This study examined how antihistamine properties of blood-brain barrier penetration, central H1 receptor binding, and sedative potential-relate to sleep quality, daytime sleepiness, cognitive failures, and functional impairment in adults managed in primary and community health settings, while accounting for sociodemographic, lifestyle, and stress-related factors. A cross-sectional study was conducted in primary care and community health settings using a questionnaire that contained the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Cognitive Failures Questionnaire (CFQ), and Work and Social Adjustment Scale (WSAS). Antihistamine exposure was classified by blood-brain barrier penetration, central H1 receptor binding, and sedative potential. Multivariable regression analyses were used to identify factors associated with sleep, cognition, and functional outcomes. Of the 385 participants, 130 (33.8%) used first-generation antihistamines and 255 (66.2%) used second-generation agents. Of the used antihistamines, 130 (33.8%) were highly sedating, 26 (6.8%) moderately sedating, and 229 (59.5%) nonsedating. Multiple linear regression showed that fixed sleep schedules were associated with less poor sleep (PSQI, B = -0.62, P = .004), while recent stress was associated with worsened sleep quality (B = 0.96, P < .001). Daytime sleepiness (ESS) was significantly associated with higher stress (B = 1.38, P < .001), night-shift work (B = 1.26, P = .003), and sedative properties (B = -1.60, P < .001). Cognitive failures (CFQ) were associated with female sex (B = 4.67, P = .009), higher stress (B = 8.75, P < .001), night-shift work (B = 6.20, P < .001), and sedative properties (B = -5.84, P < .001). Functional impairment (WSAS) was significantly associated with stress (B = 4.43, P < .001), night-shift work (B = 2.62, P = .001), sedative properties (B = -3.21, P < .001), and symptom severity (B = 2.37, P < .001). Antihistamine effects on sleep and cognition appear to be shaped by both sedative properties and patient characteristics. These findings suggest that prescribing practices should consider both symptom control and potential impacts on sleep health, cognitive performance, and social functioning, while recognizing that causality cannot be inferred without objective assessments and longitudinal designs.

Caring health from childhood is a most important challenge. To date, machine learning (ML) algorithms have been introduced to several fields of knowledge, while in education it is a novel perspective. This review aims to evaluate the effectiveness of ML applications on data registered by inertial measurement units collected from preschool to secondary education children's physical activity during school-hours. Furthermore, the review aims to explore how ML is used to process and interpret this data for outcomes like motor competence, physical activity intensity, sedentary behavior and academic/developmental indicators. Following PRISMA guidelines, we systematically searched PubMed, Web of Sciences, SCOPUS, SPORTDiscus and ProQuest Central databases. 13 studies met the inclusion criteria, covering preschool to secondary education settings across multiple countries. The methodological quality ranged from moderate to high (11-17/18 MINORS points). ML algorithms, mainly Random Forest, Support Vector Machines, Gradient Boosting and Convolutional Neural Networks, were successfully applied to classify or predict various outcomes such as motor competence, physical activity intensity, sedentary behavior and developmental or academic indicators. Reported accuracies ranged from approximately 70% to 99%, demonstrating the strong potential of wearable sensor data combined with ML to objectively monitor and assess school-related physical activity.

Purpose:Hypertension (HTN) disproportionately affects marginalized communities due to persistent healthcare disparities and socioeconomic barriers. Less than half of patients with HTN achieve blood pressure (BP) control, with Black Americans on antihypertensive medication experiencing lower rates of BP control (34.9%) compared to non-Hispanic Whites (45.0%). This pilot study evaluates the effectiveness of a telephone outreach intervention designed to improve BP control through self-management in a historically underserved population.Major Findings:This single-cohort, pre-post intervention study was conducted at a Federally Qualified Health Center (FQHC). Patients with severe hypertension were identified and contacted by trained student ambassadors (SAs). These SAs provided hypertension-specific health education, health goal-setting, guidance for self-monitoring blood pressure, and referrals to address health-related social needs (HRSN). During in-person classes, patients were educated on BP self-monitoring and goal setting regarding healthy lifestyle practices. Results from this study showed a reduction in SBP and DBP among engaged patients and improved hypertension knowledge.Conclusion:These findings suggest that telephone outreach, when combined with skill-based in-person education, can improve hypertension control in Black American populations.

The objective of this study was to assess and compare diet quality and adherence to DASH nutrient recommendations between hypertension and non-hypertensive older African American adults. A cross-sectional analysis was conducted using data collected between October 2021 and July 2022 from 100 African American adults aged ≥55 years. Diet was assessed using a validated food frequency questionnaire, and diet quality was quantified via the Healthy Eating Index (HEI-2015). DASH adherence was measured by comparing mean intake of sodium, potassium, magnesium, calcium, fiber, and % kcal from carbohydrates, protein, total fat, and saturated fat to DASH dietary targets. Participants self-reported hypertension status, sociodemographic, health, and food access information. Statistical analyses included t-tests and chi-square tests to compare nutrient means and adherence rates between participants with and without hypertension. Participants had a mean age of 68.6 years; 71% were female, and 45% were classified as obese. The majority (74%) scored a grade of "fair" or "poor" on the HEI-2015. While HEI-2015 fruit and vegetable sub-scores met recommendations, those for sodium, added sugar, and saturated fat did not. Hypertensive participants consumed significantly more sodium than non-hypertensive (P < .001), with the former consuming almost double their recommended amount (2884 ± 1103 vs 1500 mg). Additionally, hypertensive patients got fewer calories from carbohydrates (-3.3% kcal, P = .032), and more from protein (+2.5% kcal, P = .004) compared to their non-hypertensive peers. Neither group met potassium, calcium, magnesium, or fiber targets, with no difference between groups. About 30% reported food insecurity, yet over 70% still reported good availability of healthy foods in their neighborhood. Findings indicate widespread nutrient inadequacies and excessive sodium intake among older African American adults, with hypertensive participants consuming particularly high levels of sodium. Despite adequate fruit and vegetable intake and reported access to healthy foods, both groups failed to meet key DASH nutrient targets. These results highlight the need for culturally tailored, community-based interventions that specifically address sodium reduction and DASH-aligned nutrient intake to reduce cardiovascular disease risk in this underserved population.

There is limited evidence on the social and emotional wellbeing (SEWB) needs of staff working at Aboriginal Community Controlled Health Services (ACCHS) in Australia. The current study employed qualitative research methods to explore ACCHS staff's experience during the COVID-19 pandemic and its impact on their SEWB, and to identify factors that provided strength. Yarning Circles and one-on-one Yarns were employed to explore clinical and non-clinical ACCHS staff's experiences. Participants included staff who identified as Aboriginal and/or Torres Strait Islander, or were non-Indigenous. Thirty-one staff from 5 ACCHSs participated in 7 Yarning Circles and 3 one-on-one Yarns, between December 2021 and June 2022. Staff shared their perspectives on (i) ACCHSs' responses, (ii) community and staff reaction, and (iii) impact of service-level changes on their SEWB. Data was analysed using thematic analysis. The main themes identified as impacting ACCHS staff's SEWB were: (1) constant change and prolonged stress, (2) community as a source of strength, (3) leadership safeguarding community and staff, (4) pride in their response, and (5) opportunities to lessen psychological toll. Staff were motivated by the seamlessness of their roles. They were motivated by positive work environment, reliable infection control measures, and resourceful leadership. Major concerns included fear of contracting and transmitting infection, and long-term consequences of disrupted patient care. There was a lack of awareness among staff about formal SEWB support, and if aware they were hesitant to use services due to cultural safety and privacy concerns. A major source of support for ACCHS staff was peer support. During the COVID-19 pandemic ACCHS staff experienced prolonged stress exacerbated by constant changes, inconsistent information, misinformation, and lack of resources. Staff found strength in community, cultural connections, and management's response. Informal peer support was important in upholding ACCHS staff's SEWB, suggesting that structured peer support can provide ongoing support.

People with complex needs often have unmet biopsychosocial needs that require integrated services through intersectoral collaboration. Few studies have evaluated the factors influencing intersectoral collaboration for health improvement of a vulnerable population between non-profit organizations (NPOs) and primary health care partners in rural areas. The objectives of the study are: (1) to describe intersectoral collaboration between an NPO and its social and primary health care partners in a rural setting; and (2) to identify the elements that facilitate or hinder this collaboration. An instrumental case study was conducted through field research. Data collection included non-participant observation, semi-structured interviews, and analysis of documents. A thematic analysis was then carried out, and a case story was written. The case study provides an in-depth account of the case, its context, and the key factors influencing intersectoral collaboration. Fourteen factors were identified as having a significant impact on intersectoral collaboration with the NPO. These factors had positive and negative effects on collaboration efforts. Several of these effects are also factors that had, in turn, effects on collaboration. Implementing intersectoral collaborations requires a shared vision, healthy relationships, and transparent, respectful communication, among other important factors. Our study provides leaders of healthcare projects in rural areas with actionable advice to address potential challenges and enhance the effectiveness of their collaborative efforts.

Public partnerships, engagement, and outreach are essential for meaningful knowledge dissemination and exchange activities in public settings. In 2024, we formed the Atlantic Cancer Consortium Patient Advisory Committee (ACC PAC). In March 2025, the ACC PAC delivered a successful public conference on precision medicine and cancer. Our primary objective is to share the perspectives gained, lessons learnt, impact of the event, and recommendations for future public conferences and engagement. Conference topics were identified by the ACC PAC. Speaker selection and conference promotion were done using various approaches and/or tools. The WebEx virtual platform was used to deliver the conference. This conference was open to all members of the public. A participant satisfaction survey was created using Qualtrics and distributed to registrants during and after the conference. Survey responses were summarized using descriptive statistics when appropriate. ACC PAC members who participated in the conference were encouraged to reflect on their experience. The ACC PAC patient advisors were involved in all key aspects of this conference's organization and delivery. A total of 24 speakers spoke during the conference on various cancer and patient-centered topics. Comments received and self-reflection exercise responses indicated a high level of impact and satisfaction associated with the content and delivery of the conference. Issues experienced, opportunities realized, and good practices implemented, as well as the feedback received helped us develop recommendations for improved delivery of future public conferences and better public engagement activities. In this Case Report, we discuss our learnings from a public conference that was designed and delivered by a public-scientist partnership. Overall, we were able to organize and deliver a successful public conference on precision medicine and cancer, yet there is still room for improvement in practical and technical areas. Our experience, self-reflection, and participant feedback that are described in this manuscript can help inform future public engagement and conference activities in Canada and beyond. Last, we ask decision-makers, such as governments, to provide sustained support for public partnerships and engagement in oncology.Public SummaryThe Atlantic Cancer Consortium Patient Advisory Committee (ACC PAC) is a patient - scientist partnership in Atlantic Canada focusing on precision medicine and cancer, advising the ACC researchers in research and public engagement activities, and actively working to engage with Atlantic Canadians in knowledge dissemination.This group organized and delivered a one-day public conference on March 15, 2025. Topics included patient and family perspectives, precision medicine, cancer risk factors and screening programs, support services offered to cancer-affected individuals, clinical trials, and advocacy. The conference was open to all members of the public. Overall, this was an impactful event centred on patient and family priorities, experiences, as well as on information and support needs.During and after the organization and delivery of this public event, we learnt by experience and from speaker and participant feedback. In this Case Report, we discuss these perspectives, lessons learnt, impact of the event, and recommendations for future public conferences. We also ask for sustained support and emphasis on public partnerships and engagement on cancer from decision-makers.

Purpose:This commentary examines the complex maternal health landscape in rural America, highlighting the structural barriers to effective chronic disease management. We provide recommendations to center chronic disease management using a life course approach.Conclusions:Women in rural areas face significantly higher maternal mortality and morbidity rates than their urban counterparts, largely due to a disproportionate burden of chronic disease conditions such as gestational diabetes, preeclampsia, cardiomyopathy, and mental health disorders. These disparities are deeply rooted in the unequal distribution of systemic and structural determinants of health. We call for a system-level approach related to primary, secondary, and tertiary prevention efforts to improve maternal health in rural areas, based on the life course perspective.

Introduction/Objectives:Osteoporosis screening is well-established for women but lacks widely accepted guidelines for men, despite higher post-fracture mortality rates. This study aims to increase the proportion of men ages 50 years and older with risk factors who receive appropriate osteoporosis screening.Methods:We conducted an interventional cohort study examining men ages 50 years and older with risk factors seen at the study clinic between March 27, 2024, and June 1, 2024. Interventions included clinical decision support in the electronic medical record and integration of osteoporosis screening into the Medicare Annual Well Visit workflow.Results:The proportion of eligible men with up-to-date osteoporosis screening increased from 11.6% (38/329) to 57.7% (239/414). Among those screened, 33.5% had normal bone density, 47.7% were diagnosed with osteopenia, and 18.8% had osteoporosis.Conclusions:Implementing clinical decision support, workflow changes, and provider education significantly improved osteoporosis screening rates. The high prevalence of osteopenia (47.7%) and osteoporosis (18.8%) underscores the need for routine screening in high-risk men. These findings highlight the potential for targeted interventions to enhance early detection and treatment, reducing fracture risk and improving long-term outcomes.