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The process of chronic pain (CP) and strategies is to improve the patient’s health and well-being. CP is a frequent medical problem that presents a major challenge to healthcare providers because of its complex natural history, imprecise aetiology, and inadequate response to pharmacological treatment. Although different definitions exist it is widely accepted that CP is an ongoing pain that lasts more than 3 months or that persists longer than the reasonably expected healing time for the involved tissues. Also, it is acknowledged that its treatment is much different than the treatment for acute pain. When addressing a person with CP, one should always keep in mind that pain is much more about the individual than the underlying medical condition. Every person is different, and healthcare providers should take a tailor-made approach to managing their pain. This is the only way to ensure good results in pain treatment. Treatment goals should be discussed and adapted to the patient profile. It is fundamental to have clear goals from the beginning and to ensure these are realistic, individualized, and measurable. Effective treatment for CP is only achieved through a holistic framework in which the patient’s well-being is the first concern and an interdisciplinary and societal approach is implemented from the first day.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

This paper aims to describe the development, implementation and evolution of a multi-media educational tool to improve health profession students’ knowledge and awareness of stigma and ageism on the treatment of older adults with substance use disorder (SUD). In addition, this paper outlines the relationship between mental health and SUD and the impact of health provider stigmatization of older adults with behavioral health needs and the relationship between SUD and mental illness.

A literature review was conducted and initial project outlines was developed. Ten interviews were completed with content experts. The draft video was reviewed and minor revisions were incorporated. The facilitator guide accompanying the video was developed. A draft of the facilitator guide was shared with several interprofessional university faculty and the older adults with SUD. The video was presented to groups of health professions students, and following each video viewing, discussion content was used to provide additional edits.

The educational resources created for this project are appropriate for health professions curriculums related to older adults. Interprofessional health professions students are developing a basic foundation of knowledge on SUD through their standard coursework. More compassionate vocabulary is slowly being incorporated into health provider. Knowledge related to treatments and resources to treat SUD is lacking. In addition, health professions students need more education focused on assessment and interventions for individuals suspected of problematic substance use.

This paper fulfills an identified need to facilitate discussion and education around SUD for health professions students.

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

Bipolar disorder is associated with poor mental and physical health outcomes, and therefore, it is crucial to research and develop effective interventions for this population (Grande et al., 2016). Unfortunately, research on the efficacy of current interventions shows only small improvements in symptoms and quality of life (Oud et al., 2016). Additionally, individuals with bipolar disorder face barriers to accessing care like social stigma, isolation and financial constraints (Blixen et al., 2016). This paper aims to introduce and examine the effectiveness of an accessible, peer-led group program, Mood Lifters (Votta and Deldin, 2022), in those who completed the program and also self-reported a diagnosis of bipolar disorder.

Mood Lifters is a 15-week, peer-led group program that approaches mental wellness from a biopsychosocial framework using strategies from a variety of evidence-based treatment methods (e.g. cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, etc.). Participants meet once a week for 1 hour to review various mental health topics, including behavioral changes and insight into mood patterns. Individuals who participated in nonacademic groups in a company setting and self-reported a bipolar diagnosis were surveyed at the beginning and end of their program to measure various aspects of psychological functioning.

Results suggest that these individuals experienced significant improvements in depression, anxiety, social functioning and perceived stress, along with flourishing and positive and negative affect.

These findings are promising, given that bipolar disorder is historically difficult to treat (Grande et al., 2016). Based on this preliminary evidence, the authors have developed a Mood Lifters program specifically for individuals with bipolar disorder and are launching a randomized control clinical trial.

Different studies relate the presence of depression to lower cognitive performance and higher functional dependence in older people; however, this is not entirely clear. The purpose of this study is to validate the existence between the association of these conditions.

Cross-sectional and descriptive study was conducted in which the memory, metamemory and global functionality test performance of depressed and non-depressed participants was compared between two groups, one cognitively healthy and other with cognitive decline. The participants were 420 older adults, with an average age of 69 and five years of schooling.

The importance of describing cognitive performance in older adults with depression may provide evidence to support an adequate differential diagnosis and the design of an adequate future therapeutic plan. Identifying and preventing depression in the elderly can improve health and well-being in the elderly.

Depression is a prevalent and highly disabling disease. When it is suffered by an older person, it is associated with higher mortality, functional dependence, poor physical health, worse quality of life indicators and psychological well-being. In the elderly, the clinical diagnosis of depression is difficult, as it has a high comorbidity and is often confused with other health conditions prevalent during older adulthood.

Left atrial appendage occlusion (LAAO) is a structural interventional cardiology procedure that offers several possibilities for the application of additive manufacturing technologies. The literature shows a growing interest in the use of 3D-printed models for LAAO procedure planning and occlusion device choice. This study aims to describe a full workflow to create a 3D-printed LAA model for LAAO procedure planning.

The workflow starts with the patient’s computed tomography diagnostic image selection. Segmentation in a commercial software provides initial geometrical models in standard tessellation language (STL) format that are then preprocessed for print in dedicated software. Models are printed using a commercial stereolithography machine and postprocessing is performed.

Models produced with the described workflow have been used at the Careggi Hospital of Florence as LAAO auxiliary planning tool in 10 cases of interest, demonstrating a good correlation with state-of-the-art software for device selection and improving the surgeon’s understanding of patient anatomy and device positioning.

3D-printed models for the LAAO planning are already described in the literature. The novelty of the article lies in the detailed description of a robust workflow for the creation of these models. The robustness of the method is demonstrated by the coherent results obtained for the 10 different cases studied.

This paper aims to report the findings of a survey study exploring perceptions about cognitive impairment. These findings are relevant to public health campaigns and education programmes.

A survey exploring respondents’ views and knowledge about mild cognitive impairment (MCI) was circulated via UK networks. A total of 417 respondents completed the survey, including people living with cognitive impairment (n = 10), care partners (n = 23), older adults (n = 83), younger adults (n = 83), general health-care professionals (n = 96), dementia specialist health-care professionals (n = 48) and dementia specialists (n = 40).

Respondents were more confident in their knowledge about dementia than cognitive impairment but wanted more information about both conditions. Younger adults were uncertain about many aspects of MCI, and were the most likely to view MCI as a normal part of ageing. Diet (45.1%, n = 188) and personal behaviour (63.8%, n = 266) were the least endorsed possible causes of MCI, suggesting a lack of awareness of lifestyle choices as risk factors for MCI.

The results highlight the need to provide education and awareness raising about MCI to enable people to seek help in a timely manner and be able to make informed lifestyle choices that may reduce their risk of MCI and dementia. Implementing education about MCI and dementia in schools is a key target, as younger people were the most uncertain or misinformed about these topics. It is clear that further public health initiatives around MCI are both warranted and welcomed by the general public.

This study aims to determine the association between prison circumstances, perceived family support and sleep quality among male inmates at the Ibara prison, Ogun State.

It was a cross-sectional study of 300 male inmates interviewed with socio-demographic proforma and Pittsburgh sleep quality index.

While all respondents described the prison as being overcrowded, half of them used inappropriate sleeping materials daily and 41.4% decried a very noisy environment at night. Twenty-seven percent of the respondents described poor family support while 47.3% experienced poor sleep quality. Though nature of sleeping material and self-awareness of sleep problem were associated with poor sleep quality, no predictor of the latter was identified.

The study was conducted among males only because of the relative dominance of the male gender in the prison population. This makes analysis of gender difference impossible. Furthermore, sleep studies may be preferred over reports by some sleep experts.

Findings from this study may culminate in taking steps to improve the Nigerian prison conditions as well as the prisoner’s welfare.

Developing support group for relatives of inmates may be a focus of social intervention for these inmates. Also, inmates with good sleep quality are likely to partake effectively in the prison reformation programmes and may not self-medicate with sedatives.

This study provides a scholarly documentation of the state of Nigerian prisons; inmates’ perception of family support; prevalence and correlates of poor sleep quality among a group of male inmates.

This systematic review aims to gain the studies regarding the effect of Nigella Sativa (N. sativa) on adipokines including leptin, adiponectin and resistin.

Search was carried out using databases Scopus, Web of Science, PubMed and Google Scholar with no restriction on language or date until February 2023 and alert services were applied to identify any paper after the primary search.

Eighteen animal and human studies were eligible for the current systematic review. Leptin and resistin levels showed a downward tendency after consuming N. sativa and its ingredients [e.g. oil, thymoquinone (TQ) and thymol] as well as its extracts (e.g. water extract). Furthermore, considering 4 of 8 animal research studies and 2 of 5 human studies that evaluated adiponectin levels, a significant increase was observed after using N. sativa and its ingredients (e.g. oil, TQ and thymol).

The present paper collates evidence from animal and human studies regarding the effect of N. sativa on adipokines including leptin, adiponectin and resistin.