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Background Exercise addiction is associated with multiple adverse outcomes and can be classified as co-occurring with an eating disorder, or a primary condition with no indication of eating disorders. We conducted a meta-analysis exploring the prevalence of exercise addiction in adults with and without indicated eating disorders. Methods A systematic review of major databases and grey literature was undertaken from inception to 30/04/2019. Studies reporting prevalence of exercise addiction with and without indicated eating disorders in adults were identified. A random effect meta-analysis was undertaken, calculating odds ratios for exercise addiction with versus without indicated eating disorders. Results Nine studies with a total sample of 2140 participants (mean age = 25.06; 70.6% female) were included. Within these, 1732 participants did not show indicated eating disorders (mean age = 26.4; 63.0% female) and 408 had indicated eating disorders (mean age = 23.46; 79.2% female). The odds ratio for exercise addiction in populations with versus without indicated eating disorders was 3.71 (95% CI 2.00–6.89; I 2  = 81; p  ≤ 0.001). Exercise addiction prevalence in both populations differed according to the measurement instrument used. Discussion Exercise addiction occurs more than three and a half times as often as a comorbidity to an eating disorder than in people without an indicated eating disorder. The creation of a measurement tool able to identify exercise addiction risk in both populations would benefit researchers and practitioners by easily classifying samples.

To examine cross-sectional and prospective associations between perceived discrimination in daily life (based on a range of attributes), sexual orientation discrimination, and health and wellbeing in middle-aged and older lesbian, gay and bisexual (LGB) people. Data were from 304 LGB men and women aged 41-85 years participating in the English Longitudinal Study of Ageing. Perceived discrimination in daily life was reported in 2010/11. Participants could attribute their discrimination experience to characteristics including age, sex, race, physical disability, and sexual orientation. Self-rated health, limiting long-standing illness, depressive symptoms, quality of life, life satisfaction and loneliness were assessed in 2010/11 and 2016/17. Analyses adjusted for age, sex, ethnicity, partnership status and socioeconomic position. Perceived discrimination in daily life was reported by 144 (47.4%) participants. Cross-sectionally, perceived discrimination in daily life was associated with increased odds of depressive symptoms (OR = 2.30, 95% CI 1.02 to 5.21), loneliness (OR = 3.37, 95% CI 1.60 to 7.10) and lower quality of life (B = -3.31, 95% CI -5.49 to -1.12). Prospectively, perceived discrimination in daily life was associated with increased odds of loneliness (OR = 3.12, 95% CI 1.08 to 8.99) and lower quality of life (B = -2.08, 95% CI -3.85 to -0.31) and life satisfaction (B = -1.92, 95% CI -3.44 to -0.39) over six-year follow-up. Effect sizes were consistently larger for participants who attributed experiences of discrimination to their sexual orientation compared with those who attributed experiences of discrimination to other reasons (e.g. age, sex, race). These results provide cross-sectional and prospective evidence of associations between perceived discrimination in daily life and health and wellbeing outcomes in middle-aged and older LGB adults in England.

Growing evidence reports that chronic kidney diseases (CKD) might play a role in erectile dysfunction (ED), but limited knowledge is available. Therefore, we performed a systematic review up to 21/08/2019 to investigate the associations between CKD and ED. The main analysis reported the prevalence of ED as absolute estimates (in %) with their 95% confidence intervals (CIs) and across CKD stages (when specified), hemodialysis and transplant, calculating the p for interaction across strata. Among 291 studies, we included 34 articles with 5986 men. We found an overall prevalence of 76% (95%CI: 72–79) with a high degree of heterogeneity (I2 = 84.2%; p < 0.0001). Analyzing the data by CKD stage, we found a significant higher prevalence of ED in CKD (78%; 95%CI: 75–81%; I2 = not possible) compared with hemodialysis stage (prevalence = 77%; 95%CI: 73–80%; I2 = 84.5) or to patients undergoing transplant (prevalence = 64%; 95%CI: 54–74%; I2 = 54%) (p across strata = 0.036). Considering the high prevalence of ED in men with CKD, health care practitioners should focus on issues of sexual health in men with CKD. Given the advancements in dialysis and therapy and the associated advancements in survival and life expectancy, maintaining the patients’ sexual function is important for their well-being and quality of life.

IntroductionCancer remains a major global health challenge, affecting millions annually and ranking as the second leading cause of death worldwide. The complexity of cancer treatment requires an interdisciplinary approach, connecting professionals from various fields to deliver personalised and integrated care. However, structural issues and insufficient interdisciplinary training can impede effective collaboration, which is why effective interprofessional education (IPE) is needed. This protocol depicts the planned procedures for a scoping review that aims to explore the role of IPE in enhancing interdisciplinary collaboration within oncology by mapping and synthesising the implementation, impact and evaluation strategies of patient-centred IPE programmes.Methods and analysisThis scoping review will be conducted in line with the Joanna Briggs Institute guidelines for scoping reviews. The research team will develop a comprehensive search strategy and apply it to the following databases: CENTRAL, CINAHL, Embase, MEDLINE, PsycInfo, Scopus and Web of Science . Additionally, we will search for grey literature (eg, using OpenDOAR) and contact relevant organisations for pertinent reports. Each database will be searched without date restrictions on 11 September 2024. In the first stage, eligibility criteria will be assessed through a blinded title and abstract screening, followed by a full-text review. The research team will then extract and synthesise data related to the scoping review questions, focusing on implementation, impact and evaluation strategies employed in the included studies.Ethics and disseminationAs this protocol does not involve collecting primary data, ethical approval is not required. The results of this review will be published in a peer-reviewed journal and disseminated through institutional websites and conferences.

Background Cancer remains a critical global health issue requiring a comprehensive interdisciplinary approach for effective treatment. Interprofessional education (IPE) is essential for overcoming barriers to collaboration among healthcare professionals and fostering efficient teamwork in cancer care. Objective This systematic scoping review aims to explore the role of IPE in enhancing interprofessional collaboration within cancer care by mapping and synthesizing the implementation, impact, and evaluation strategies of patient-centered IPE programs in this field. Methods A comprehensive search was conducted across seven databases, including CENTRAL, CINAHL, Embase, MEDLINE, PsycInfo, Scopus, and Web of Science, from their inception to January 2024. Grey literature was also sought through online sources and by contacting relevant organizations. Data were extracted and synthesized narratively following a standardized protocol. Results Seven studies met the inclusion criteria, highlighting various educational methods such as web-based platforms, face-to-face interactions, experiential learning, and simulation-based training. Patient-centered IPE programs notably improved interprofessional collaboration, communication, knowledge, and self-confidence among healthcare professionals. Additionally, several programs led to concrete changes in clinical practice and institutional policies. Evaluation strategies primarily utilized established frameworks such as Kirkpatrick’s model and Moore’s outcome levels to assess multiple layers of outcomes, including participant satisfaction, knowledge acquisition, competence, and behavior change. Conclusions The findings indicate that patient-centered IPE programs effectively promote interprofessional collaboration and enhance clinical competencies in cancer care. Future research should focus on long-term evaluations, address systemic barriers, expand geographical scope, and utilize standardized evaluation frameworks to further improve the design and implementation of patient-centered IPE programs in cancer care.

Purpose Body dysmorphic disorder (BDD) has been consistently linked with eating disorders, however studies that stratify associations between BDD in subjects with and without eating disorder symptomology are sparse. It was, therefore, the aim of this study to assess correlates of BDD (including social media use, motivations for exercise, exercise addiction, and sexuality) stratified by eating disorder symptomology. Methods Cross-sectional study of 1665 health club users recruited online completed a battery of surveys. BDD prevalence rates were calculated and logistic regression models were created in two sub-samples: indicated or no-indicated eating disorder symptomology. Results The key findings showed the prevalence of BDD in participants with indicated-eating disorder symptomology was significantly higher than in participants without indicated-eating disorder symptomology, yielding an odds ratio of 12.23. Furthermore, several correlates were associated with BDD only participants with an absence of eating disorder symptomology (gender, BMI, exercise addiction, exercising for mood improvement, attractiveness and tone), with others being significantly associated with BDD in participants in the presence of indicated eating disorders symptomology (exercising for health and enjoyment, relationship status, and ethnicity). Conclusions This study provides more evidence of the complex relationship that exists between BDD and eating disorders. Furthermore, it is recommended that practitioners working with BDD subjects should screen for eating disorders due to the high morbidity associated with eating disorders. Level of evidence Level III: case-control analytic study.

To investigate the association between weight status and sexual activity in middle-aged and older adults. Cross-sectional analysis on Wave 6 (2012/13) of the English Longitudinal Study of Ageing. Data were from 2,200 men and 2,737 women aged ≥50 years (mean 68.2 years). The explanatory variable was weight status, defined as normal-weight (BMI: ≤24.9), overweight (BMI: 25.0-29.9) or obese (BMI: ≥30) based on objective measurements of height and weight. Outcome variables were any self-reported sexual activity in the last year (yes/no) and, if yes, frequency of sexual intercourse in the last month. Covariates included a range of sociodemographic, lifestyle, and health-related variables. Associations were analysed using binary (past-year sexual activity) and ordinal (frequency of past-month sexual intercourse) logistic regression models. The majority (73.3%) of men and half (50.0%) of women reported any sexual activity in the last year. The odds of reporting any sexual activity in the last year did not differ significantly by weight status in either men or women. However, among those who were sexually active, men with overweight (OR = 1.45, 95% CI 1.15-1.81, p = 0.002) or obesity (OR = 1.38, 95% CI 1.07-1.77, p = 0.015), and women with overweight (OR = 1.34, 95% CI 1.05-1.71, p = 0.017) reported significantly more frequent sexual intercourse in the last month compared with those who had a BMI in the normal-weight range, after adjustment for covariates. Older adults with overweight or obesity who are sexually active engage in more frequent sexual activity than those who are normal weight.

Background People experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context. Methods We conducted an exploratory cross-national qualitative study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically. Results Findings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers. Conclusions The results of this study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH’s access to mainstream primary care. This can also be further complemented by investment in ‘in-reach’ services and other tailored and person-centred forms of health care. Trial registration This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.

Ruth Kutalek and colleagues share their Perspective on Kipruto Chesang and colleagues' qualitative study of beliefs and practices among healthcare providers managing STIs in Kenya and discuss the value of this type of research for addressing biosocial challenges.

Background The use of psychoactive substances is a key public health issue due to its impact on mental, physical, and social health. Integrated drug checking is a well-known harm reduction and addiction prevention measure and is currently implemented in four federal states in Austria. The aim of this study is to investigate the prevalence of drug checking use among a web-survey sample of people who use drugs (PWUD) in Austria and to examine differences in socio-demographic and substance use characteristics between individuals with and without drug checking experience. In addition, reasons for not using these services are explored. Methods A secondary data analysis of the Austrian data from the European Web Survey on Drugs (EWSD), a targeted survey conducted between March and May 2021 was performed. Based on reported drug checking experience, the data set was divided into two groups - those with and without drug checking experience – and compared. Results In this web-survey sample of PWUD ( n  = 1113), 20.1% reported prior use of a drug checking service in Austria. The groups with drug checking experience ( n  = 224) and those without ( n  = 889) differed significantly in both univariate and multivariate analyses. Univariate analysis revealed significant differences in terms of age, household composition, highest level of education, employment status, region of residence, substance use prevalences and treatment experience. Participants who used cannabis only had significantly less experience with drug checking. No significant differences were found regarding gender and income. While logistic regression analysis showed a significant relationship between sociodemographic predictors and drug checking experience, this relationship was relatively weak. The main reasons for not having used the services yet included a high level of trust in the source of supply (68%), confidence in receiving high quality of substances (64%), and a lack of service availability near the place of residence (62%). Conclusions The results indicate that drug checking services are well-accepted and trusted but not equally accessed by and accessible to all PWUD. Specifically, people who use only cannabis and those residing with parents or in rural or small-town areas access services less. In conclusion, there is considerable potential for expanding the availability and accessibility of drug checking services in Austria, particularly to reach underserved groups of PWUD who could benefit from this intervention.