As populations age rapidly, understanding the psychological benefits of sustained employment has become increasingly important. In South Korea, where the suicide rate among older adults is one of the highest among Organisation for Economic Co-operation and Development (OECD) countries, identifying modifiable social determinants, such as employment, may inform effective prevention strategies.

This retrospective cohort study used data from the Korean Welfare Panel Study (2009–2024), a nationally representative longitudinal survey. Individuals with depressive symptoms or suicidal ideation at baseline were excluded. The main exposure was participation in a government-led senior employment program. We employed discrete-time survival analysis using a generalized linear model with a complementary log–log link function, which appropriately handled the interval-censored structure of the panel data.

Older adults who participated in the employment program had a significantly lower risk of developing depressive symptoms (adjusted hazard ratio [HR] = 0.76, 95% confidence interval [CI]: 0.67–0.86) and suicidal ideation (adjusted HR = 0.60, 95% CI: 0.45–0.81) compared to those who did not participate. Subgroup analyses revealed that the strength of the association was particularly strong among individuals aged ≥80 years, those with chronic illness, poor self-rated health, and those who were previously or never married.

Structured government-supported employment may mitigate the risk of depressive symptoms and suicidal ideation in later life. These findings support the potential of senior employment programs as effective mental health promotion and suicide prevention strategies for aging populations.

This review explored whether and how prescribers modify their prescribing behaviour for older people (≥65) with hearing, visual or dual impairment (hereafter referred to as sensory impairment) in primary care settings and identified what evidence sources exist to inform prescribing for these specific patient populations.

Older people with sensory impairment may experience substantial challenges with medicines management compared with older people without sensory impairment. The prevalence of sensory impairment and medicine use increases with age, as such, practitioners may need to consider how to modify their prescribing behaviour to improve the safe and effective use of medicines.

This study was conducted to reflect the Joanna Briggs Institute [JBI] methodology for scoping reviews. Electronic databases were searched: MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, and Google Scholar. Qualitative and quantitative studies were included if published between January 2012 and April 2023. Grey literature sources, including Google and Google Scholar, were also searched. Studies were eligible for inclusion if they focussed on prescribing behaviour for older people with sensory impairment in primary care settings. Independent duplicate data extraction was undertaken of details about the participants, concept, context, study methods, outcomes, and key findings relevant to the review question.

A total of 3,590 records were identified through database searching and 10 full text articles were retrieved. Grey literature identified a further 61 records. On examination, none of the articles fulfilled the inclusion criteria for this review.

This review has highlighted a gap in the evidence regarding prescribing for these high risk patient populations. There may be a need for the development of resources, such as evidence based guidelines, to support the safe and effective use of medicines for these specific patient populations.

Instrumental activities of daily living (iADLs) are critical in aging and neurodegenerative research, both diagnostically (e.g., distinguishing dementia from mild cognitive impairment) and as endpoints for trials maintaining or improving functioning. However, measurement has not consistently kept pace with a changed world wherein the ability to navigate technology is pertinent to maintaining independent functioning. The current study used harmonization approaches to link traditional and technological iADLs measures using two samples.

262 individuals (53.4% women, 91.7% non-Hispanic White, Mage = 76.2, Meducation = 15.6) completed both measures: (1), the Functional Activities Questionnaire (FAQ), and (2), the new Expanded FAQ. Item response theory (IRT) analyses extracted item parameters to characterize measure psychometrics and accurately determine individual functional ability. Harmonization was done using both nonequivalent groups anchor test (NEAT) and equipercentile linking methods with supplementary traditional iADL parameter estimates from the National Alzheimer Coordinating Center (n = 48,605).

Correlations verified the measures were sufficiently related (rs = .79), and confirmatory factor analyses and reliability determined all items assessed a single construct. Items from both measures complemented each other to provide more information about milder and more severe functional change. NEAT models converged to provide IRT linking equations and equipercentile conversation tables.

This study provides critical information for harmonizing evolving technological iADLs with traditional iADLs that are assessed in longstanding cohorts. It further provides support for use of an expanded FAQ.

Shared genetic risk has been shown across psychiatric disorders. In particular, anorexia nervosa (AN), obsessive-compulsive disorder (OCD), and schizophrenia (SCZ) show shared genetic risk that matches clinical evidence of shared illness and cognitive phenotypes. Given this evidence, we leveraged a large US-based population-based study to determine genetic associations of disorder-specific and shared psychiatric, cognitive, and brain markers and explore whether the latter might be state versus trait markers in eating disorders.

We used data from the population-based Philadelphia Neurodevelopmental Cohort (N = 4,729) and conducted sex-stratified analyses to test for associations between genetic risk for three disorders (AN, OCD, and SCZ) and mental health phenotypes, neurocognitive traits, and cortical features in a non-clinical population. Exploratory analyses on cortical features were run on a subset with neuroimaging data (N = 626).

Genetic risk for AN was significantly associated with body image distortion (pFDR = 0.02), and body image distortion was significantly related to a reduction in grey matter volume (pFDR = 0.05).

Genetic risk for AN associates with AN trait in a non-clinical sample of youth, particularly in females. Whilst genetic risk was not associated with cognitive or cortical markers, the AN phenotype was associated with cortical markers.

Cardiovascular surgeries can be lifesaving, but mediastinitis following these procedures results in increased morbidity and mortality. We sought to increase the number of days between cases of mediastinitis at our institution from an average of 58 to greater than 223 days, the upper control limit of our baseline data.

Quality improvement initiative.

Freestanding pediatric hospital.

We convened a multidisciplinary team to identify potential interventions. As many infections were not captured by the Solutions for Patient Safety definition, we monitored mediastinitis cases using the Society of Thoracic Surgeons definition. Our outcome measure was cases of mediastinitis. Plan-Do-Study-Act cycles were completed within our operating rooms (ORs) and cardiac care unit (CCU). We tracked measures on statistical process control charts and with descriptive statistics.

From a baseline of 58 days, our hospital has gone over 450 days without a case of mediastinitis. No special causes were noted in our balancing measures. All process measures showed improvement.

A series of OR- and CCU-based interventions significantly increased the amount of time between our cases of mediastinitis. This work highlights the importance of engaging both OR and postoperative stakeholders in proactive mediastinitis prevention work.

Verification of the coincidence between the radiation and mechanical isocentres is an essential quality assurance (QA) procedure for linear accelerators (linacs) in radiotherapy. Ensuring this alignment is critical for accurate beam targeting, especially in conformal and intensity-modulated radiotherapy techniques.

This study aimed to evaluate the feasibility and effectiveness of using computed radiography (CR) with a bare imaging plate (IP) to assess the coincidence between radiation and mechanical isocentres, as a practical QA method, especially applicable in resource-limited settings.

The study was conducted on a Precise linac installed at Bac Ninh General Hospital No2. A Fujifilm IP and an FCR Prima T2 reader were used. Mechanical isocentre marking was performed via 1 monitor unit (MU) open-field exposure. Radiation isocentre verification involved multiple exposures with narrow rectangular fields at various gantry, collimator and couch angles. The latent images were processed using FCR View software to analyse displacement diameters between mechanical and radiation centres.

The CR system demonstrated sufficient sensitivity to detect exposures as low as 1 MU. Deviations (diameters) were 0·44–1·04 mm with expanded uncertainty U up to 0·44 mm (k = 2). All measurements were within the ±2 mm tolerance recommended by American Association of Physicists in Medicine (AAPM) for non-stereotactic systems.

The use of a bare IP in CR offers a reliable and low-cost alternative for verifying the coincidence of radiation and mechanical isocentres. This method is suitable for routine QA procedures in clinical environments lacking access to radiochromic film or electronic portal imaging devices.

The aim was to document sociodemographic and clinical data of patients with musculoskeletal injuries who applied to the Physical Medicine and Rehabilitation clinic after the earthquake, to share experiences, and thus contribute to preparation for subsequent disasters.

The study was planned as retrospective, cross-sectional, and analytic. A total of N = 230 earthquake victims, 105 (45.7%) males and 125 (54.3%) females, aged between 1 and 79, were included in our study.

Regarding injury location, the lower extremity was primarily affected with N = 125 (54.3%). The number of amputated patients was N = 29 (12.6%), and the most common location was transfemoral amputation with N = 14 (6.1%) patients. The number of fractures was N = 130 (56.5%), and the most common fracture site was the lower extremity in N = 66 (28.7%) patients. N = 162 (70.4%) of the patients had soft tissue injuries. There was peripheral nerve damage in N = 76 (33%) of the earthquake victims; the most frequently damaged nerve was the peroneal nerve in N = 36 (15.7%) patients. A vertebral fracture was present in N = 9 (3.9%) patients, and the most frequently fractured vertebra was the lumbar vertebra in 11 (4.8%) patients.

Defining the profiles of patients with musculoskeletal injuries in the early period, determining their needs, and including them in the rehabilitation program will ensure successful functional gain.

This study investigated the dose difference (DD) in the surrounding dose area using the real-time motion tracking (RTMT) system in tomotherapy.

Seven stereotactic ablative body radiotherapy treatment plans with a single lesion were used for the investigations. Each treatment plan was evaluated for the Gamma passing rate (GPR) analysis in a static target motion using the ArcCHECK® phantom. Subsequently, each plan was matched with 8 clinical respiratory cycles to simulate moving target motion. The DD was calculated through point-to-point comparison and expressed as the frequency of the DD levels. The DD frequency was analysed for significant correlations with the target travelling distance, target size and respiratory frequency.

The GPR for criteria of 3%/2mm and 3%/3mm revealed values of 97·8 ± 1·9% and 99·5 ± 0·6%, respectively, for static motion. The highest frequency of DD was in the 5 – 10% range. A significant correlation was found between the target travelling distance and the frequency of percent DD at the 2·0 – 3·0% and 10·0 – 15·0% levels, as well as between target size and the frequency of percent DD at the 0·0 – 4·0% and 10·0 – 25·0% levels. Finally, no significant correlation was found between the frequency of percent DD and respiratory frequency.

RTMT introduced the DD in the surrounding treatment area. The DD was found to be up to 15·0% at 119·5 mm (water-equivalent distance) from the phantom centre. The DD was varied depending on the target travelling distance and size, but it did not depend on the respiratory frequency.

Recovery rates for panic disorder in NHS Talking Therapies (NHSTT) services in the United Kingdom do not match those in randomized trials. Previous research has found that training therapists in ‘focused cognitive behavioral therapy’ (CBT) improves outcomes. The primary aim was to examine whether focused CBT delivered by trained psychological well-being practitioners (PWPs) can improve treatment outcomes for panic disorder. An exploratory aim was to evaluate the potential impact of a novel component of focused CBT, which includes the use of ‘approach-supporting behaviors’ (ASBs) where safety-seeking behaviors (SSBs) are prominent.

We conducted a randomized parallel trial. Participants were randomly allocated to focused CBT or the current treatment at ‘Step Two’ (treatment as usual) in two NHSTT services (ISRCTN:11268881).

We found a significant group-timepoint interaction. Those in focused CBT had significantly greater reductions in the primary measure of panic severity relative to those in treatment as usual (TAU). The level of ASBs did not predict a change in panic severity; however, the level of SSBs at the end of treatment did predict a change in panic severity.

Focused CBT is effective for panic disorder and is superior to TAU, supporting the applicability of this lower-intensity and panic-specific version of CBT for panic disorder.

Dexmedetomidine is frequently used in paediatric anaesthesia. This includes use in patients with CHD, but detailed analysis of haemodynamics after administration in these patients has not yet been published. We performed a systematic review and meta-analyses examining haemodynamic changes immediately after dexmedetomidine administration in patients with CHD.

We conducted a systematic review of PubMed, Embase, and Medline from inception until May 31, 2024. Inclusion criteria were studies that contained children with CHD who received dexmedetomidine for a cardiac procedure and reported at least one haemodynamic variable before and after administration of dexmedetomidine. Exclusion criteria were studies of noncardiac procedures. We performed a meta-analysis on each haemodynamic variable that was reported by at least four studies.

We screened 5383 abstracts. We included 85 studies for review, and 16 studies were accepted for four meta-analyses (heart rate, 16 studies, n = 408; systolic blood pressure, 11 studies, n = 280; diastolic blood pressure, 10 studies, n = 276; mean arterial pressure, 5 studies, n = 130). Analysis of heart rate, systolic blood pressure, and diastolic blood pressure showed a statistically significant reduction (p < 0.001), while there was no significant change in mean arterial pressure. The clinical difference was minimal with a decrease in heart rate of 11.3 beats per minute, and a decrease in systolic blood pressure/diastolic blood pressure of 5.9 and 6.2 mmHg, respectively. Heterogeneity was high in all analyses.

Dexmedetomidine is associated with small changes in heart rate, systolic blood pressure, and diastolic blood pressure in children with CHD. Further study is warranted.

This study explored Italian Emergency Medical Services (EMS) professionals’ perceptions regarding a hypothetical wearable device during Mass Casualty Incidents (MCIs), aiming to improve MCI management and patient outcomes. The device includes patient identifier, vital sign monitoring, LED-based triage coding, geolocation, and real-time data transmission. Using the Technology Acceptance Model (TAM), perceived usefulness, perceived ease of use, and behavioral intention to use the device were measured.

An anonymous online survey was distributed to the 67 EMS dispatch centers across Italy. After an introduction to the device, participants answered demographic and TAM-based questions using a seven-point scale.

Among the 141 respondents, most were males (60.3%), nurses (66.7%), and reported over 10 years of EMS experience (63.1%); 51.8% had prior MCI response experience. The wearable device was positively rated for improving situational awareness and coordination, with concerns about workflow integration and potential rescue delays. The questionnaire showed high internal reliability (Cronbach’s α = 0.96). Principal Component Analysis (PCA) highlighted distinct perceptions between features supporting scene coordination and those enhancing triage accuracy.

The study highlights the perceived value of the wearable in improving MCI coordination and situational awareness. However, concerns regarding workflow integration and possible rescue delays warranted further research on real-world application.

Metabolic syndrome (MetS) is linked to later-life cognitive decline and brain aging, but early detection of vulnerability in midlife remains challenging. This study applied two methods to detect subtle changes in midlife adults with MetS: (1) latent profile analysis (LPA) to identify cognitive performance patterns and (2) an MRI-derived brain-predicted age metric to assess structural brain aging.

Participants were cognitively unimpaired, community-dwelling adults from prior studies on metabolic and brain health (N = 230; ages 40 – 65). MetS status was assigned using clinical criteria based on cardiovascular indicators and medical history. Cognitive test scores, adjusted for age, sex, and education, were analyzed using LPA, identifying four cognitive subgroups: High Memory, Low Executive, Global Average, and Low Memory. T1-weighted MRI scans were processed with brainageR to compute brain-predicted age difference (PAD). Analyses were conducted in R using chi-square tests, ANCOVA, regression, and nonparametric methods, with appropriate covariates and effect size estimates.

MetS prevalence differed across cognitive profiles (χ2 = 10.99, p = .012, V = 0.22), with higher rates in the Low Memory and Global Average groups than in the High Memory group. Individuals without MetS had younger brain ages than those with MetS (p = 0.003, η2 = 0.03). Only elevated triglycerides were associated with greater PAD (p = 0.012, η2 = 0.02). A Johnson–Neyman analysis showed the MetS–PAD association was significant between ages 40.0 and 54.6. PAD did not differ by cognitive profile.

Cognitive profiles and brain-predicted age metrics identify early vulnerability in midlife MetS, underscoring the importance of early intervention.

Hospital sink drains are recognized reservoirs for gram-negative bacteria (GNB). This study evaluates the efficacy of a sink drain disinfection strategy using hydrogen peroxide-based foam, mechanical cleaning, and drain cover replacement in reducing GNB bioburden in a neonatal intensive care unit (NICU).

We conducted a prospective cohort study of 30 NICU room sinks comparing three interventions: (1) foam disinfection alone (n = 5), (2) foam with mechanical cleaning (n = 5), and (3) foam with drain cover replacement (n = 5), and (4) foam, mechanical cleaning, and drain cover replacement (n = 5), to controls (no intervention, n = 10). Samples from sink drains, faucets, counters, basins, and drain covers were collected at baseline (Day 0) and post-intervention (Days 1, 3, 5, and 7). Bacterial colony counts were analyzed using linear regression models.

At baseline, sink drains and drain covers had the highest bioburden (total GNB mean ln-CFU: 15.4 and 16.4), with Pseudomonas aeruginosa (33%) and Stenotrophomonas maltophilia (39%) as predominant isolates. The intervention combining foam, mechanical cleaning, and drain cover replacement achieved the greatest bioburden reduction on Day 1 in drains (mean ln-CFU reduction = 11.0, 95% CI: 6.4, 16.0, p < 0.001) and covers (mean reduction = 14.0, 95% CI: 8.7, 19.0, p < 0.001), with sustained effects through Day 7. Recolonization to ∼50% of baseline was evident by Day 5 in both sites.

Physical bioburden removal improved the effect of a foaming disinfectant in reducing GNB. However, recolonization occurred by day 5.

Therapies provided in nontraditional settings or by individuals without knowledge of core principles of infection prevention and control (IPC) may place consumers at risk of adverse events. We summarize findings from our recent consultation experiences in the Division of Healthcare Quality Promotion (DHQP) at the Centers for Disease Control and Prevention (CDC) to help identify targets for prevention efforts and enhanced consumer protections.

We reviewed records of DHQP consultations with state, local, or territorial health officials conducted from 2016 to 2023 to identify investigations involving nontraditional therapies or settings in the United States. Information collected included type of procedure or therapy, type of setting, pathogens involved, number of affected individuals, and types of IPC issues identified.

Of 1500 consultations, we identified 30 (2%) involving nontraditional therapies or settings. Therapies were performed for esthetic reasons, general wellness, or as treatment for pain. Infectious pathogens were identified in the blood, joint fluid, and skin and soft tissue, and included viruses, bacteria, and fungi. Investigations revealed breaches in injection safety, medical device reprocessing, medication preparation and handling, and environmental disinfection. Over 7000 consumers received notification regarding potential exposure to an infectious pathogen.

This summary highlights the potential infectious risks to consumers posed by nontraditional therapies, which may have unproven benefits and poorly defined risks. With continued expansion of nontraditional therapies and settings, consumers will benefit from education, training, and oversight of those who provide therapies in these settings.