The families of cancer patients experience many forms of distress, as a result of their loved one’s cancer diagnosis. However, there have been no reports of suicide attempts of caregivers directly linked to the diagnosis of advanced cancer in a family member.

We reported a caregiver who attempt suicide two months after his wife was diagnosed with advanced cancer.

The subject was a 69-year-old male who had been caring for his wife, diagnosed with advanced stomach cancer, for two months. The patient’s husband, acting as her caregiver, was referred by his wife (a cancer patient) to meet with a nurse. He reported insomnia and a desire for hastened death. Despite repeated recommendations for specialized care at a caregiver clinic, he declined. Following an argument with his wife at home, he felt unable to cope and attempted suicide. The husband had no psychiatric history but had a history of colon cancer. After the attempt suicide, he began visiting the “Caregivers’ Clinic,” where he received ongoing psychological support that continued until the death of his wife.

In cancer care, it is essential to continuously assess not only the patient’s suicide risk, but also that of closely related family members.

To examine how race, income and food insecurity (FI) interact during pregnancy and whether FI contributes to disparities in maternal and infant health outcomes.

Observational cohort study employed sequential explanatory a mixed-methods design, with a survey phase (including Household Food Security Survey Module [HFSSM] six-item) and medical record abstraction followed by semi-structured interviews.

Online survey, virtual interviews.

The participants were individuals who gave birth in Louisiana, USA, between June 2020 and June 2021. The quantitative phase comprised 1691 individuals who completed the survey. A nested cohort of forty individuals (evenly split by race (Black v. White) and income (low v. high)) subsequently completed semi-structured interviews.

Race and income were independently associated with both FI and maternal and infant health outcomes. When considering both income and FI, low-income individuals with FI were 1·73 times more likely to deliver low birthweight (LBW) infants (adjusted Odds Ratio [aOR] 95 % CI: 1·07, 2·82) and 1·43 times more likely to experience adverse infant outcomes (aOR 95 % CI: 1·02, 2·00) than high-income individuals without FI. Black individuals with FI were 2·49 times more likely to deliver LBW infants (aOR 95 % CI: 1·45, 4·29) than White individuals without FI. Interview findings revealed low-income individuals faced disproportionate barriers to accessing healthy food and making dietary choices, which were further complicated by pregnancy-related conditions.

The interplay between race, income and FI significantly increases the risk of adverse infant health outcomes, demonstrating a synergistic effect. Targeted efforts to address FI, particularly among low-income pregnant individuals, are essential to improving maternal and infant health outcomes.

To estimate the prevalence of nutrition security and examine its association with community food environment factors, including food access and affordability.

This cross-sectional study used data from the 2012–2013 National Household Food Acquisition and Purchase Survey, including its restricted-use Geography Component (FoodAPS-GC). Household nutrition security measure was derived by combining self-assessed food security and self-rated diet quality indicators into four categories: food secure with high diet quality (FSHD), food secure with low diet quality (FSLD), food insecure with high diet quality (FIHD) and food insecure with low diet quality (FILD). Only FSHD households were considered nutrition secure. Multinomial logit analysis identified factors associated with nutrition security.

4685 households with primary respondents aged 20 years or older

Nationally representative sample of US households

Approximately 31·0 % of households were classified as nutrition insecure, including 15·0 % as FSLD, 9·3 % as FIHD and 6·7 % as FILD. The remaining 69·0 % were nutrition secure (FSHD). Nutrition insecurity was significantly associated with younger age, lower educational attainment, lower income, obesity, smoking and poorer self-rated health. Food environment factors, including low geographic access to food and higher local food prices, were not significantly associated with nutrition security. Relying on someone else’s car to reach a primary food store was linked to higher odds of nutrition insecurity.

The proposed nutrition security measure can be used to monitor nutrition security in national surveys. Comprehensive measures of the food environment are needed to understand its relationship with nutrition security and to guide targeted policy interventions.

Educational attainment (EA), which comprises cognitive (CogEA) and noncognitive (NonCogEA) components, is positively genetically correlated with alcohol and cannabis use but negatively correlated with alcohol and cannabis use disorders (AUD and CUD). These paradoxical associations suggest that shared genetic influences with EA may differ by level of substance involvement.

To test this, we examined the shared genetic architecture of EA, CogEA, and NonCogEA with alcohol consumption (AC), AUD, lifetime cannabis use (CanUse), and CUD. We used bivariate causal mixture models, local genetic correlation analyses, and conditional/conjunctional false discovery rate analyses to identify global, regional, and variant-level overlap for EA and substance-related trait pairs.

EA shared 57.57% of causal variants with AC and 62.42% with AUD, while sharing 48.07% of causal variants with CanUse and 84.18% with CUD. Among shared variants for AC, 48.12% had concordant effects with CogEA and 52.86% with NonCogEA. For AUD, 38.40% and 41.02% of causal variants had concordant effects with CogEA and NonCogEA, respectively. CanUse had higher concordance with CogEA (71.42%) and NonCogEA (65.56%) than CUD (37.97% and 42.23%, respectively). Functional enrichment in brain tissues varied across substance use and EA pairs.

EA is associated with greater alcohol and cannabis use and lower risk for AUD and CUD, a pattern that reflects both concordant and discordant variant effects. CogEA and NonCogEA show partially distinct patterns, particularly for cannabis-related traits, highlighting the importance of disaggregating EA to clarify the genetic architecture underlying its paradoxical associations with substance-related traits.

Professional guidelines recommend an early switch from intravenous (IV)-to-oral antibiotics for community-acquired pneumonia (CAP) to facilitate early discharge and prevent hospital-related complications. However, it is unknown how often these IV-to-oral switches occur in clinical practice.

We performed a retrospective cohort study across 124 acute-care Veterans Administration hospitals to measure the frequency of early switches.

Patient-admissions during 2018–2023 who had CAP and were started on IV antibiotics upon admission.

We measured the percentage of hospitalized patients with CAP who had an early switch from IV-to-oral antibiotics, i.e., within 72 hours of admission. In addition, we calculated an observed-to-expected ratio for early switches at each hospital and compared a composite outcome (mortality and/or hospital readmission within 30 days of discharge) at hospitals with switch rates that were higher and lower than expected.

Of 31,183 patient-admissions for CAP, 17,282 (55.4%) were switched to oral antibiotics by day three of therapy. Overall, 5,629 (18.1%) died and/or were re-admitted within 30 days. The O:E ratio for early antibiotic switches ranged from 0.78 among hospitals in the lowest quartile to 1.23 in the highest quartile. There was no difference in the composite outcome across quartiles.

Early switches from IV-to-oral antibiotics for CAP occurred in half of eligible cases. The frequency of these switches varied widely across facilities. Outcomes among patients at hospitals with high switch rates were comparable to outcomes at hospitals with low rates, thereby supporting the safety of early switches. More concerted efforts to promote these switches are needed.

The increasing diversity of the UK’s population, along with significant inequalities in health outcomes among diverse cultural and ethnic groups, highlights the critical need for healthcare providers, including physiotherapists, to deliver culturally competent care. Research demonstrates that cultural competency (CC) in healthcare can enhance patient outcomes, improve treatment adherence, and address health inequalities. This quality improvement project aimed to evaluate the impact of a brief training intervention on perceived CC among physiotherapists engaging in cross-cultural, clinical encounters.

The design of this project was informed by principles of the Plan-Do-Study-Act (PDSA) cycle. Musculoskeletal physiotherapists voluntarily participated in this educational intervention by completing a CC e-learning course developed by Health Education England. A retrospective evaluation method was used, where participants rated their awareness, knowledge, and skills in providing care to diverse patient groups after completing the training as compared to before.

The pre-and post-training responses assessed three constructs of CC: awareness, knowledge, and skills. Significant increases were observed in the mean scores for each construct, as well as in the overall aggregate CC score, indicating measurable improvements following the training.

Improvement in CC is viable and achievable through targeted training. CC is a lifelong, dynamic process that requires ongoing education. Therefore, further PDSA cycles are recommended with more advanced educational sessions. Additionally, future projects should assess the impact of enhanced CC on patient outcomes and experiences. Cultural competency must encompass cultural issues beyond racial and ethnic differences.

Understand current Candidozyma auris prevention practices in the United States and identify opportunities to improve containment.

Electronic survey.

Acute care hospitals.

Society for Healthcare Epidemiology (SHEA) Research Network (SRN) facilities located in the United States.

REDCap survey distributed via email exploring knowledge and perceptions related to C. auris screening methods, prevention practices, barriers to prevention, and tools needed to improve containment.

Responses were received from 51/96 (53%) U.S.-based SRN facilities, with 80% identifying as teaching hospitals. Two-thirds of facilities (34/51) reported first-hand experience with C. auris, with 15/34 also experiencing at least one C. auris outbreak. Routine C. auris screening occurred in 47% (24/51) of facilities. C. auris prevention practices commonly included patient isolation, signage to notify staff of isolation status, and placement in a single patient room. When asked to identify barriers to control of C. auris at their facility, participants ranked lack of communication between healthcare facilities, lack of infection control at outside healthcare facilities, and lack of training as the top three barriers. C. auris prevention resources or tools perceived to be most helpful in their facility included effective decolonization regimens, standardized protocols for C. auris screening, and improved communication between healthcare facilities.

SRN facilities commonly used isolation practices to prevent the spread of C. auris. Development of additional tools to improve prevention practices should target effective decolonization strategies and standardized screening protocols to support C. auris containment.

Persistent affective disturbance is a core, disabling feature of major depressive disorder (MDD), thought to stem from a dysfunctional interaction between emotional bias and cognitive control. However, the underlying neural dynamics are debated, with studies reporting both hyper- and hypoactivation. This study utilized high-temporal-resolution electroencephalogram (EEG) to resolve this discrepancy by examining distinct stages of emotional information processing.

We recruited 175 medication-free patients with MDD (Hamilton Depression Rating Scale-17 ≥ 14) and 101 healthy controls (HCs) who completed an emotional Stroop task while an EEG was recorded. We analyzed event-related potentials reflecting conflict monitoring (N250), inhibition (N450), and resolution (LSP) using a 2 (group) × 2 (valence) × 2 (congruency) analysis of variance.

Results revealed a stage-specific neural cascade. Compared to HCs, the MDD group showed: (1) hypoactivation during initial conflict monitoring (attenuated N250 amplitude); (2) compensatory hyperactivation during conflict inhibition (a significant N450 interaction revealed generalized conflict activity in MDD, unlike the context-specific response in HCs); and (3) subsequent hypoactivation during conflict resolution (reduced LSP amplitude for negative stimuli). Crucially, altered N450 correlated with depression severity, and the entire neural cascade predicted behavioral performance.

The apparent contradiction in the literature reflects a multistage process. MDD is characterized by an inefficient neural cascade: an initial deficit in conflict monitoring is followed by compensatory overactivation during inhibition, which ultimately proves insufficient, leading to impaired late-stage resolution. This temporally specific model advances our understanding of the pathophysiology of depression and identifies potential stage-specific targets for intervention.

Health Technology Assessment (HTA) guides healthcare decision-making, while Implementation Research (IR) addresses challenges in operationalizing these decisions. The SAVING (Sustainable Access and Delivery of New Vaccines in Ghana) Consortium aims to enhance health intervention delivery in Ghana, focusing on HTA evidence. This study identifies barriers to the application of HTA-related evidence (cost analysis) in coronavirus disease 2019 (COVID-19) vaccine deployment in Ghana.

This qualitative exploratory study purposively selected 12 key stakeholders with high interest and power relating to COVID-19 vaccine deployment in Ghana. Through in-depth interviews, seven stakeholders from diverse sectors contributed insights into barriers to the application of HTA-related evidence. Thematic analysis was conducted with narrative reporting supported by direct quotes for substantiation.

Six main barriers were identified: (1) timing and access to HTA reports, (2) technical complexities, (3) relevance of content, (4) political considerations and power dynamics, (5) health system fragmentation, and (6) poor responsiveness of decision-makers to research. Proposed solutions include engaging political decision-makers continuously, simplifying technical reports, aligning report content with policymakers’ needs, reducing political considerations, enhancing capacity building, fostering health system cohesion, and improving responsiveness to research.

HTA is vital for informed healthcare decisions. However, technical complexity, relevance of content, inappropriate timing, and lack of access to HTA reports, among other barriers, prevent the uptake of HTA findings. Continuous and improved engagement between HTA producers and policymakers, along with rapid production of HTA, has the potential to improve the uptake of HTA findings, even during public health emergencies.