This article explores the concept of “flow” in the context of neurodivergence, focusing on the interaction between the default mode network (DMN) and task-positive networks (TPNs), particularly in conditions such as autism spectrum condition (ASC) and attention-deficit/hyperactivity disorder (ADHD). Flow, a state of deep immersion and focused engagement, is associated with enhanced performance and satisfaction across activities. The DMN, typically active during rest and self-referential thinking, interacts uniquely with TPNs during flow states, creating a dynamic balance crucial for sustained focus and reduced self-referential thinking. Neurodivergent individuals often exhibit distinct DMN activity patterns, which affect their capacity for achieving flow. For instance, individuals with ADHD may experience flow in stimulating tasks, whereas those with ASC may achieve it in areas of deep interest due to their intense focus. This paper examines the expertise-and-release model in creative flow and transient hypofrontality as a potential mechanism facilitating flow in neurodivergent individuals. It also proposes strategies to enhance flow through personalized cognitive training, specialized task environments, and technology-assisted interventions, aiming to harness neurodivergent strengths and accommodate unique cognitive profiles. This comprehensive analysis deepens understanding of neurodiversity and offers practical applications for improving quality of life and performance in neurodivergent populations.

Dialysis, including hemodialysis (HD) and peritoneal dialysis, is initiated when kidney function deteriorates to a glomerular filtration rate below the normal range. In addition, dialysis manages renal failure through diffusion and ultrafiltration but does not completely replace kidney function. Conversely, kidney transplantation involves replacing a diseased kidney with a healthy donor kidney, offering restored kidney function and improved quality of life (QoL). Herein, this review compares the QoL and cost-effectiveness of dialysis versus kidney transplantation for patients with end-stage renal disease (ESRD). Transplant recipients generally report better physical and mental well-being, higher independence, and greater overall life satisfaction compared to dialysis patients. Economically, kidney transplantation, despite its high initial costs, proves more cost-effective in the long run due to reduced ongoing healthcare expenses. Dialysis, particularly in-center HD, incurs higher long-term costs. The findings advocate prioritizing kidney transplantation for eligible ESRD patients while also emphasizing the need for improved support for dialysis patients.

Insufficient financing is limiting mental health services for universal health coverage (UHC) in sub-Saharan Africa (SSA). Without ambitious steps to enhance mental health services, UHC will fall far below its historical agenda; however, adequate mental health financing could strengthen governments' capacity to provide additional budgetary resources. This paper aims to identify potential strategies for more equitable and sustainable mental health financing in SSA. Using Uganda as a key example, we provide a contextual analysis and highlight current gaps. We draw parallels with successful countries and discuss recommendations for engagement from the global mental health community. This perspective focuses on health systems, mental disease burden, and macro-fiscal situation. Drivers of fiscal space for health indicate prospects to boost mental health budgets for socioeconomic development. Governments should conduct consistent mental health investment cases and expedite fiscal space for aggressive taxation to health reforms.

This paper discusses why using random price generators in an economic model for medical markets may be useful. It summarizes the different steps for the development of the model and describes an original contribution of the physicians' choice model with random drug prices applied to Type 2 diabetes in the US. Pharmaceutical markets have been supply-driven to boost life science and medical technologies; however, with the widening inequalities inside national health systems and the global agenda for universal health coverage, more economic research is being done to strengthen the analysis of demand for healthcare services. Research, especially, examines more disaggregated levels of demand systems to understand the heterogeneity of physicians' choices and better capture patient needs. It can also be an approach to calibrate supply and demand adjustments in medical markets. This paper argues that choice modeling is particularly relevant, using random price generators in a structural model where a demand approach is useful. If validated by additional experimental studies, this first study by Professors Huttin & Hausman (2021) could be used in advanced value assessment frameworks. Random price generators on medical markets could also be tested with additional models that fit oligopolistic market structures (e.g., models for differentiated product markets such as the Berry-Levinsohn-Pakes model). It may also help with a policy analysis process that addresses major disruptive transformations of market dynamics, evolving boundaries in science, fast digitalization, and artificial intelligence-based information systems.

The human immunodeficiency virus (HIV) epidemic among youths in Sub-Saharan Africa underscores the exigency for effective prevention education programs tailored to their needs. This article examines barriers hindering HIV prevention efforts for youths in the region and proposes strategies for developing more inclusive and impactful health education interventions. Despite the challenges faced by HIV-positive adolescents, comprehensive youth-friendly services remain limited. Impediments such as stigma, poverty, and lack of health-care infrastructure obstruct HIV prevention. Access to information and services, negative attitudes of service providers, and scarcity of youth programs present challenges. The article discusses approaches such as involving youth in program design, establishing community advisory boards, mobilizing community health workers, integrating services, engaging schools, employing gender-sensitive methods, and advocating supportive policies. These strategies aim to enhance cultural sensitivity, community engagement, and accessibility of education for all youths. Sustained commitment through ongoing funding, monitoring, capacity building, and multisectoral collaboration can empower youths with the knowledge and support needed to curb their long-term risk of HIV.

India, a developing country and currently the most populous nation, has been experiencing a rapid and unpredictable increase in the proportion of its older population. The healthcare system is already struggling to meet the needs of the current population, and the rising number of older adults is expected to further strain resources. Therefore, this study aimed to investigate the distribution of the older population in Indian cities and their access to advanced health facilities. The study uses data from Census of India, 2011, which is the latest census data available. A Health Facilities Index was developed to assess the availability of health facilities, and a geospatial approach was adopted to determine aging patterns and access to health facilities across cities. Despite similar aging trends, health infrastructure was unevenly distributed across cities. The study revealed that advanced health facilities were concentrated in specific areas, primarily metropolitan cities, whereas smaller cities lacked adequate health facilities and accessibility. Therefore, improving health infrastructure in smaller cities to match that in larger ones should be prioritized. The findings highlight a notable infrastructure gap in Indian cities, which presents a significant challenge to achieving healthy aging in the country.

On January 1, 2020, the State of Cameroon instituted a policy to eliminate direct payments by people living with human immunodeficiency virus (PLHIV). However, limited data are available on the implementation of this policy. This study aims to identify the determinants of the improper implementation of this policy by healthcare providers. To this end, a cross-sectional study was conducted with 164 medical and paramedical staff involved in the care of PLHIV. Data were collected using a Google Forms questionnaire and administered in health facility forums. Determinants were assessed using multiple logistic regression analysis. The study found that the job profile of a doctor or pharmacist (odds ratio adjusted [AOR] = 9.64 [95% confidence interval (CI): 2.32 - 44.09]; p = 0.002), access to policy guidelines (AOR = 2.81 [95% CI: 1.02 - 7.86]; p = 0.045), perception of the policy's impact on quality of care (AOR = 4.26 [95% CI: 0.79 - 26.95]; p = 0.034), and the context of working in a system in which the policy is partially effective (AOR = 4.0 [95% CI: 1.53 - 11.08]; p = 0.005) significantly increased the chances of improper practices related to policy implementation. Awareness-raising and capacity-building strategies must be developed to policy implementation by healthcare providers in Cameroon. The policy of “user fees elimination” marks the first step toward universal health coverage, and this study also provides a basis for reflection to facilitate its optimal implementation.

This research delves into the global impact of climate change on quality of life. Drawing on country-level data from the World Bank, we utilize visual analytics to examine the association between key climate change indicators such as carbon dioxide (CO₂) and methane emissions, PM2.5 (fine particulate matter) air pollution, annual freshwater withdrawal and quality-of-life variables such as child mortality, immunization against measles, school enrollment, gross domestic product (GDP) growth, unemployment, and others. Key findings suggest CO₂ emissions declined in South Asia and Sub-Saharan Africa. Overall, CO₂ emissions appear to be associated with GDP growth, implying that developed countries are responsible for the overall higher emissions as a result of industrialization. CO₂ emissions are also associated with higher unemployment, signaling that health issues are likely causing absenteeism and staying away from jobs. Finally, CO₂ emission is associated with higher air pollution and higher under-five mortality rates. Simultaneously, immunization rates appear to decline. Another significant finding is that higher air pollution is associated with higher child mortality, particularly in South Asia and Sub-Saharan regions. Generally, emissions and pollution have an adverse impact on quality of life indicators, affirming the urgent need to mitigate climate change. The results aim to foster an understanding of the multifaceted effects of climate change and to support the development of effective policies to bolster resilience and improve life quality in the face of environmental shifts.

Anxiety, stress, and depression are elements of everyday life for some people. Situations and choices such as attending higher education institutions make these states even more difficult. Parallel employment and increased family obligations are thought to burden the mental states of students. This study purposed to highlight the increased levels of anxiety, stress, or depression experienced by college students who are also parents. It also explored the sources of these adverse mental states and probed how students with children tackled them. It was assumed that students who were parents would be more burdened by these mental states than other students. The administered questionnaire was based on the Depression, Anxiety, and Stress Scale-21 (DASS-21) with added questions regarding the sources of anxiety, stress, or depression and the ways participants dealt with them. However, the original hypothesis was rejected because the data obtained from the study sample of 94 participants revealed that students without children experienced more anxiety than students who were parents. No difference was found in the stress and depression levels reported by the two groups. Participants also highlighted how educational institutions can burden the mental state of students, for instance, through the number of assigned tasks and the examination period. Participants reported that they turned to their family members and friends or stayed at home to reduce anxiety, stress, and depression. Therefore, studies should be conducted to discover the probable reasons for higher levels of anxiety, stress, or depression sensed by college students who are not parents and how students who are parents mitigate these states.

In recent years, teleworking (also referred to as telecommuting) has been the focus of academic research, due to its wide implementation during the COVID-19 pandemic and its significant implications, including psychosocial effects, job satisfaction, and social interactions among employees. Thus, this study employed a quantitative approach to examine these concepts and determine to what extent they have been changed by the implementation of teleworking in companies. Based on the findings, the most important aspect of teleworking was the need for social interactions. These three concepts also showed a statistically significant, but not a strong correlation. First, the women in the sample had higher psychosocial effects and a greater need for social interactions, compared to the men, whereas the younger participants had less psychosocial effects. Second, the participants aged 51 - 60 years had lower averages for job satisfaction, while the participants aged 41 - 50 years had lower averages for social interactions. Third, those who worked in companies consisting of 51 - 200 employees had significantly higher psychosocial effects, but significantly lower job satisfaction, compared to the rest of the sample. Finally, demographic and work characteristics played important roles in the assessment of the impact of teleworking on psychosocial effects, job satisfaction, and social interactions.

Introduction: Obesity and type 2 diabetes mellitus (T2DM) are among the most significant public health challenges worldwide, with profound effects on morbidity, mortality rates, and healthcare costs. Objective: The aim of this study is to evaluate the trends in deaths, hospitalizations, and hospital costs associated with T2DM and obesity in Acre, Brazil, from 2000 to 2021. Method: This retrospective time-series study utilized official microdata from the Mortality Information System, the Hospital Information System (SIH/SUS), and the Information System for Notifiable Diseases, all registered with the Ministry of Health through the SUS Department of Informatics. Data were extracted for T2DM cases between 2000 and 2021, and for obesity cases from 2013 to 2021, focusing on age, sex, and race/skin color, as well as death rates, hospitalizations, hospital costs, and municipality-level variations. Results: Our findings reveal a significant increase in T2DM-related deaths over the study period, accompanied by rising hospital costs. A higher prevalence of T2DM-related mortality was observed among older age groups, with a roughly equal distribution between men and women. For obesity, hospitalizations were more frequent after the age of 30, particularly among women. In addition, a strong correlation was found between deaths from T2DM and hospitalizations due to obesity, suggesting that many T2DM-related deaths occurred among individuals also hospitalized for obesity, a condition that often involves multiple comorbidities.

This study assessed 191 ward development committees (WDCs) and 200 primary healthcare center (PHC) catchment communities in Kebbi State, northwestern Nigeria, to determine the status and functionality of WDCs and their level of engagement with PHCs. The existence of other community structures relevant to primary health care was also explored. The study employed a cross-sectional design involving questionnaire survey with members of WDCs, health facility workers, and community members, in addition to reviewing records and documentation at PHCs and in the communities. The study found a pervasive existence and functioning of WDCs in all wards in Kebbi State. Almost all WDCs hold regular monthly meetings, with meeting notes available for the majority. While most of the WDCs had independent means of generating funds, the majority of them did not have functional bank accounts. We found that most WDCs performed key roles and activities, including supervision of health facilities, social mobilization, monitoring performance indicators, and using data for decision-making. We also found that the majority of the communities had other community-level structures, such as traditional birth attendants, volunteer community health workers, and the existence of a community emergency transport system to transfer pregnant women to PHCs during emergencies. WDCs and other community-based structures can potentially improve primary healthcare services in Kebbi State. However, efforts to optimize their performance are needed, including strengthening WDCs' capacity for financial management and encouraging a more widespread existence of other community-based health-related initiatives. Primary healthcare services in Kebbi State can be improved by optimizing the performance of WDCs and other community-based structures, leading to better health outcomes for the population.

An earthquake devastated northern Pakistan on October 08, 2005, significantly affecting the mental health of the victims. Although post-traumatic stress disorder (PTSD) rates were noted to change, no official study has quantified its prevalence following this disaster. This study examines the relationship between PTSD symptoms and memory functions in child and adolescent earthquake survivors, focusing on those attending schools in the affected areas. Participants first completed a self-assessment PTSD questionnaire, followed a week later by the Rivermead Behavioral Memory Test. Subsequently, the Children and War Foundation's “Writing for Recovery” manual (April 2008 version) were implemented. The PTSD questionnaire and memory test were then re-administered to evaluate intervention outcomes. Results revealed that all three groups, control (A) and earthquake survivors (B and C), improved memory test scores after the intervention. However, control group A consistently outperformed groups B and C. PTSD symptoms in groups B and C decreased after applying the intervention, while no change was observed in the control group A. These findings highlight significant correlations between trauma and the severity of PTSD in adolescents. Adolescents exposed to trauma (groups B and C) demonstrated poorer memory functions compared to peers without PTSD (group A). Furthermore, the “Writing for Recovery” intervention effectively reduced PTSD symptoms and improved memory performance in earthquake survivors. This study underscores the critical impact of PTSD on neurological cognition and memory in young populations following natural disasters and demonstrates the potential benefits of targeted psychological interventions for trauma recovery.

The novel coronavirus (SARS-CoV-2), which causes COVID-19, has claimed millions of lives since December 2019. The rapid development of vaccine candidates and treatments has led to increased confusion and mistrust regarding the development, emergency authorization, and approval processes. To better understand vaccine hesitancy, we analyzed two publicly available datasets: One from the Inter-University Consortium for Political and Social Research Covid-19 database and the other from the United States (US) Census Bureau's Household Pulse Survey Phase 3.2. In India, 90.2% of 1,761 participants indicated acceptance of a COVID-19 vaccine. A binary logistic regression model, using vaccine hesitancy as a dichotomous variable, showed that rural populations had an odds ratio (OR) of 3.45 (p < 0.05) for vaccine hesitancy. In addition, income played a significant role, with individuals earning 7501 – 15,000 Indian Rupees (INR)/month, or US$ 91 – 183, having an OR of 1.41 compared to other income groups. In the US, 67.3% of 1,768 participants expressed willingness to accept the vaccine. White participants had an OR > 1 compared to other racial groups, while low-income groups earning US$ 2000 – 4999/month had an OR of 1.03. In China, 90.0% of 1,727 participants indicated they would accept a vaccine, with high-income groups showing the least resistance (OR = 0.96) compared to other groups. Among the three countries studied, the US exhibited the highest rate of vaccine hesitancy. This ongoing issue warrants attention from the World Health Organization.

In the online health community (OHC), each patient review of doctors includes an evaluation and an emotional attitude toward the doctor. Subsequent patients usually browse the comments of other patients about doctors when choosing a doctor and subsequently make decisions based on these reviews. Through sentiment analysis, a user's emotional orientation can be judged from the review, enabling an understanding of patients' emotional tendencies and main concerns regarding doctors during medical treatment. This also provides a reference for OHC doctors to improve service quality. This study used a method based on a sentiment dictionary to analyze the sentiment value of reviews and selected three different types of diseases (diabetes, leukemia, and depression) as examples from user reviews of the “Good Doctor Online” community. SnowNLP, a Python library for Chinese natural language processing, was used to realize the sentiment analysis of the reviews. The program correctly identified the sentiment of most reviews. Although the sentiments of OHC reviews are mostly positive, there are also a few extremely negative reviews. Most positive patient reviews about doctors are related to their good attitude and patience with patients and their condition.

This study examines the implementation of a health-promoting project in a university faculty campus in northern Germany, involving students enrolled in nursing and health care, social work, and inclusive education programs, both in full-time and vocational tracks. The study explores students' current level of awareness regarding the main health-promoting activities through a baseline survey. The survey's primary objective was to inform and enhance the university's existing student health activities. This paper outlines the study design and presents the descriptive findings of the baseline survey data, focusing on students' awareness, involvement, and needs on campus. The survey represents a practice-oriented approach to actively monitor students' needs while raising awareness about health promotion within the university environment.

The initiation of post-partum contraception is crucial for the health of mothers and their children. The early acceptance and uptake of modern contraceptive methods among women can be significantly boosted by the provision of maternal and child healthcare (MCH) services. This study examined whether the utilization of MCH services increases women's early adoption of modern contraceptive methods. The data were taken from the Pakistan Demographic and Health Survey (2017 - 2018) for currently married women aged 15 - 49 years, and a multinomial logistic regression model was used to analyze the data. The results reveal that the richest women were twice as likely (relative risk ratio [RRR] = 2.14, p < 0.001) to use modern contraceptive methods and 4 times more likely (RRR = 4.16, p < 0.001) to use traditional contraceptive methods than the poorest women. Similarly, women with media exposure were more likely (RRR = 1.43, p < 0.001) to use modern contraceptive methods in comparison with their counterparts. Notably, women aged 30 - 34 years (RRR = 2.08, p < 0.001) were more likely to use modern contraceptives. Expanding MCH services, focused on addressing wealth disparities, media exposure, and education levels, is crucial. In addition, regional and age-specific barriers to contraceptive use should be tackled, particularly in underserved areas such as Balochistan and among younger reproductive age groups.

This study investigates the multiplex association between gender inequality and healthcare. The aim of the study is to comprehend how inequalities in gender affect healthcare across different populations worldwide. Visualization was conducted to study the effect of various gender inequality variables on different healthcare indicators. The study emphasizes the critical need for eliminating gender inequalities to reduce disparities in healthcare. By analyzing publicly available data from the World Bank, we find that higher access to anti-retroviral drugs is associated with a lower incidence of human immunodeficiency virus (HIV) among both genders and higher life expectancy. Importantly, increased female engagement in politics and government is linked to higher life expectancy. In addition, higher female representation is associated with lower fertility rates (particularly in high-income countries) and a declining incidence of HIV over time. Higher parity among the genders in school enrollment increases overall life expectancy, with female expectancy exceeding that of males. Simultaneously, higher parity is associated with reduced fertility rates. A lower enrollment among females is also correlated to higher fertility rates. Finally, higher parity also reduces the mortality rate for several diseases. Economic growth, education, income, political and government representation, population, and unemployment influence gender inequities, leading to disparities in healthcare delivery.

Since the onset of the coronavirus disease 2019 pandemic, there has been a total of 776 million confirmed infection cases worldwide with both countries, China and the US contributing a substantial number of cases. Aside from the grand number of cases, the pandemic has also demonstrated a worldwide financial toll. Specifically, as of May 20, 2020, China has been reported to obtain a cost of $373.20 million in overall patient hospitalizations. Yet, aside from these hospitalizations, the purchasing of personal protective equipment (PPE) to mitigate one's risk for infection can also be expensive. In addition, the pandemic itself has resulted in a wealth of businesses shutting down worldwide, consequently resulting in job losses and attenuated income for workers worldwide. Thus, exploring the behavior of PPE purchasing by primary respondents of individual households as well as the degree in mediating their expenses following the pandemic was the focus of this study. Specifically, the present investigation sought to examine the association between medical and fitness expenditure toward PPE purchasing behavior for mainland residents of China aged 45+ due to the lack of existing literature examining this relationship from the best of our knowledge. The former relates to both direct and indirect medical expenses whilst the latter refers to the purchasing of exercise equipment and health supplements. Second, these expenditures were further utilized to explore its association with the level of ease in covering expenses following the pandemic as well. This was a secondary data analysis that used cross-sectional data from the China Health and Retirement Longitudinal Study database, wherein generalized linear mixed effects models were applied in examining the associations. Both medical and fitness expenditure were insignificant predictors of PPE purchasing behavior whilst they expressed a significant association toward predicting the degree of ease for the included participants in covering their daily expenses following the onset of the pandemic.

Palliative care is a holistic approach aimed at improving the quality of life for those facing life-limiting illnesses and their families. Palliative care services often face financial constraints that restrict their ability to reach all those in need. There are difficulties accessing traditional funding mechanisms; therefore, innovative fundraising strategies are required to sustain and expand palliative care initiatives. In this paper, diverse fundraising approaches for palliative care are described, based on group discussions and collective brainstorming sessions by clinicians undergoing a Fellowship in Palliative Care. Fundraising approaches that were deemed innovative, yet feasible to apply in each locality, were shortlisted and described, with their strengths and challenges outlined in detail. These approaches include art and photography exhibitions, “piggy-bank” projects, community-based fundraising, charity shops, lottery and lucky draws, shuttle bus services, grants from international organizations and collaborative networks, the use of tap-on technology, festive events, and restaurant partnerships. It is hoped that through these innovative approaches, collaborative efforts, strategic planning, and resource mobilization, it would be possible to generate funds to develop and provide palliative care services for those in need to fulfill a fundamental human right.