Anorexia nervosa is associated with high personal and financial costs for sufferers, carers and society in general, but little is known about the long-term health economic burden.

To examine healthcare utilisation, social assistance, sick leave and disability pension in individuals with anorexia nervosa over a period of 30 years.

Fifty-one individuals with adolescent-onset anorexia nervosa and 51 matched comparison cases (COMP) were recruited in the community and followed prospectively from 1985. All individuals were examined on five occasions. At the 30-year follow-up, mean age 44, data on in- and out-patient care, prescribed medications, social assistance, sick leave and disability pension were collected from Swedish national registers.

The anorexia nervosa group had more days of in-patient care (p < 0.001) and out-patient visits to psychiatry (p < 0.001), more days of sick leave (p = 0.006), more days of disability pension (p = 0.002) and were prescribed more psychotropic medication (p = 0.045) compared with the COMP group. Of the anorexia nervosa group, 22% had ever received a disability pension compared with 2% in the COMP group (p = 0.004) and less than half the anorexia nervosa group worked full-time at the 30-year follow-up. In the anorexia nervosa group, 45% had received social assistance at some point, compared with 22% in the COMP group (p = 0.02). Age at onset of anorexia nervosa emerged as a predictor of healthcare utilisation with significant odds ratios for psychiatric in-patient (odds ratio 0.61, 95% CI: 0.39, 0.94; p = 0.027) and out-patient care (odds ratio 0.63, 95% CI: 0.40, 0.98; p = 0.042), i.e. individuals with a later onset of anorexia nervosa were less likely to require psychiatric care.

The long-term burden of adolescent-onset anorexia nervosa comprises increased utilisation of healthcare and dependence on society for a significant minority. A later onset of anorexia nervosa predicted a lower healthcare utilisation.

We evaluated whether patient perceptions of cleanliness are associated with objective measures of Clostridioides difficile infection (CDI), as an early indicator of facility-level CDI rates and prevention.

Cross-sectional analysis of Medicare-certified hospitals across the United States.

Data from the CMS Hospital Compare website and U.S. Census Bureau from 2023 were analyzed using multivariate logistic regression models. The primary outcome was C. difficile standardized infection ratios (SIRs) compared to the national average. The primary exposure was patient-rated cleanliness star ratings from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

The population studied was 3,616 medicare-certified hospitals with an estimated 17,994,034 unique patient admissions. There was no association between better patient-rated cleanliness and improved CDI performance. Facilities with a 5-star cleanliness rating were not more likely to have an SIR less than or equal to the national average compared to those with a lower star rating. For every 1% increase in patients who reported their room and bathroom as always clean, the odds of CDI observed cases being higher than predicted increases by 4.2% (ie, increasing patient-related cleanliness was weakly associated with worse CDI performance).

Patient-rated cleanliness was not associated with improved CDI performance in U.S. national hospital data. Findings were consistent across multiple operationalizations of cleanliness and CDI suggesting patient perceptions of cleanliness are not a strong indicator of CDI control measure performance.

Disaster medicine (DM) prepares health care professionals to manage emergencies caused by significant societal disruptions. Training recent graduates and final-year students is an essential element of disaster preparedness. This review aims to examine the use of Virtual Simulation (VS) in undergraduate students’ DM training.

The research team searched Scopus, PubMed, WOS, and Scielo. The team followed the 6-step approach described by Mak to conduct Scoping Reviews. We identified 262 reports, and 17 articles met the inclusion criteria. We extracted and analyzed data, focusing on educational settings, professions involved, and intervention characteristics. The report followed PRISMA guidelines.

The implementation of VS in DM training has been geographically concentrated, with most studies focused on nursing education. Most programs use virtual reality, with limited augmented or mixed reality integration, principally in nursing students. The training focused primarily on triage, disaster preparedness, evacuation, decontamination, improving knowledge retention, self-confidence, and decision-making.

Although VS has effectively enhanced technical skills and disaster preparedness, its use remains limited in undergraduate health education. Further research is needed to expand its application in interprofessional and non-nursing contexts, with deliberate practice principles to maximize efficiency. Integrating VS into community training can reduce costs and enhance large-scale emergency response.

We evaluated the olfactory fossa and Keros classification in patients with unilateral mucosal contact points in septal deviation.

Paranasal sinus computed tomography images of 60 patients with mucosal contact points on the septum were compared with those of the control group (N = 60). The Keros types, septal deviation angles, mucosal contact point angles, olfactory fossa widths and depths, crista galli lengths, widths and pneumatisations, as well as the presence of anatomical variations, were analysed.

The depth of the olfactory fossa contralateral to the mucosal contact point was greater in patients with septal deviation compared to those without (p < 0.05). A significant correlation was found between increased crista galli height and a higher Keros degree on the right side (p < 0.05).

The presence and differences of mucosal contact points should alert surgeons both before and during the surgical procedure, and further studies on this topic are of great importance.