Articles

<b>Background:</b> Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. <b>Methods:</b> A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. <b>Results:</b> Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). <b>Conclusions:</b> Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.

An effective mentor is critical to the success of an online doctoral student. Researchers have found that online doctoral students prefer frequent interactions with their mentor, while faculty prefer mentees to be autonomous. Transformative online doctoral mentoring (ODM) requires the development of a strong collaborative working relationship between the mentee and mentor, who serves as the link between the student and academia, as well as their guide and working partner throughout the dissertation process. In this paper, I argue that the ultimate objective of ODM, the establishment of such a relation-ship between mentor and mentee, increases the likelihood of student success. I support this contention with a set of principles and practices grounded in relevant models and methods of human development, participative leadership, and collaborative change management that provide insights into the what, why, and how of transformative ODM.

Wernicke’s encephalopathy (WE) is a neurological emergency related to a severe thiamine (vitamin B1) deficiency, an essential cofactor in cerebral energy metabolism. Although historically associated with chronic alcoholism, this condition can occur in any context of malnutrition, prolonged vomiting, or hypercatabolism. We conducted a retrospective descriptive study on seven patients admitted to our neurology department between 2015 and 2020, in order to de-scribe the clinical, radiological, and outcome characteristics of this pathology. The diagnosis was made in the presence of suggestive signs (at least two among confusion, ataxia, oculomotor disorders), a risk context of deficiency or malnutrition, typical MRI abnormalities and/or rapid improvement after thiamine ad-ministration. Our series included two male patients with chronic alcohol consumption, and five pregnant women with severe hyperemesis gravidarum, with an average age of 32.4 years. Mental confusion was the most frequent sign, followed by gait disturbances and oculomotor abnormalities. The most characteristic MRI lesions involved the thalamus, the periaqueductal region, and the mammillary bodies. All patients received high-dose intravenous thiamine supplementation (500 mg every eight hours for three days), followed by oral maintenance therapy. The outcome was favorable in five cases, while two patients had persistent memory disorders. These observations confirm that WE is not limited to alcoholic forms and must be considered in any situation with nutritional risk. Early diagnosis and rapid administration of intravenous thiamine remain essential to prevent irreversible neurological sequelae and improve functional prognosis.

<b>Background: </b>While the link between depression and smoking is known, less is known about<b> </b>the relationship between hopelessness and smoking in large national community-based sample of Black people.<b> </b><b>Aims: </b>This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically diverse nationally representative sample of Black adults.<b> </b><b>Methods: </b>Data from the NSAL were analyzed. Hopelessness and smoking status were assessed using structured interviews. Logistic regression was employed to assess the link between hopelessness and smoking status, controlling for potential confounders such as demographic factors and socioeconomic indicators as well as depression.<b> </b><b>Results: </b>4,939 participants entered our analysis. Hopelessness was significantly associated with higher odds of smoking status. This association remained robust after adjusting for confounders such as demographic factors, socioeconomic status, and depression.<b> </b><b>Conclusions: </b>Hopelessness<b> </b>may be a critical risk factor for smoking in Black adults. Promoting hope as a component of targeted tobacco cessation programs may help reduce tobacco use of Black populations.

<b>Background:</b><b> </b>Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. <b>Aims:</b><b> </b>This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. <b>Methods:</b><b> </b>Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. <b>Results:</b><b> </b>Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. <b>Conclusions:</b><b> </b>Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.

<b>Background: </b>Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. <b>Objective: </b>To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. <b>Methods: </b>Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. <b>Results:</b> In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, <i>p</i> < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, <i>p</i> < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, <i>p</i> < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, <i>p</i> < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, <i>p</i> < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, <i>p</i> < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. <b>Conclusion:</b> Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.

<b>Background: </b>Emotional problems have been associated with substance use, yet longitudinal research examining this relationship during childhood and adolescence in large, diverse, community-based samples remains limited.<b> </b><b>Aims: </b>This study investigates the prospective associations between three emotional problems—hopelessness, depression, and suicide attempts—before ages 9–10 and the subsequent initiation of tobacco and marijuana use before ages 14–15, using data from the Adolescent Brain Cognitive Development (ABCD) study.<b> </b><b>Methods: </b>Data from the ABCD study were analyzed. Baseline emotional problems, including hopelessness, depression, and suicide attempts, were assessed at ages 9–10 through structured parent interviews. Substance use outcomes (tobacco and marijuana initiation) were tracked from baseline to follow-up at ages 14–15 using structured self-report measures. Structural Equation Modeling (SEM) was employed to assess the predictive roles of these early-life emotional problems, controlling for potential confounders such as demographic factors and family and neighborhood socioeconomic status.<b> </b><b>Results: </b>Baseline hopelessness, depression, and suicide attempts at ages 9–10 were significant predictors of tobacco and marijuana use initiation at ages 14–15. These associations remained robust after adjusting for confounders, indicating the independent effects of early emotional problems on adolescent substance use initiation.<b> </b><b>Conclusions: </b>Emotional problems in early childhood, including hopelessness, depression, and suicidal behavior, are critical predictors of substance use initiation during adolescence. These findings underscore the importance of early identification and targeted mental health interventions to reduce the risk of substance use among vulnerable youth.

<b>Background:</b> Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. <b>Methods:</b> This cross-sectional study was conducted from December 2023 to February 2024 among 372 nursing students enrolled in selected nursing colleges in Bangladesh. A purposive sampling technique was used, and data was collected using a semi-structured questionnaire. The questionnaire assessed socio-demographic characteristics, academic challenges, and psychological symptoms, with mental health stress measured using a Likert scale. Descriptive statistics and Chi-square tests were used to analyze the data, with a 95% confidence interval applied to all analyses. <b>Results:</b> The findings revealed that 31.7% of nursing students experienced severe stress, 23.9% reported moderate stress, and 16.7% had mild stress. Age, academic semester, and course load difficulties were significantly associated with stress levels (p < 0.05). Psychological symptoms such as anxiety, difficulty concentrating, and loss of interest in activities were also significantly linked to higher stress levels. Notably, students in their first semester and those reporting harder course loads were more likely to experience stress. However, gender was not significantly associated with stress levels. <b>Conclusions: </b>This study underscores the high prevalence of stress among nursing students in Bangladesh, driven by academic and clinical challenges and psychological symptoms. The findings highlight the need for targeted interventions, such as stress management training, enhanced mental health support, and policies to alleviate academic pressures. Future research should explore longitudinal trends in stress and evaluate the effectiveness of interventions to support a resilient nursing workforce.

This study examined the psychological impact of poverty on the mental health and wellbeing of children in Adentan Municipality, Ghana. The study adopted a phenomenological qualitative approach. A sample of 15 children from poor homes were selected using purposive and snowball sampling for the study. Data were collected using a semi-structured interview guide and analysed using thematic analysis. The study found that the main experiences of the children raised in poor homes were that they had unmet basic needs and limited income. Also, it was found that the psychological impact of poverty on children included stigma and inferiority, distress and hopelessness. From the results, it was concluded that poverty can have a psychological impact on the mental health and wellbeing of children. it was recommended that Social Welfare liaise with community leaders to identify children from poor homes and provide support for these children in terms of their basic needs like food and clothing.

The COVID-19 pandemic has had a significant impact on individuals worldwide, affecting not only their educational futures but also their mental health. This paper aims to explore college students' perceived barriers to accessing mental health services during the pandemic. The study finds that there is a significant difference between stigma-related and non-stigma-related barriers, with non-stigma items being rated higher on average. The most commonly reported non-stigma barriers include wanting to solve the problem independently, financial constraints, and the belief that the issue will resolve itself. Stigma-related barriers include feeling embarrassed or ashamed, concern about having a mental health problem on medical records, and fear of being seen as crazy or weak. This research sheds light on the challenges students face in seeking mental health care during the pandemic and highlights the need to address these barriers.

Antenatal and postpartum major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) is defined as either daily sustained sad mood or lack of enjoyment or desire for a minimum two weeks plus four associated manifestations (only three if the two major symptoms are present) that start throughout pregnancy or during the first 4 weeks postpartum respectively: 1) Unintentional notable slimming up or down; 2) Sleepiness or sleeplessness; 3) Tiredness sensation; 4) Guilty or futility sensation; 5) Declined concentration capacity; 6) Frequent suicidal thoughts; 7) Psychomotor excitation or delay. Perinatal depression carries vital and adverse consequences on mother’s psychosocial aspects of life, pregnancy and delivery outcomes, her interrelations specifically with the new born with poorer overall health and influences negatively on offspring from the intrauterine life passing by complicated delivery experiencing hard unstable childhood reaching unhealthy adolescence and adulthood. These negative consequences necessitate a great attention for prevention, screening and prompt treatment for antenatal and postnatal depression to prevent such disastrous effects.

Family planning and the use of contraceptives have been introduced in Ghana to control the fertility rate and ensure the prevention of unplanned pregnancies. The study examined the perceptions of married men and women on the use of contraceptives, their access to information and the effects of mass media on the use of contraceptives in the Obuasi-East District. The research adopted a qualitative approach using the phenomenological case study design. Purposive and convenience sampling techniques were used to sample 15 married men and women for the study. The data was collected using interviews and presented through thematic analysis. The study revealed that participants had in-depth knowledge of contraceptives and male and female participants held different perceptions. Married men have knowledge of the types of contraceptives peculiar to both sexes. The women were familiar with condoms used by men and various types of contraceptives used by women. The most common contraceptive known and used by married men is a condom because of its effectiveness, ease of use and accessibility. The married women preferred injectables. The frequency of information from the mass media has reduced significantly compared to previous years. The study concluded that mass media has an effect on the use of contraceptives among married men and women and recommends that mass media frequently educate the general public on the use of contraceptives. Besides, information on contraceptives and their use should be diversified by media houses in the form of drama, poems, books and music to attract married couples.

Breast cancer is the most prevalent cancer in women worldwide, with approximately two million new cases every year. The number of cases increases despite the high survival rate. The aim of this study is, therefore, to understand this cancer by finding out what has been studied in this area using scientific evidence published between 2003 and 2023. A search was therefore carried out for scientific articles and other relevant sources on the subject with free access, and 48 documents were then analyzed. According to the analysis, many studies have been conducted in the area, particularly on quality of life and body image. However, little has been done in terms of environmental sustainability and breast cancer.

A regular menstrual cycle is important to maintain a woman’s fertility. This cycle has been linked to optimal function of the thyroid gland in the production of its hormones. Disturbance of thyroid gland functions could result to female infertility due to changes in menstrual patterns.<b> </b>Aim of this research was to determine the correlation between thyroid gland functions and menstrual patterns amongst infertile and fertile women attending a tertiary care hospital in North-Central Nigeria.<b> </b>This comparative, cross-sectional study recruited 106 women who visited the hospital's Gynecology Clinic and Family Planning Clinic. 53 of the 106 patients were women with a history suggestive of either primary or secondary infertility and the remaining 53 women with no history of infertility served as the control. A well-structured questionnaire was used to obtain data on the patients’ menstrual patterns. Anthropometric data were measured and obtained. Collected blood samples were analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) technique to determine the serum levels of thyroid hormones. All obtained data was analyzed, and the level of significance was set at <i>p</i><0.05, at a 95% confidence interval.<b> </b>33 patients had menstrual anomalies (78.8% infertile women; 21.2% fertile women who served as control, <i>p</i>=0.012). The incidence of menstrual anomalies in the infertile women group and control group was 7.5% versus 0.0% for amenorrhea; 20.8% versus 5.7% for menorrhagia; 9.4% versus 7.5% for oligomenorrhea; 7.5% versus 0.0% for hypomenorrhea; nil polymenorrhea for both groups; and 50.9% versus 86.8% for normal menstrual patterns. Ten (9.43%) patients were diagnosed with thyroid dysfunctions (80% in infertile group; 20% in control group, <i>p</i>=0.046). Six (18.2%) out of 33 women with menstrual anomalies were diagnosed with thyroid dysfunction. Five (83.3%) out of these 6 women with both menstrual anomalies and diagnosed thyroid dysfunction were infertile while only one (16.7%) was fertile.<b> </b>Thyroid gland dysfunction correlates strongly with abnormal menstrual patterns, which implies that it is vital to evaluate thyroid hormone levels in blood serum in the course of treating menstrual irregularities and female infertility. Early detection of thyroid dysfunction is important in achieving a positive treatment outcome for female infertility.

The article is about the finding (after stealing) and restauration of the frescos from the Church of Evphemianos, near Lysi, Cyprus. These wall-paintings have been dated to the thirteenth century. A team of British specialists lead by Laurence J. Morroco restored them and put them back <i>in situ</i> in 2012.

The present article seeks to provoke a discussion into how video games can be used in anxiety treatments and social stimulation tools among middle-year students and children of that same age. To do so, we initially start this article by reflecting on how the covid-19 pandemic disparate all anxiety alerts in our society including mental health issues such as depression and special anxiety disorders. Then we compare how the numbers of anxiety among children and young adults were already alarming before the lockdowns imposition and the social distance measures, especially in urban centers. This rising anxiety condition can be felt especially in the years that followed the social isolation of children especially because their social connection and recognition were just starting to grow and to establish important connections between their peers in-person and in virtual environments, throwing light on how to screen media and children"s homes are related with the anxiety increase and how we can investigate that phenomenon without succumbing to excessive positivism to today"s technology or to a deconstructive pessimism that leads us to distrust those media that are already in contact with middle-year students and children"s in that same age. To do so, we will resort to philosophical tools such as Edusemiotics and Cultural Studies to understand how games such as <i>Minecraft</i> and <i>Roblox</i> can be used in school environments to help students and teachers manage anxiety levels and surpass socialization issues past covid-19 lockdowns. To finish our reflection we also bring some data related to how those same media and games helped middle-year students to surpass social isolation and family disconnection during the pandemic while their kept exercising school content in those games, sharing and debating with their peers on virtual platforms.

Exercise is an important factor of rehabilitation in heart failure patients, improving several indicators of disease prognosis and functional capacity. The aim of the present study was to examine the effect of a cardiorespiratory rehabilitation program on the physical and mental fatigue, general health and anxiety in patients suffering from heart failure. Thirty-one patients with heart failure [(M±SD) age: 67.59±7.60 years] participated in a cardiorespiratory rehabilitation program. The program included aerobic exercise on cycle ergometers and muscle strengthening for 3 months (12 weeks), 3 times/week. Before and after the program, patients' fatigue, general and mental health were assessed using the following self-reported questionnaires: a) Fatigue Assessment Scale (FAS), b) Goldberg's General Health Questionnaire (GHQ-28) and c) Spielberger's Anxiety Questionnaire. Data analysis showed a statistically significant tendency of reduction in social dysfunction (from 1.99±0.42 to 1.75±0.45, p=0.05), while anxiety (from 27.10±7.61 to 26.40±4.35) showed no change (p>0.05).Also, evaluating the changes in the health level after attending the program, there was a trend of improvement in physical activity and functioning with the appearance of fewer physical symptoms (from 1.38±0.43 to 1.24±0.31, p=0,13). These results show that exercise can contribute to increasing the general well-being of these patients and reducing feelings of helplessness, making them able to cope with their daily activities and tasks.

This paper brings to light efforts of male institutional leaders in the University of Education, Winneba in promoting the gender equality agenda and effects of their efforts in bridging the gender gaps in staff and students’ levels. It sheds further light on involving men in the gender mainstreaming efforts. Both primary and secondary data on gender equality and equity measures were used in this study. The study found that male Vice-Chancellors have over the years been devoted to promoting gender equality agenda in the University. The effects of their efforts are largely seen in the increase in the number of females that have benefited from the institutional mentorship and scholarship programmes, which has impacted positively on addressing the gender gaps in the University. It is recommended that new strategies be adopted in promoting gender equality agenda. These strategies include revision in gender policies to involve men as agents of change in gender mainstreaming activities; gender training for male staff and students of all levels and categories for effective gender work, offering specific trainings and interactive discussions on gender issues for men as volunteers for gender mainstreaming. The study further suggests among other things, the need to engage the university community in entertaining activities like cycling for the equality agenda to be made more real to men and court their interest to promote men’s involvement in gender work.

The aim of the present research through the study of the mastectomy experience of women with breast cancer, is the investigation of its consequences in women who took part, as well as the role of counseling therapy in promoting mental their health. Five women voluntarily participated in semi-structured interviews, which they had undergone mastectomy and attended counseling. For in the analysis of the interviews, the Phenomenological Analysis was used. From the analysis of the interviews, it became clear that mastectomy brings about both physical changes, from the sensation of breast loss, as well as changes in their mental world, as their mental health is directly affected in awareness of breast removal. Therefore, the provision of advisory support is one of the main factors contributing to the relief of psychological symptoms, controlling negative thoughts and reducing negative one’s emotions experienced by women. Through the therapeutic process the women besides promoting their mental health, know themselves better through the eyes of others (partner, family). The results of the research contribute significantly to the theoretical and objective understanding of the mastectomy experience, as they highlight important aspects of it her experience regarding the negative effects of mastectomy. Simultaneously highlight the special importance of providing psychological support in order to strengthening their mental world. Finally, they reveal its necessity conducting qualitative research to further explore and understand the experience of women who have undergone a mastectomy.

The present study examines a sample of 140 juveniles. Study aimed to explore the relationship between interparental conflicts, irrational beliefs and mental health. Sample of the study was taken from borstal jail Faisalabad and district jail Lahore. Perceived interparental conflicts scale (CPIC), Irrational beliefs inventory (IBI) and mental health inventory (MHI) was use Results indicated that psychological distress has significant positive relationship with interparental conflicts and mental health. Furthermore, it was found that interparental conflicts significantly predict irrational beliefs. The study will give insights into as what type of interparental conflicts predicts irrational beliefs and different mental health problems in juveniles. It may help clinical psychologists/mental health practitioners to develop appropriate ways to manage interparental conflicts, irrational beliefs and mental health problems. Findings of the study may help mental health practitioners to develop appropriate assessment and treatment programs.