Overweight and obesity are emerging public health challenges among young adults in Vietnam, particularly within university settings where lifestyle transitions frequently occur.

To determine the prevalence of overweight and obesity among university students in Vietnam and identify associated sociodemographic and behavioral factors.

A cross-sectional study was conducted among 2,000 students from ten universities across Northern, Central, and Southern Vietnam. Anthropometric measurements were collected using standardized procedures. Overweight and obesity were diagnosed according to the World Health Organization recommendations for Asian populations, with a cut-off of BMI ≥ 23 kg/m2. Multivariable logistic regression was performed to examine factors independently associated with overweight and obesity.

Among 2,000 students, 25.5% were overweight or obese (12.3% overweight, 13.2% obese), with prevalence significantly higher in males than females (35.1% vs. 17.5%, p < 0.001). Regional differences were observed, with underweight more common in Central Vietnam and overweight and obesity most prevalent in the South, p < 0.05. Multivariable analysis showed significant associations between overweight or obesity and male sex (OR = 2.8), ethnic minority status (OR = 1.7), Southern residence (OR = 1.9), high waist to hip ratio (OR = 4.2), and being married (OR = 3.2). Prolonged weight loss dieting was positively associated (OR = 2.9), while sleeping 8 to 10 hours per day was associated with lower odds (OR = 0.6).

Overweight and obesity affect approximately one in four university students in Vietnam. Targeted prevention and long-term weight management strategies are needed for young adults in academic settings.

The COVID-19 pandemic has exerted significant mental health impacts worldwide, with a major concern in the literature being its potential effect on suicide rates. Brazil, one of the countries most severely affected by the pandemic, still lacks clear evidence regarding the consequences of the crisis on self-inflicted deaths. This paper aims to estimate the impact of the COVID-19 pandemic on suicide rates in Brazil.

We employed an interrupted time series design with seasonal adjustments to estimate changes in suicide rates per 100,000 population. The analysis was based on deaths from all forms of self-inflicted injury, as classified by the International Classification of Diseases. We estimated trends for the total population, stratified by sex and administrative region.

Suicide rates increased significantly before the pandemic (β₁ = 0.00148, p < 0.001). No significant change in trend was observed after the onset of the pandemic at the national level (β₃ = 0.00092, p > 0.05). Among men, both the pre-pandemic trend (β₁ = 0.00236, p < 0.001) and the post-pandemic increase (β₃ = 0.00155, p < 0.05) were significant. For women, the pre-pandemic trend was modest (β₁ = 0.00065, p < 0.001), and the post-pandemic slope was not significant (β₃ = 0.00033, p = 0.10). Regionally, the Central-West (β₃ = 0.00217, p < 0.01) and North (β₃ = 0.00186, p < 0.05) experienced significant post-pandemic increases, while the Southeast (β₃ = 0.00087, p > 0.05) and South (β₃ = −0.00034, p > 0.05) showed no significant changes. Seasonal effects revealed consistent mid-year declines across all groups and regions.

The COVID-19 pandemic did not produce a statistically significant shift in national suicide trends but coincided with the persistence of pre-existing upward patterns in specific demographic and regional contexts. These findings underscore the need for targeted and region-specific suicide prevention strategies.

The increasing presence of artificial intelligence (AI), electronic patient-reported outcomes (ePROMs), and digital infrastructures in palliative care is transforming how clinical encounters are organized and how suffering is interpreted. These technological shifts heighten the risk of relational compression and a reduction of dignity to measurable outputs. This paper proposes the DiRePal model (Relational–Temporal Dignity in Palliative Care) as a philosophical framework to re-examine dignity beyond coherent narrative identity or autonomy-centered ethics, emphasizing relational presence, temporal sensitivity, and structural conditions of care.

A philosophical–ethical analysis informed by narrative identity (P. Ricoeur), ethics of alterity (E. Levinas), capabilities theory (M. Nussbaum), and care ethics (J. Tronto). Critical readings of dignity frameworks, AI ethics, and digital health literature were synthesized to develop a relational–temporal account of dignity and 2 operational concepts: the temporal dignity indicator and the architecture of prudence.

While digital tools can enhance communication and support anticipatory care, they also risk reducing patients to data profiles, narrowing listening practices, and eroding opportunities for narrative, silence, and relational presence. The DiRePal model reframes dignity as a fluctuating, co-constructed achievement that depends on temporal attentiveness, ethical listening, institutional conditions, and prudent integration of AI and ePROMs. It further expands dignity to include post-biographical dimensions such as memory, grievability, and digital legacy.

End-of-life care in the algorithmic age requires an ethics that recognizes dignity as relational, temporal, and structurally mediated. The DiRePal model offers clinicians and institutions a conceptual grammar to resist technological reductionism, protect time for presence, and safeguard the narrative and post-biographical continuity of persons whose voices may be fragmented, vulnerable, or digitally extended.

Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise.

A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs).

Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs.

Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation by VAMC.

The average workload that champions and ID consultants allocated to VAST activities was 6.7% (range 1.0%–20.0%) and 8.4% (range 2.0%–12.5%) full-time equivalents (FTEs), respectively. Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%–2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%–31.6%). Process maps showed four phases common to each VAST’s workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. Champions carried out most tasks related to case finding and meeting preparation; the ID consultants completed most documentation tasks.

The distribution of tasks within and among the VASTs indicated opportunities to improve workflow efficiency. Investing <12.5% of the FTE allocated to VA Antimicrobial Stewardship programs to support the time of an ID consultant from another VAMC can help rural VAMCs achieve staffing sustainability.

Lifestyle changes and unhealthy eating habits have led to a sharp rise in obesity rates worldwide. Obesity is closely associated with a range of complications, including cognitive impairment and dementia. Accumulating evidence indicates that obesity negatively affects cognitive function and may increase the risk of neurodegenerative diseases. Conversely, cognitive dysfunction may further contribute to the development and progression of obesity. With growing attention in this field, obesity-related cognitive impairment has emerged as an important research focus at the intersection of metabolic and neurological disorders.

This article reviews the potential mechanisms underlying obesity-related cognitive impairment and summarizes emerging therapeutic strategies.

The development and progression of obesity-related cognitive impairment involve multiple mechanisms, including insulin resistance, systemic and central inflammation, immune dysregulation, microcirculatory alterations and changes in neurotransmitters and synaptic plasticity. Recent studies have focused on the adipose tissue-brain axis and the microbiota–gut–brain axis, in particular, the targeted effects of extracellular vesicles released from adipose tissue and microbiota on the brain.

This article systematically reviews the mechanisms underlying obesity-related cognitive impairment and presents novel therapeutic strategies.

To support Antimicrobial Stewardship programs (ASPs) as well as the clinical care of patients with infections, we disseminated and implemented a Videoconference Antimicrobial Stewardship Team (VAST) to connect multidisciplinary teams from rural Veterans Affairs (VA) medical centers with geographically distant ID experts. Here, we describe the clinical syndromes discussed and the response to recommendations made during VAST sessions.

Between September 2021 to February 2024, eight ID consultants established VASTs with ten rural VAMCs, holding regularly scheduled videoconference sessions to discuss clinical cases and provide recommendations. Data were collected on patient demographics, clinical syndromes, and recommendations. Acceptance of recommendations within one week of each session was assessed via chart review. Six months after the intervention began, we conducted semi-structured interviews to assess participants’ perceptions of VASTs.

VASTs reviewed 626 cases involving 527 unique patients. Among 763 clinical syndromes discussed, the most common were infections of the respiratory (29%) or urinary tract (21%). Overall, VASTs made 973 recommendations, of which 71% were accepted. Of 570 recommendations related to antibiotics, 459 (80%) were accepted. Among 403 other recommendations, 235 (58%) were accepted. Interviews with participants indicated the importance of building trust and strong interpersonal relationships.

VASTs effectively supported Antimicrobial Stewardship in rural VA medical centers (VAMCs) without local ID expertise. High acceptance rates, particularly for antibiotic-related recommendations, suggest that telehealth-enabled provider-to-provider models enhance stewardship efforts.

Attention-deficit hyperactivity disorder (ADHD) is increasingly recognised as a social identity as well as a medical diagnosis. Social identity theory suggests that group identification can benefit self-esteem, well-being and mental health, but little is known about ADHD social identification or preferred terminology in English.

We aimed to measure ADHD social identification and preferred terminology in a sample of adults with ADHD in the UK and to understand whether ADHD social identification is related to improved self-esteem, well-being and mental health.

Three hundred and nineteen adults with ADHD in the UK participated. They were aged between 18 and 73 years and 59% were female. Participants completed self-report measures of ADHD social identification, self-esteem, well-being, anxiety, depression, terminology preferences, medication use and sources of learning about ADHD. Descriptive statistics were used to identify the percentage of participants who preferred ADHD-first versus person-first terminology. Pre-registered serial mediation models tested hypothesised pathways from ADHD identification to mental health via self-esteem and well-being. Further analyses examined associations between terminology preferences, medication use and sources of learning about ADHD.

ADHD identification was not significantly correlated with self-esteem, anxiety or depression. Most participants (77%) preferred person-first terminology (‘person with ADHD’). Higher ADHD identification was associated with identity-first language preference and medication use. Social media was the only source of learning about ADHD related to higher ADHD identification. In mediation models, ADHD identification was not associated with self-esteem or well-being; however, a subcomponent of ADHD social identification – satisfaction – was indirectly related to better mental health via self-esteem and well-being.

These cross-sectional findings indicated that ADHD identification did not show the hypothesised protective associations with mental health. Preferences for person-first terminology suggest ADHD is not always central to identity. Longitudinal and qualitative studies are needed to clarify causal relationships and clinical implications.

In India, the term euthanasia is frequently used to describe a wide range of end-of-life practices, including withdrawal of life-sustaining treatment and administration of lethal drugs. Such usage diverges from more narrow definitions that restrict euthanasia to the intentional administration of lethal drugs.

This systematic review and meta-analysis examines how euthanasia has been defined and operationalized in quantitative studies of Indian physicians’ and nurses’ attitudes, and estimates the prevalence of approval when euthanasia is defined narrowly.

Following PRISMA 2020 guidelines, searches were conducted in PubMed, EMBASE, PsycINFO, and CINAHL for studies published from 2010 onward. Two investigators independently screened studies, extracted data, and assessed risk of bias using the Mixed Methods Appraisal Tool (MMAT). Studies were included in the meta-analysis only if they reported attitudes toward euthanasia as narrowly defined.

Nine studies met inclusion criteria for the systematic review. Definitions of euthanasia varied considerably, and several studies combined attitudes toward treatment withdrawal with attitudes toward the administration of lethal drugs. Four studies reporting on 519 nurses and physicians provided data suitable for meta-analysis. Approval of euthanasia, defined as the intentional administration of lethal drugs, ranged from 12% to 20%, with a pooled prevalence of 16% (95% confidence interval: 0.13–0.19). This prevalence is notably lower than in earlier reports on Indian healthcare professionals’ attitudes.

Definitional inconsistency substantially affects reported attitudes toward euthanasia in Indian research. When euthanasia is defined narrowly, approval among healthcare professionals is low and consistent across studies. These findings highlight the need for conceptual clarity in future research to support accurate interpretation of empirical data and to strengthen the contribution of studies on ethical attitudes to ethical and palliative care scholarship.