In this study, we aimed to validate and test the reliability of the Yonsei lifestyle profile (YLP) in assessing multifaceted health lifestyle levels in a study population from the United States.
The YLP-English version and health-promoting lifestyle profile II were administered to 100 individuals living in the United States. Concurrent validity was analyzed using Pearson's correlation coefficient, and discriminant validity was examined by comparing sex and age differences through t-tests and multiple variance analysis. Internal consistency was assessed using Cronbach's α for each sub-factor.
The YLP-English Version demonstrated concurrent validity with the Health-Promoting Lifestyle Profile II, showing consistent correlations for the total score (0.3, p < 0.01) and frequency sub-factors (0.25–0.69, p < 0.01). Among the satisfaction sub-factors, only nutrition showed a weak negative correlation (−0.19, p < 0.01); all others were nonsignificant. Discriminant validity revealed no significant sex differences, but physical activity frequency varied across age groups. Internal consistency was high (Cronbach's α = 0.80–0.86).
In this study, we validated the YLP-English version as a reliable instrument for assessing health-related lifestyle behaviors. The YLP uniquely captures both lifestyle frequency and satisfaction, offering a comprehensive perspective on health behaviors. Although this tool is currently most applicable in population-level studies, future research should establish clinical thresholds to enhance its utility in individualized health assessments and interventions.
The risk of internal fixation failure remains relatively high in stable femoral neck fracture (FNF) (Garden I or II). Preoperative sagittal displacement of the femoral head has been proposed as a potential influencing factor. This study aimed to evaluate the impact of sagittal displacement on the outcomes of cannulated screw internal fixation (CSIF) in patients with stable FNF (Garden I or II) by reconstructing the axial sagittal oblique plane of the fracture using preoperative computed tomography (CT) imaging.
This study included 167 patients with FNF who underwent CSIF. The sagittal tilt angle of the femoral head (STAFH) was evaluated using three-dimensional CT (3D-CT). The distribution of preoperative STAFH was analyzed, and its independent association with treatment failure was assessed. Treatment failure was defined as the need for revision surgery within 2 years postoperatively due to avascular necrosis, nonunion, or internal fixation failure.
Among the 167 patients, 9 (5.4%) exhibited anterior tilt (AT) of the femoral head, 158 (94.60%) presented with posterior tilt (PT). A total of 50 patients (29.9%) demonstrated excessive sagittal displacement (AT ≥ 10° or PT ≥ 20°). In the failure group, 80.0% of patients had excessive sagittal displacement compared to 28.1% in the healed group. Excessive sagittal displacement was significantly associated with an increased risk of surgical failure (odds ratio: 11.953, 95% CI: 3.656–39.083, p < 0.05).
In patients with Garden I or II FNF, greater preoperative sagittal displacement of the femoral head was correlated with a higher likelihood of CSIF failure. AT ≥ 10° or PT ≥ 20° were identified as independent predictors of CSIF failure in FNF patients. Nevertheless, these findings still require confirmation through prospective, multi-center clinical trials with large sample sizes.
To evaluate sex-related differences in the risk factors associated with nonhealing or recurrence of hyperthyroidism (NHRH) in patients with Graves' disease (GD) treated with radioactive iodine.
In total, 285 patients were enrolled. Data on radioactive iodine (RAI) dosage, ultrasound indexes of the thyroid, and other clinical factors were collected. Patients were divided into NHRH and non-NHRH (hypothyroidism or euthyroidism) groups based on treatment outcomes. Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH. Sex-specific analyses of these risk factors were also conducted.
There were no significant differences between the two groups in terms of sex, thyroid shear wave elastography velocity values, or pretreatment serum free thyroxine (FT4) levels. Thyroid volume and age were independently associated with NHRH, with the odds of NHRH gradually decreasing as age increased. In subgroup analyses, both age and thyroid volume were independent risk factors for NHRH in female patients (p < 0.05), while in male patients, only FT4 was independently associated with NHRH (p < 0.05).
In patients of different sexes, the influence of thyroid volume, age, and FT4 on treatment outcomes exhibits distinct patterns.
Having a primary care usual source of care (USC) is associated with better population health outcomes. However, the percent of adults in the United States (US) with a usual primary care provider is declining. We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.
We analyzed data from 57,152 participants in the All of Us study who reported having a USC. We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing, enabling, and need factors, according to the source of usual care.
An urgent care clinic, minute clinic, or emergency department was the source of usual care for 6.3% of our sample. The odds of seeking care at this type of facility increased with younger age, lower educational attainment, and better health status. Black and Hispanic individuals, as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity, were also less likely to have a primary care USC. Financial concerns, being anxious about seeing a provider, and the inability to take time off from work also increased the likelihood of having a non-primary care USC.
Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient, affordable primary care. Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.
Digital health is transforming healthcare by integrating advanced technologies to make healthcare more accessible, efficient, and personalized. From electronic health records, telemedicine, wearable devices, and artificial intelligence to the recent smart hospitals, digital health is improving patient care and outcomes while reducing healthcare costs. However, the integration of digital health faces several challenges, including data privacy, cybersecurity risks, and inequitable access to technology. This article provides an overview of the current state of digital health, key challenges in implementation, and potential solutions to maximize the benefits of digital health and ensure efficient, equitable, and patient-centered healthcare in the future.
An individual's mental health influences their capacity to think effectively, feel emotionally stable, and perform daily activities. As mental health concerns become more prevalent worldwide, new awareness and diagnostic and treatment tactics are needed. Digital tools and technology are helping solve these problems by providing scalable, tailored solutions for large populations. This detailed review examines mental health-promoting internet tools. Smartphone applications, web-based therapy systems, wearable tech, artificial intelligence-powered resources, and virtual reality (VR) technologies were evaluated for efficacy and side effects. PubMed, PsycINFO, Scopus, IEEE Xplore, and Google Scholar were carefully searched. Search terms included “digital mental health tools,” “online therapy,” and “AI in mental health.” Randomized controlled trials, cohort studies, cross-sectional studies, systematic reviews, and meta-analyses of digital technology and mental health were included from among the literature published after 2010. Cognitive behavioral therapy methods, mood monitoring, and mindfulness exercises are among the numerous features of smartphone applications that have been demonstrated to mitigate symptoms of anxiety, depression, and tension. Online therapy platforms let marginalized individuals obtain therapy remotely. Wearable technology may detect heart rate, blood pressure, and sleep length, which may reveal mental health difficulties. Chatbots employ machine learning algorithms and natural language processing to deliver customized support and show promise for quick intervention. Exposure therapy for anxiety and trauma is increasingly using virtual reality environments. Although digital mental health therapies face challenges in relation to data privacy, limited long-term efficacy, and technological inequality, digital technologies are modernizing mental healthcare. By offering inexpensive and effective alternatives to traditional therapies, digital technologies may help healthcare systems meet the growing demand for mental health services and overall well-being.
The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face, particularly in the developing world. Telemedicine, with its capacity to overcome geographical barriers and provide patients with real-time medical services, has shown considerable potential in addressing these issues, attracting widespread attention. Compact medical communities and family doctor systems play important roles in improving healthcare accessibility. However, despite the critical nature of patients' perceptions of healthcare accessibility, research in this domain is sparse. This study aimed to explore the impact of telemedicine on rural residents' perceived healthcare accessibility in China, analyze the mechanisms underpinning this relationship, and elucidate the roles of compact medical communities and the family doctor system.
Survey data from 3311 rural residents were analyzed using a probit model, instrumental variables, and subgroup regression analyses to ascertain causal effects, perform heterogeneity analysis, examine mechanisms, and ascertain the robustness of the findings.
Telemedicine significantly enhanced rural residents' perceived healthcare accessibility, with particularly notable benefits for those in sparsely populated areas, regions with high-speed internet access, within the purview of compact healthcare consortiums, and those with access to family doctor services. Furthermore, telemedicine improved rural residents' perceived healthcare accessibility by encouraging the use of primary care services.
Telemedicine in China has played a significant role in improving the perceived healthcare accessibility among rural residents and aiding in the reduction of disparities in accessibility across different demographic groups. This is consistent with the broader objective of achieving universal health coverage. However, the efficacy of telemedicine in enhancing healthcare accessibility is contingent upon certain preconditions. Policymakers must confront local infrastructure challenges, particularly regarding internet connectivity, when expanding telemedicine services to ensure their effective operation. The synergistic interaction observed between telemedicine, the family doctor system, and compact medical communities highlights the importance of integrating telemedicine into existing healthcare systems
We report the successful application of a surgical and medical co-management (SMC) strategy in an 82-year-old man with hemophilia A (HA) undergoing pancreaticoduodenectomy for pancreatic head carcinoma. No major complications or perioperative bleeding occurred. Optimal management of HA patients undergoing major surgery requires multidisciplinary coordination to avoid postoperative complications. The SMC team integrates internists (who assess chronic disease status, adjust medications, and determine best hemostatic therapies) and surgeons (who evaluate the surgical feasibility of procedures and rely on advanced surgical skills) to improve perioperative planning to minimize complications and promote recovery. This case illustrates the utility of a shift from passive and conservative treatment to active and preventive treatment and highlights the value of SMC in many complex clinical situations.
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