a gap in digital competence that limits collaborative learning and clinical simulation. This study provides evidence on digital technology use amongst undergraduate nursing students, showing frequent use of basic tools but limited engagement with advanced, interactive technologies.

Patients with chronic obstructive pulmonary disease (COPD) with a history of frequent exacerbations have a high disease burden and poor progression, demanding optimized management. This study aimed to evaluate the real-world clinical situation, adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations, and the associated factors. We conducted a cross-sectional analysis of baseline data from the national multi-center Quality Improvement Program, which enrolled 1055 COPD patients with a high exacerbation risk from 40&#xa0;hospitals across five geographic regions in China (NCT05638646). Patient characteristics, disease burden, management patterns and the associated factors were analyzed. The study population had a mean age of 66.2 years, and 85.6% were male. Most patients had substantial disease burden, with 43.3% classified as GOLD stages 3-4 and 93.6% categorized into GOLD group E. In previous 12 months, 39.0% and 67.2% of these patients experienced at least one moderate or severe exacerbation, respectively. Overall, 75.1% received maintenance therapy using long-acting bronchodilators, but only 17.7% were receiving maintenance therapy consistent with the GOLD recommendations for initial treatment. Among patients receiving inhaled therapy, 70.9% initiated maintenance therapy within one month after diagnosis, whereas the self-reported good compliance was only 47.3%. Despite most patients received inhalation technique checks and education, only 61.9% can use the inhalation device appropriately, as evaluated by research team. Hospital level, hospital region, availability of blood eosinophil counts, and disease severity were significantly associated with the management patterns. COPD patients with a high exacerbation risk in China had a substantial disease burden and important gaps between real-world management patterns and GOLD recommendations. These findings suggest opportunities to improve guideline implementation, particularly in secondary and county-based hospitals. Future studies should evaluate whether targeted quality improvement interventions can improve patient outcomes. NCT05638646.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) affects around 35%-50% of men during their lifetime. The efficacy of current oral medication for CP/CPPS remains limited. Recent studies demonstrated that vagus nerve stimulation may improve chronic pelvic and abdominal pain. Accordingly, transcutaneous auricular vagus nerve stimulation (taVNS) might represent a promising, non-invasive therapeutic approach for the clinical management of CP/CPPS. The trial of Transcutaneous Auricular vagus nerve Stimulation for moderate to severe Chronic Prostatitis/CPPS is a prospective, randomised, sham-controlled trial with a 1:1 allocation ratio. Participants will be assigned randomly to either the taVNS group or the sham-taVNS group. The intervention period will consist of a 4-week treatment (a total of 40 sessions), followed by an 8-week follow-up period. The primary outcome is the change from baseline in the National Institutes of Health Chronic Prostatitis Symptom Score Index total score at week 4. Secondary outcomes include the International Prostate Symptom Score Scale, European Quality of Life 5-Dimensions-5-Levels questionnaire, Self-Rating Anxiety Scale and Self-Rating Depression Scale. Safety assessments will be conducted throughout the entire study period. This study protocol and informed consent documents were reviewed and approved by the Institutional Review Board of Guang'anmen Hospital, China Academy of Chinese Medical Sciences (approval number: 2023-250&#x2009;KY). Written informed consent will be obtained from all participants and/or their legal guardians prior to trial participation. The findings will be disseminated through publication in a peer-reviewed journal and presentations at scientific conferences. The research data will be made available on reasonable request. NCT06287970.

Evidence-based nutrition and physical activity influence perioperative optimization and surgical outcomes, yet formal training in these domains during plastic surgery residency remains unclear. This study surveyed US plastic surgery residents to assess their self-reported knowledge, counseling confidence, and curricular preparation. A 28-item REDCap survey was distributed to residents in the Northeastern, Southeastern, and Midwestern plastic surgery societies (September 2024-February 2025). Questions covered training level, self-rated counseling skill, 17 knowledge domains, and 4 preparation Likert scales. Categorical variables were reported as counts/percentages, and ordinal skill and curriculum preparation scores were numerically coded and reported as mean &#xb1; SD. Two-sample t tests compared integrated versus independent tracks and junior (postgraduate year [PGY] 1-3) versus senior (PGY &#x2265; 4) residents (&#x3b1; = 0.05). Fifty-two residents responded (12% rate); 75% were in integrated programs and 73.1 % were senior (PGY 4+). Most felt comfortable with weight management counseling, but knowledge was lowest for counseling special populations (children, pregnancy, older adults). Counseling skills were largely "competent," with 25 % (nutrition) and 31 % (physical activity) reporting "advanced" competence. Preparation scores were neutral (~3/5) and less than10% strongly endorsed curricular adequacy. Skill scores trended higher for seniors and integrated residents, but only the nutrition skill difference between senior and junior residents reached statistical significance (P < 0.05). Plastic surgery residents report moderate self-perceived preparedness and confidence in nutrition and physical activity counseling, with opportunities for enhanced curricular support. These findings highlighted the potential value of structured education to support comprehensive perioperative patient care.

Hidradenitis suppurativa (HS) is a disease that impairs the quality of life (QoL), sexual functioning, and fertility of the patients. The relationship between disease characteristics and sexual function remains insufficiently characterized. The aim of this study is to evaluate the rate of sexual dysfunction among HS patients; and to evaluate its relationship to disease or patient characteristics. In this multi-centered cross-sectional study, patients were asked to complete a structured online questionnaire including demographics, disease characteristics, the Hidradenitis Suppurativa Self-Assessment Tool (HSSA), HS-specific Dermatology Life Quality Index (HS-DLQI), and validated sexual function instruments (International Index of Erectile Function-5 [IIEF-5] for males; Female Sexual Function Index [FSFI] for females). A total of 522 HS patients were included. Higher HSSA stages correlated positively with worse HS-DLQI scores (r&#x2009;=&#x2009;0.258, p&#x2009;<&#x2009;0.001). Lesions in the head/neck, inframammary, gluteal, and inguinal regions were associated with greater QoL impairment. Male patients had significantly lower IIEF scores and higher erectile dysfunction (ED) prevalence compared to controls; however, HS was not an independent risk factor for ED in multivariable analysis. Female patients had significantly lower total FSFI scores than controls, particularly in arousal, orgasm, satisfaction, and pain domains, whereas lubrication remained unaffected and desire scores were higher. Recall bias, the self-reported nature of questionnaires, and sociocultural barriers to discussing sexual health may have influenced results. HS significantly impairs quality of life, particularly with increasing disease severity and involvement of specific anatomical regions. HS is associated with impaired sexual function in both women and men, with a more pronounced and multifaceted impact observed in female patients. Effective pain and inflammation control may improve sexual outcomes, underscoring the importance of comprehensive, domain-specific assessment in HS management.