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Background: Chronic rhinosinusitis with nasal polyps (CRSwNPs) is a chronic inflammatory disease associated with frustrating symptoms, particularly nasal obstruction and loss of smell. We conducted a patient survey on the significant burden of the disease, with a specific focus on conditions that affect health, sleep quality, absenteeism, and presenteeism, including the caregivers' perspectives. Methods: An online questionnaire was sent to 4230 randomly selected recipients, and 200 matched the inclusion criteria for self-reported CRSwNPs symptoms. A total of 100 participants not matching the inclusion criteria for CRSwNPs were recruited as a control group. The study also collected the perspectives of 50 caregivers. Results: Patients with CRSwNPs experienced very bothersome symptoms, such as nasal congestion, headache, and rhinorrhoea, with a profound impact on their health-related quality of life (HRQoL). The patients and their caregivers showed significantly lower quality of sleep, experiencing a poor night's sleep on average 72.1 and 51.7 days per year, respectively. Smell and taste impairments significantly impacted patients' social and working lives, with 39.5% feeling in danger because of hyposmia and 34.5% because of limited taste. Out-of-pocket costs were up to EUR 40/month for 68.5% of patients. CRSwNPs alone was responsible for an average of 24.7 days of absenteeism and 25.1 days of presenteeism. Conclusions: Our results highlight how CRSwNPs has a negative impact on patients' and caregivers' HRQoL. Most bothersome and health-conditioning symptoms involve nose symptoms and poor sleep quality, resulting in patient absenteeism and presenteeism with a strong burden on cognitive and emotional functioning for both patients and their caregivers.

Background/Objectives: The use of scientific evidence for the diagnosis and treatment of mental disorders is crucial for achieving optimal clinical outcomes and providing high-quality care. This study investigates the knowledge, sources of evidence, and attitudes of Brazilian clinical psychologists regarding evidence-based practice in psychology (EBPP) and discusses barriers to its implementation. Methods: A total of 696 Brazilian clinical psychologists participated in an online questionnaire designed to assess their understanding of EBPP, their familiarity with scientific platforms/databases, and their professional development investments. Latent class analysis (LCA) was conducted, which can be used to identify subgroups of psychologists with similar patterns of professional and training characteristics. Results: The results indicate that while psychologists recognized the importance of EBPP for effective patient care, there was a significant gap in understanding its fundamental principles and concepts. Many participants reported the limited use of scientific databases, missing opportunities to access the latest research advancements. A lower percentage of psychologists consistently implemented EBPP in their clinical practice, highlighting a gap between knowledge and application. Four latent classes emerged from the LCA: I-experienced/established professional psychologist; II-academic psychologist; III-supervised traditional psychologist; and IV-young professional psychologist. Conclusions: This study emphasizes the need for better integration of EBPP into psychology curricula and continuing education programs. Enhancing clinical psychologists' understanding and proficiency in EBPP can promote evidence-based decision-making and improve the quality of mental health care in Brazil. Efforts should be made to familiarize psychologists with reliable scientific databases, equip them with skills to critically appraise research, and foster a culture of lifelong learning and professional development. Additionally, it is essential to develop strategies tailored to the distinct profiles of professionals identified in this study, considering their training sources, reference usage, and knowledge of EBPP.

Objectives: The objective of this study is to quantify healthcare resource utilization, economic burden, and the multi-level medical security system for Spinal Muscular Atrophy (SMA) patients in Shaanxi Province, China, from a societal perspective using a survey. Methods: This observational study employed an online survey with a retrospective cross-sectional design in Shaanxi Province, China. The survey examined various aspects of SMA, including resource utilization, direct and indirect economic burdens, and co-payment mechanisms within a multi-level medical security system. Results: Following the inclusion of nusinersen in the National Reimbursement Drug List (NRDL) in 2022, the treatment rate for SMA patients increased significantly. After risdiplam was added to the NRDL in 2023, its use also saw a marked increase. Treatment costs varied by SMA type: Type 1 incurred the highest costs (RMB 300,000 or USD 41,000), followed by Type 2 (RMB 270,000 or USD 37,000), Type 3 (RMB 200,000 or USD 27,000), and Type 4 (RMB 80,000 or USD 11,000). The primary sources of costs were productivity losses due to primary caregivers (32.94%), nusinersen usage (29.29%), and risdiplam usage (17.33%). Out-of-pocket costs for SMA patients accounted for 29.29% of the total costs. In 2023, basic medical insurance covered 49% of direct costs and 32% of total costs. Patients still had to pay 25.73% of the total cost for the direct costs. Conclusions: Basic medical insurance is a critical foundation for patient security and plays a pivotal role in reimbursement. In contrast, commercial insurance has a relatively limited impact on covering the costs for SMA patients. These findings highlight the substantial healthcare burden faced by SMA patients under the current healthcare system in China.

Introduction: Healthcare providers' understanding of how self-efficacy and social support affect medication adherence and depression in dialysis patients can lead to holistic interventions and improve outcomes. This study aimed to investigate how self-efficacy and social support indirectly influence the relationship between medication adherence and depressive symptoms in patients with chronic kidney disease (CKD) undergoing dialysis. Methods: We employed a cross-sectional observational study design with 668 CKD patients from outpatient departments (OPDs) and dialysis centers in the Hail region of Saudi Arabia. The data were collected between April and May 2024. Results: The participants had a relatively high level of self-efficacy (median = 82.00/100) and greater perception of social support (median = 75.500/84) with minimal to mild depressive symptoms (median = 15.00/63); however, 50% of participants scored ≥ 5 (out of 10) on the level of adherence to their medication regimen. Depression was prevalent, with a mean score of 5.03 on the PHQ-9 scale, and was positively correlated with nonadherence. Social support and self-efficacy were negatively correlated with depression, and both partially mediated the link between depression and non-adherence. Conclusions: This study found that, despite high social support and self-efficacy, a significant number of patients with CKD on dialysis exhibited medication non-adherence. Depression has emerged as a key factor influencing adherence, even in the presence of social support and self-efficacy. These findings suggest that depression is crucial for CKD management. Healthcare providers, owing to their frequent interactions with patients with CKD, are ideally placed to screen for depression and incorporate management strategies into patient care plans. By addressing both the biological and psychological aspects of CKD, they can empower patients to take a more active role in their treatment, ultimately leading to improved health outcomes.

Background: Visual impairment can significantly impact an individual's performance, productivity, and overall quality of life.

Objectives: The objective of this paper is to report the prevalence, causes, and risk factors associated with visual impairment in Qbah, a rural community in the Qassim Province of Saudi Arabia.

Methods: A descriptive cross-sectional study was conducted in Qbah, a rural community, with 587 subjects aged 6 to 80 years. Data were collected as part of a major campaign by Qassim University, and each participant underwent a comprehensive eye examination. Finally, the visual impairment was classified based on the International Classification of Diseases 11th revision, 2018 (ICD-11).

Results: The overall prevalence of presenting visual impairment was 159 (27.1%). This included mild visual impairment 84 (14.37%), moderate visual impairment 65 (11.7%), severe visual impairment, and blindness 5 (0.90%). The main causes of visual impairment were uncorrected refractive errors (UREs), at 132 (83.0%), followed by amblyopia, at 14 (8.8%), and cataract, at 9 (5.7%). The prevalence of hyperopia, myopia, and astigmatism was 134 (22.8%), 174 (29.6%), and 13 (2.2%), respectively. Regression analysis revealed that the odds for visual impairment were 2.71 times higher in the elderly compared to the young participants. Women have 2.234 times higher odds of visual impairment compared to men, while the odds of visual impairment were 14.83 times higher in the participants with the URE compared to the emmetropic participants. Almost two-thirds of participants (65.8%) reported never having had an eye examination before.

Conclusions: Visual impairment was common in the community, especially among older people and females, and URE was the main cause of visual impairment, followed by amblyopia and cataract. Considerable subjects reported never having had an eye examination before; this highlights the challenges in accessing healthcare in rural areas. These findings emphasize the importance of improving healthcare accessibility in rural regions.

Background/objectives: Nurses' workplaces are critical to both the levels and types of care nurses can deliver as well as to employee retention. The quality of the workplace environment is a significant predictor of employment outcomes, such as improved care and a decrease in nurses' desire to leave their work. Moreover, a favourable work environment can significantly improve organisational performance. A healthy nursing workplace is a safe, empowering, and fulfilling place of employment in which all healthcare personnel work tirelessly for patients' optimal health and wellness. The aim of this study is to identify the association between workplace environment and work engagement among nurses in clinical settings.

Methods: A descriptive cross-sectional correlational design was used. Convenience sampling was used to recruit 349 nurses from various hospitals in the central northern region of Saudi Arabia. A four-part electronic questionnaire eliciting information on participants' sociodemographic characteristics, job characteristics, work-related quality of life (WRQoL), and work engagement was collected. All ethical guidelines for scientific research on human beings were strictly followed.

Results: The participants had average levels of WRQoL. However, they had generally moderate to high levels of work engagement, which reflects their moderate to low intention to leave work. The findings demonstrated a statistically significant positive link between the WRQoL and work engagement of the participants.

Conclusions: When the nurses' WRQoL improved, their work engagement increased significantly. Improving WRQoL will almost definitely enhance nurses' work engagement, which will reduce nurses' intentions to leave their employment. It is advised that nurses enhance their WRQoL in order to increase their engagement in the workplace, have fewer thoughts about leaving, and make fewer plans to leave.

Objective: To evaluate the psychometric properties of the Shortened Version of the Token Test (SVTT), the Peabody Picture Vocabulary Test (PPVT-III), and the Rey-Osterrieth Complex Figure (ROCF) using an item response theory (IRT) framework and to establish normative data for Waranka children and adolescents based on their ability scores.

Methods: A total of 436 healthy people aged between 6 and 17 participated in this study. The factor structure was evaluated using confirmatory factor analysis (CFA) and the difficulty and discrimination parameters using IRT through the two-parameter logistic model for the SVTT and PPTV-III, while for the ROCF, the graded response model was used. The ordinal alpha and McDonald's omega were used for reliability.

Results: For most items, a low ability was enough to achieve the highest scores for the ROCF and SVTT. For the PPVT-III, the items aligned sequentially based on the difficulty, and a low level of ability was enough to achieve the highest score for the first 40 items. The ROCF, SVTT, and PPVT-III demonstrated adequate reliability. The ROCF copy and immediate recall scores were influenced by the mean parents' years of education (MPE) and quadratic age interaction. The SVTT performance was affected by the quadratic age and sex interaction, and the PPVT-III by the interaction effect of the MPE and quadratic age.

Conclusions: This is the first study to analyze the psychometric properties of the ROCF, SVTT, and PPVT-III through IRT models that are accurate and relevant for the validity of the obtained data and generate normative data in the under-represented nation of Ecuador for clinical and research purposes.

Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) poses significant therapeutic challenges. The introduction of Mepolizumab, an anti-interleukin-5 monoclonal antibody, offers a new therapeutic option for patients with severe, uncontrolled CRSwNP. This prospective observational study aims to assess the efficacy and safety of Mepolizumab for treating severe CRSwNP in Italy. Methods: A single-center prospective observational study conducted in real-life settings with the patients of our center. Prior to enrollment, each patient underwent an interdisciplinary evaluation involving a pulmonologist and an allergologist if deemed necessary. All patients who were referred for treatment with Mepolizumab in compliance with the AIFA guidelines and the EPOS/EUFOREA update were included in the study population: (1) subjects who were over the age of 18, (2) who had severe CRSwNP, (3) whose condition was not successfully managed with standard therapies alone, and (4) whose blood eosinophil counts were greater than 150 cells/mL. Mepolizumab was administered subcutaneously through a 100 mg injection once every four weeks in addition to the standard-of-care therapy. Results: At the end of the enrollment process, 20 patients with severe CRSwNP were enrolled. Significant improvements were observed in Nasal Polyp Score, quality of life (SNOT-22; p < 0.05), and nasal obstruction and rhinorrhea (p < 0.05), while no significant improvements were seen in olfactory function (p < 0.05). Eosinophil levels also significantly decreased (p < 0.05). Conclusions: Mepolizumab effectively manages severe CRSwNP, showing improvements in symptom control and quality of life with an acceptable safety profile.

Background/objectives: Although physical exercise provides numerous health benefits, it can occasionally become addictive, leading to negative consequences for physical and mental health. Specifically, the role of maladaptive schemas in the relationship between exercise addiction and self-esteem underscores the importance of addressing these cognitive patterns in therapeutic settings to develop practical interventions that enhance exercise with healthier self-perceptions. This study aims to analyze the role of early maladaptive schemas in the relationship between exercise addiction and self-esteem.

Methods: The design of this study is non-experimental, correlational, and cross-sectional. The sample comprised 788 university women students (mean age 20.39 years, SD = 2.28).

Results: Exercise addiction is negatively associated with self-esteem and shows positive but weak correlations with most early maladaptive schemas, except for Impaired Autonomy. A mediating effect was identified for Disconnection and Rejection (β = -0.08, p = 0.008), Impaired Limits (β = -0.03, p = 0.019), Other Directedness (β = -0.04, p = 0.032), and Over-Vigilance and Inhibition (β = -0.05, p < 0.001). Full mediation was observed for Disconnection and Rejection and Over-Vigilance and Inhibition, while Impaired Limits and Other Directedness showed partial mediation.

Conclusions: These findings suggest that the decrease in self-esteem among individuals with exercise addiction could be explained by the activation of maladaptive schemas that influence exercise motivation, with Over-Vigilance and Inhibition standing out in particular. Furthermore, it is necessary to develop cognitive behavioral therapy (CBT)-based interventions focused on modifying early maladaptive schemas and strengthening self-esteem. Additionally, it would be advisable to implement educational programs in university and sports settings that promote well-being and enjoyment over the pursuit of external validation or obsession with body image. These strategies could help prevent exercise addiction and mitigate its negative effects on self-esteem.