Adolescents and adults spend several hours a day on social media, raising concerns that extensive social media use may negatively affect family life. However, it remains unclear whether social media use is associated with changes in family relationship quality, as prior research has not separated stable between-family differences from within-family prospective effects and has often relied on single-informant data. These limitations risk inflating associations through shared methods variance and invite misinterpretation of cross-sectional links as developmental processes. Data were drawn from two birth cohorts from Trondheim, Norway, followed across six biennial waves from ages 10 to 20 (n = 979, 52.20% girls). Adolescents' frequency of checking social media, social media activity, and social media screen time were assessed using interviews and objective measures. Parents' frequency of checking social media and problematic social media use were assessed using questionnaires. Adolescents reported on their closeness and conflicts with their parents. Attachment was measured by self-report and observation of parent-child interaction, while family functioning was assessed by both adolescent- and parent-report. Using random intercept cross-lagged panel modelling, no evidence was found for either between-family associations or within-family prospective links between adolescents' and parents' social media use and poorer quality of family relationships, family functioning, or attachment. These findings suggest that normative variation in social media use is unlikely to be a meaningful driver of changes in family relationship quality, and that concerns about everyday social media use harming family life may not be warranted.
Social media has emerged as an important tool for disseminating information to medical students; however, their platform preferences and usage purposes remain unclear. We conducted a multicenter web-based survey of medical students from eight Japanese medical schools in 2025, assessing their overall social media use, platform preferences by purpose, daily usage time, and the perceived usefulness of social media for career decision-making. A total of 1,515 students participated in this study. YouTube (71.6%), Instagram (65.1%), and X (43.7%) were frequently used platforms, whereas Facebook (1.9%) was rarely used. Platform use differed by academic year: YouTube use was significantly higher among early-year students, whereas X use was significantly more common among advanced-year students (P = 0.043 and P < 0.001, respectively). Overall, 763 respondents (50.4%) perceived social media as useful for career decision-making, with X being used most frequently for this purpose, followed by YouTube and Instagram; this perception was significantly more common among the early-year students (P = 0.005). These findings provide valuable insights for educators and professional organizations seeking to engage medical students through social media. Understanding these trends is especially important as Japan faces a shortage of surgeons.
Social risk factors (SRF), or adverse social drivers of health, have become an increased area of focus in health care, particularly among Emergency Medical Services. Prehospital identification and response to SRFs have been reported, most notably among mobile-integrated models, such as Community Paramedicine. Incorporating SRF screening within routine EMS practice is not standard, despite reports of willingness to do so among clinicians. Therefore, it was the aim of this study to evaluate the integration of a prehospital SRF documentation tool. A 14-item prehospital SRF documentation tool derived from the World Health Organization's social determinants of health categories was integrated into our EMS agency's patient charting platform as a required field on July 11, 2024. We conducted a retrospective cohort study of all adult emergency and non-emergency calls from the start of integration to January 11, 2025 to evaluate overall identification and prevalence of reported SRF. Descriptive statistics were used to characterize the study sample. Bivariate statistics were used to evaluate differences across demographic and encounter level variables and SRF type using Chi-Square tests and Wilcoxon rank-sum tests, where appropriate. Covariates were further evaluated by whether they had a documented SRF or not. A total of 57,899 encounters were identified, with 4.0% having at least one documented SRF (n = 2,326); the remaining sample had no SRFs documented. The SRF sample overall was 66.9% male, 28.9% White and median age of 50 years (IQR: 36-66), and 30.8% had more than one SRF identified. There were 116 individuals that had more than one encounter during the study time period. The most frequently reported SRFs were substance use (31.3%), housing instability (25.7%) and disability (25.4%). Over 75% of encounters were low acuity. Compared to encounters with no SRFs documented (n = 55,573), patients were older and female (p-values >0.05). Identified SRFs were low among our sample, highlighting the need to determine the barriers preventing recognition and reporting. Young males are a high-risk group, particularly for repeated encounters. There is a need to identify improved mechanisms for EMS clinicians to document and communicate pertinent SRF information, particularly to Emergency Department teams.
Colorism is a harmful phenomenon that can impact an individual's psychosocial functioning, especially for Black women. The B.E.T.T.E.R. S.E.L.F. Framework (BSF) is a clinical practice tool designed to help Black women mitigate the harm caused by colorism while improving psychosocial well-being. Research shows that Black women experience more adverse effects of colorism, like lower self-esteem and poorer health outcomes. This model provides a safe and curated space for Black women to share and explore their experiences with colorism in therapeutic settings that have often been overlooked. Colorism-Informed Clinicians (CIC) provide support and validation, helping heal the harm caused by colorism. Grounded in principles of Black Feminist Theory (BFT) and Narrative Therapy (NT), the BSF actively supports Black women in fostering their 'better self.' A fictional case vignette will illustrate how the BSF can be used in therapy to enhance psychosocial functioning. The BSF is a culturally responsive clinical framework that aims to acknowledge and heal the ongoing impact of colorism.
Olfaction is crucial for rodent social behavior, and olfactory dysfunction has been observed in multiple autism spectrum disorder (ASD) models, but its phenotype in Shank3⁻/⁻ mice (a classic ASD model) remains unclear. We systematically assessed olfactory function in Shank3⁻/⁻ mice by using a modified olfactory three-chamber test and optimized ultrasonic vocalization (USV) detection in combination with resting-state functional magnetic resonance imaging (rs-fMRI), whole-brain c-Fos mapping, and three-dimensional (3D) behavioral analysis. Our results showed abnormal odor preference and hyperconnectivity in olfaction-associated brain networks. Upon exposure to neutral, appetitive, and social pheromone odors, Shank3⁻/⁻ mice displayed atypical whole-brain c-Fos activation patterns, which were coupled with synchronized locomotor suppression and stereotyped behaviors. This study maps the neural-behavioral responses to odors in Shank3-/- mice, linking olfactory deficits to autism-like behaviors, and highlights the olfactory system as a targetable pathway for sensory-based autism therapies.
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Epilepsy is associated with an increased risk of suicidality across the lifespan, including during adolescence, a developmental period characterised by heightened psychological vulnerability. Evidence on suicidality among adolescents with epilepsy in sub-Saharan Africa is limited. This study examined the prevalence of suicidality and its correlates among adolescents with epilepsy attending national referral hospitals in Uganda. A cross-sectional study was conducted among adolescents aged 10-17 years with clinician-confirmed epilepsy attending Butabika National Mental Referral Hospital and Mulago National Referral Hospital in Kampala. Suicidality and current psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Coping strategies were measured using the Brief Coping Orientation to Problems Experienced (COPE) and perceived social support using the Multidimensional Scale of Perceived Social Support (MSPSS). Hierarchical multivariable logistic regression was used to examine the incremental contribution of sociodemographic, clinical, psychiatric, coping, and social support domains to suicidality. Nearly one-third (30.5%) reported at least one form of suicidality, most commonly passive suicidal ideation (27.8%). In multivariable analysis, female sex was associated with higher odds of suicidality (aOR 2.20, 95% CI 1.14-4.25), and poor treatment adherence was also associated with increased odds (aOR 2.28, 95% CI 1.09-4.74). Current depression showed the strongest association with suicidal behaviour (aOR 11.18, 95% CI 3.81-32.81). Higher perceived social support was associated with lower odds of suicidality (aOR 0.85, 95% CI 0.75-0.98), suggesting a protective role. Coping strategies were not significantly associated with suicidality after adjustment for clinical and psychiatric factors. Suicidality is common among adolescents with epilepsy in Uganda. Psychiatric comorbidity, particularly depression, accounts for the greatest proportion of explained variability in suicidal behaviour, while perceived social support provides additional protection. Integrating routine mental health screening and strengthening family and community support within epilepsy care may reduce suicide risk in this vulnerable population.
BackgroundIn Ethiopia, young women's pregnancy is a serious public health issue that hurts the health outcomes of both the mother and child. However, no research has been done on the use of contraceptives to delay first birth and associated factors among married young women aged 15-24 in Ethiopia.ObjectivesThis study aimed to assess the contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia, in 2024.DesignA community-based cross-sectional study design was employed.MethodsThe sample size for the study was 422 married young women. A census was conducted to obtain a sample frame, and a simple random sampling method was used to select the study participants. Data were collected using interviewer-administered structured questionnaires. The collected data were entered into EpiData version 4.6 and exported to SPSS version 23 for further analysis. Binary logistic regression analyses were performed to identify variables associated with contraceptive use to delay first birth, with a p-value of less than 0.05 considered significant.ResultsThe overall contraceptive use to delay first birth among married young women was 16.3%, with a 95% CI (12.8, 20.3). The following were found to be factors associated with the use of contraceptives to delay first birth among married young women: exposure to contraceptive information. [AOR=4.36; [95% CI: (2.14, 8.86)], p=0.001], a favorable attitude toward contraceptive methods (95% CI: (1.72, 7.31)), and p=0.001]; intention to use contraceptives [AOR=4.16; (95% CI: (1.96, 8.84); p < 0.001)]; perceived social approval [AOR=3.48; (95% CI: (1.65, 7.35)); p=0.001]; beliefs about contraceptive myths at the community level) [AOR=3.74; 95% CI: (1.82, 7.66); p < 0.001); and family planning counseling [AOR=5.19; 95% CI: (2.43, 11.08); p < 0.001) were among the significant variables associated with contraceptive use to delay first birth among young married women.ConclusionsThe contraceptive use to delay first birth among married young women was low. Healthcare providers, policymakers, and program designers should intensify their efforts to create awareness about the importance of contraceptive utilization among young married women to delay their first birth. Why was this study needed? Young women’s pregnancy is a serious public health issue that negatively impacts the health outcomes of both the mother and child. Therefore, this focuses on the use of contraceptives to delay first birth and associated factors among married young women aged 15-24 in rural parts of central Oromia, Ethiopia. Understanding the prevalence of contraceptives to delay first birth and associated factors among married young women in rural parts can help to create more pregnancy delay strategies.What did the researcher aim for? This study aimed to investigate the contraceptive use to delay first birth and its associated factors among married young women in rural parts of central Oromia, Ethiopia, in 2024.What did the researcher do? A community-based one-time data collection was used as a design for the study. We included 422 married young women aged 15-24 years from nine kebeles of rural central Oromia, Ethiopia, for the study. On starting a mass registration of all young married women in the selected rural kebeles to obtain a sample frame, multistage sampling was used for proportional allocation of the sample. A simple random sampling method was used to select the study participants. Data were collected using interviewer-administered structured questionnaires on sociodemographic and economic factors; knowledge, attitude, and intention to use contraceptive methods; perceived social approval; and community-level beliefs and enhance about modern contraceptive use and counseling services. Then, the collected data were entered into EpiData version 4.6 and exported to SPSS version 23 for further analysis. Binary logistic regression analyses were performed to identify variables associated with contraceptive use to delay first birth, with a p-value of less than 0.05 considered to declare the statistical significant association between the exposure and outcome variables.What did the study find? Out of 405 study participants, the overall contraceptive use to delay first birth among married young women was only 66 (16.3%). 162 (40%) of the women were married at ages younger than 18 years, and 340 (84%) study participants were housewives by occupation. Nearly 160 (39.5%) of the respondents’ spouses had completed secondary school. 221 (54.6%) had a monthly income of 10-30 USD.Young married people with exposure to contraceptive information were four times more likely to be contraceptive users than those with no exposure to contraceptive information. Furthermore, having a favorable attitude toward contraceptive methods, intention to use contraceptives, perceived social approval, good beliefs about contraceptive myths at the community level, and family planning counseling by healthcare providers were among factors that enhanced contraceptive use to delay first birth among young married women.What do the findings mean? The contraceptive use to delay first birth among married young women was low. Thus, this study highlights the need for targeted interventions to enhance contraceptive use to delay birth among young married women in rural Ethiopia. These interventions should focus on information, a favorableattitude, social behavioral change, and counseling on modern contraceptive methods for the better health of young married women. Healthcare providers, policymakers, and program designers should intensify their efforts on modern contraceptive methods and services for young married women to delay their first birth.
In recent years there has been much research regarding the extent to which behavioural immune system (BIS; behavioural responses that evolved to detect and avoid pathogens) is related to a variation in social profile and personality traits such as extroversion among individuals. However, most research on the relationship between BIS and sociality is based on short-term experimental studies and thus little is known about the degree to which BIS is related to the actual frequency of day-to-day proximity contacts. We used data obtained from secondary students (n = 84, age 16-19yo, n schools/classes = 3) to determine whether the variation in BIS values is associated with the frequency of proximity contacts. Proximity data were derived from sensors registering the proximity of other classmates within a 2 m radius. Students belonging to the same class were wearing proximity sensors within the school environment for the period of 4 weeks. BIS activity was assessed using a total score of Perceived Vulnerability to Diseases (PVD) questionnaire. Our findings, based on real-world face-to-face proximity patterns, do not support the assertions of previous studies suggesting that BIS activation, as reflected in higher PVD values, is associated with a lower rate of social interactions. However, this does not rule out the existence of the relationship under investigation. Future studies should include larger samples and analyses of other measures of integration within close social networks.
Respiratory syncytial virus (RSV) vaccination during pregnancy protects infants, yet its psychosocial determinants remain understudied. Guided by the Theory of Planned Behavior, this cross-sectional study examined predictors of RSV vaccination intention in a convenience sample of 463 Chilean women of reproductive age recruited through social media. Structural equation modeling showed good fit and explained 64.7% of the variance of intention, controlling for age, number of children, perceived social status, children`s vaccination status, and conspiracy beliefs. Positive attitudes were the strongest predictor (B = 0.422, p < 0.05), followed by negative attitudes (B = -0.284, p < 0.05), perceived infant risk (B = 0.155, p < 0.05), and pro-vaccination social norms (B = 0.100, p < 0.05). Perceived maternal risk was not significant (B = 0.027, p = 0.589). Findings highlight the role of attitudes and infant risk perceptions in shaping intention, with implications for communication strategies promoting maternal RSV vaccination.
The underuse of psychosocial care services by migrants from Southwest Asian countries residing in countries of the global north warrants systematic investigation. Literature suggests that this underutilization reflects not only structural barriers such as language difficulties, but also more negative attitudes toward seeking professional psychological help compared to residents of Western countries. However, systematic comparisons of such attitudes among individuals with a Turkish migration background in Germany, Turks in Turkey and Germans without a migration background are scarce. Drawing on the Theory of Planned Behaviour, the present study additionally examined stigma, perceived social support, male role norms and relevant sociodemographic covariates as potential factors associated with help-seeking attitudes. This online cross-sectional study compared attitudes toward seeking professional psychological help and relevant predictors among these three groups (N = 942; n = 296 Germans, n = 271 Turkish migrants, n = 375 Turks in Turkey). Turkish migrants reported more negative attitudes than Turks in Turkey. There were no differences in the attitudes between Turkish migrants in Germany and Germans. Stigma and male role norms were negatively associated with attitudes toward help-seeking and partially accounted for group differences. Perceived social support showed no consistent effects. Attitudes toward seeking professional psychological help among Turkish migrants and Turks appear to be more complex than initially predicted. Findings are consistent with the Theory of Planned Behaviour assumptions, suggesting that culturally shaped subjective norms, particularly male role beliefs, may be more central in explaining help-seeking attitudes than group membership alone.
BackgroundMenstrual hygiene management (MHM) remains a neglected concern in Togo, despite its critical importance for the education, health, and dignity of girls and women. Neglecting MHM directly impacts women's reproductive morbidities that may adversely affect fertility outcomes. However, there is limited literature on MHM practices in Togo and their impact on individual fertility.ObjectivesThe study aims to examine the (1) effects of structural determinants-namely WASH infrastructure, socio-economic disparities, and social norms on menstrual hygiene practices, and (2) causal effect of MHM on reproductive health outcome, measured in terms of fertility of Togolese women. Considering the endogeneity of MHM, we aim to provide evidence that the roles of WASH facilities, social norms, and socio-economic factors influence MHM and thereby linking it directly to fertility of women.DesignThe study uses secondary data from a cross sectional survey of nationally representative Multiple Indicator Cluster Survey (MICS6, 2017) for Togo.MethodsWe have used control function (CF) approach to address the endogeneity of MHM to estimate the causal inference of MHM on the fertility of ever-married women aged between 15-49 years in Togo. The source of endogeneity of MHM is explained through the channels of social exclusion-related unobservable, and availability of WASH facilities.ResultsThe access to WASH facilities improve the probability of MHM by 31-53 percentage points. Our study establishes the existence of a strong causal relationship between MHM and fertility rate, establishing the endogeneity of MHM. The fertility increases (4-5%) significantly for women who manage their menstrual hygiene.ConclusionEffective MHM is crucial for individual dignity, health, and well-being. Our study indicates that proper menstrual hygeine management has significantly affect the reproductive health of women measured in terms of fertility. To foster an enabling environment of MHM concerned, the study recommended a few public policy interventions. Menstrual hygiene management remains a neglected concern in Togo. Neglecting menstrual hygiene directly impacts women’s reproductive health and is closely linked to gender equality and empowerment. However, there is limited literature on menstrual hygiene practices and their impact on fertility rates. Our study aims to fill this gap by providing evidence of the existence of a causal impact of self-reported menstrual hygiene management on the fertility rate of Togolese women. Using the Multiple Indicator Cluster Survey (MICS6) of Togo for 2017, our findings indicate the significance of access to water, hand-washing facilities, and cleaning supplies in improving menstrual hygiene management. Furthermore, we find that socioeconomic factors such as education level, family affluence, etc, influence women’s ability to manage their menstrual hygiene. Our study underscores the need for integrating menstrual hygiene into reproductive health policies and addressing key socio-economic and structural barriers that hinder proper menstrual hygiene management.
Understanding how protective factors and strengths operate to promote positive youth development is critical for supporting youth who have experienced childhood maltreatment. Guided by the Resilience Portfolio Model, including the poly-strengths framework, this study examined how both the configuration (i.e., strengths portfolios) and cumulative presence (i.e., number of strengths) of multi-level strengths predict adolescents' prosocial behaviors and academic achievement. Data were drawn from the second cohort of the National Survey of Child and Adolescent Well-Being and included 357 adolescents (M_age = 13.21 years; 40.34% boys). Latent class analysis was conducted to identify distinct patterns of strengths, and Ordinary Least Squares regression analysis was used to examine the cumulative effects of poly-strengths. Results indicated that adolescents in the Multi-domain resilience portfolios group consistently demonstrated the best prosocial and academic outcomes. A future-oriented group that struggled with regulation generally appeared to have higher functioning than a well-regulated group with limited meaning and connection. Although the overall number of strengths (i.e., poly-strengths) predicted greater prosocial skills, it did not significantly predict academic achievement. These findings provide empirical support for resilience models that account for both the cumulative and configurational nature of strengths in youth development following maltreatment.
Frailty is increasingly recognized as a clinically relevant condition in older adults with Type 2 Diabetes Mellitus (T2DM), with important implications for functional outcomes and individualized care. This study examined the association between multidimensional frailty and quality of life in older adults with T2DM. A cross-sectional study was conducted among 112 older adults aged ≥ 65 years in the Trikala Regional Unit, Central Greece. Frailty was assessed using the Tilburg Frailty Indicator (TFI), and quality of life was measured using the Older People's Quality of Life Questionnaire (OPQOL-35). Overall quality of life was operationalized as the OPQOL-35 mean score. Pearson correlation analysis was performed to examine the association between quality of life and frailty components, and multiple linear regression analysis was used to examine independent associations with quality of life. The sample demonstrated a moderate level of frailty (M = 7.88, SD = 2.78), exceeding the established cut-off for frailty. Physical fatigue and upper limb weakness were the most frequently reported physical limitations. All frailty components (physical, psychological, and social) were significantly associated with poorer OPQOL-35 mean scores (p < .01). The strongest correlation was observed for physical health-related problems (r = .690, p < .001), followed by social (r = .582, p < .001) and psychological components (r = .486, p < .001). The regression model explained 77.2% of the variance in quality of life (R² = 0.772), with physical frailty emerging as the strongest associated factor (β = 0.459, p < .001), followed by social (β = 0.303, p < .001) and psychological components (β = 0.202, p = .005). Frailty shows a strong multidimensional association with quality of life in older adults with T2DM. These findings highlight the importance of early frailty screening and support the implementation of individualized, multidisciplinary management strategies in primary care to preserve functional ability and overall well-being in this vulnerable population.
While surgeon burnout is extensively documented, the medical community has limited corresponding data regarding what it might mean to thrive in the profession as captured by robust measures of "flourishing." We conducted a cross-sectional survey measuring flourishing in a sample of 1,000 practicing US surgeons from the American Medical Association Masterfile between September and December 2025, including the Harvard Flourish Index (FI) and Secure Flourish Index (SFI). We used multivariable regression to assess personal and professional correlates of flourishing. Of 959 eligible surgeons in our sample, 283 (30%) responded. Mean flourishing (SFI) score was 7.98 (± 1.21) on a 0-10 scale (higher score=higher flourishing). Surgeons reported the highest flourishing in "Financial and Material Stability" (8.57 ± 2.11) and "Meaning and Purpose" (8.50 ± 1.39), while "Close Social Relationships" (7.41 ± 2.08) was the lowest-ranked domain. In multivariate linear regression, working fewer hours (adjusted β (each additional hour), -0.02; p<0.001), having children (adjusted β, 0.43; p=0.05) and viewing surgery as a calling (adjusted β, 0.28; p=0.006) were associated with higher flourishing. A majority (88%) of surgeons view the profession as a calling. Practicing surgeons report high levels of flourishing, with scores surpassing several historical medical and non-medical cohorts. Most surgeons reported comparatively high scores in meaning and purpose concurrent with deficits in social connectivity. Burnout and well-being conversations in the surgical professions may benefit from a flourishing framework. Naming meaning and purpose exemplars while being able to identify key deficits like social connectivity may be crucial for helping surgeons thrive.
Returning results from psychological assessments is increasingly viewed as an ethical duty and a way to strengthen engagement and trust. The WHO International Classification of Functioning, Disability and Health (ICF) offers a framework to describe functioning across strengths, challenges, and contextual facilitators/barriers. Although ICF-based approaches map functioning in autism and ADHD, their use for individualized feedback to caregivers is underexamined. We evaluated caregivers' perceptions of a digital summary report derived from a proxy-rated ICF-based assessment for children and adolescents with autism and/or ADHD. A multiple-methods survey was sent to 707 caregivers from a prior ICF Core Sets study; 357 provided valid responses. Items covered perceived accuracy, changes in awareness and agency, and perceived usefulness in healthcare, education, and social services. Quantitative data were analysed with nonparametric statistics; qualitative responses were thematically categorized. Caregivers rated the report accurate for their child's strengths (91.3%) and challenges (92.2%). About half reported increased awareness of strengths (49.9%), challenges (48.7%), and environmental facilitators (49.3%) and barriers (49.6%). Many reported greater ability to use strengths (53.2%), manage difficulties (48.4%), and seek help (39.5%). Parents of autistic children reported larger awareness gains than parents of children with ADHD; no differences emerged by caregiver or child gender. The report was considered useful in healthcare (62.1%), education (65.3%), and social services (60%). ICF-based feedback was perceived as accurate, useful, and empowering, supporting clinical and educational practice. Impact may increase if delivered earlier and further tailored. Implementation studies should assess usability, acceptability, and benefits for decision-making.
The zebrafish (Danio rerio) is a widely used model organism for studying neurobehavioral processes and neuropsychiatric disorders. Numerous protocols in adult zebrafish assess anxiety-like, locomotor, social and cognitive responses. The increasing experimental complexity and experimentation throughput has led many studies to combine multiple assays into behavioral test batteries. However, the methodological implications of such multi-test designs remain insufficiently understood. Here, we examined current practices in zebrafish behavioral batteries through an initial laboratory survey followed by a systematic literature analysis. Responses from 24 active zebrafish behavioral neuroscience laboratories were used to characterize experimental workflows and guide a targeted PubMed literature search. We further analyzed 357 studies employing the novel tank test (NTT) to assess the prevalence of multi-assay designs, identify commonly co-reported behavioral paradigms, and evaluate methodological variability. Our analyses confirm the central role of the NTT, frequently combined with the light-dark, open field, social interaction, and Y-maze tasks, and indicate that multi-assay experimental designs are common in the literature. However, methodological descriptions also often lacked sufficient clarity on whether assays were conducted sequentially in the same animals (as test batteries) or performed in independent cohorts. These findings highlight an important methodological gap in the field, and emphasize the need for greater clarity and consistency in the design and reporting of zebrafish behavioral batteries to improve the interpretability and comparability of multi-domain behavioral phenotyping.
Primary health care in the African setting is the foundational level for accessing health services; but the quality of services is often challenged by different systemic vulnerabilities. Climate change occurs as a threat multiplier that amplifies these vulnerabilities. This continuing professional development article aims to update the knowledge of primary care providers with evidence-based information on the impact of climate change on health, healthcare services and facilities. The article uses the planetary health framework to explain the pathways from the ecological crisis to its health and social effects. Climate change and pollution are among the global ecological drivers that impact health and society via various proximate causes, such as changes in food production, water quality and quantity, and extreme weather events (e.g. frequent heatwaves, droughts, heavy rainfall and flooding). The effects can be mediated by factors such as wealth, governance, leadership, technology and the strength of the health system. The potential effects on health span the burden of disease from infectious diseases to non-communicable diseases, to mental health problems, maternal and child health, as well as injury and trauma. Social effects such as conflict, displacement, loss of livelihoods and migration have additional effects on health and wellbeing. Primary care providers need to understand how climate change will impact their communities and alter primary care morbidity and mortality. Providers need to prepare, build resilience and explain to patients how climate change is contributing to their health needs and disease patterns.
Falls and physical inactivity are major public health concerns affecting older adults' well-being. Regular physical activity (PA) can reduce fall risk, yet extreme heat and poor walkability may limit activity. Using data from 250 low-income older adults (LOAs) in Orlando, Florida, we examined how PA and community environmental factors (CEFs) influence fall risk and how CEFs affect PA. Fall risk was measured with the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk checklist. PA was monitored continuously with FitBit devices for 6 months. CEFs included urban heat island (UHI), walk score, and social vulnerability index. Results indicate physically active LOAs had lower fall risk than inactive counterparts. Higher walkability was linked to lower fall risk, while UHI was not significantly related. LOAs in socially vulnerable communities had lower PA levels. Findings suggest promoting PA and improving senior community environment may help reduce fall risk and enhance LOAs' health.
Social media now allow the evaluation and documentation of people's reputations online (e.g. upvotes and downvotes). The psychological mechanisms (Deservingness, Rivalry) associated with such evaluation were probed by considering reactions to vignettes outlining the success or failure of an honest or plagiarising professor. 109 participants completed the Tall Poppy scale, and provided their reactions to the vignettes on 5 point Likert scales, rating their Satisfaction, Amusement as well as attributions of Responsibility and Fairness, and willingness to support (Upvote or Donate). In a 2 × 2 Outcome (success/fail) by Context (original/plagiarised work) Multivariate Analysis of Variance there was significant disapproval of the successful plagiarist, and approval when the plagiarist failed. The strongest reactions elicited involved dissatisfaction and attributions of unfairness. Upvoting was less likely when plagiarism was reported. Strength of effects indicated that satisfaction and attributions of unfairness could be important components of people's reactions. Upvoting and willingness to donate in support were greater when the Professor was honest and outcomes were unfair. People were more concerned when a vignette suggested a breakdown of the social order.