Since 1978, the Rohingya population has faced multiple humanitarian crises, including racial disparities, which significantly escalated during 2017, leading to widespread exile from Myanmar. Reportedly, violence, persecution, and trauma have posed grievous impacts on the mental health of these forcibly displaced people. This scoping review aimed to synthesize the evidence regarding the overall epidemiologic burden of psychological problems of Rohingya refugees with their associated factors. We evaluated five major databases and additional sources till July 31, 2024, and included articles according to the eligibility criteria following the Joanna Briggs Institute (JBI) guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. Out of 373 citations retrieved from multiple sources, we included 35 articles in this review. Most of the articles reported a high prevalence of different psychological symptoms of Rohingya refugees, such as depression, anxiety, post-traumatic stress disorder, persistent complex bereavement disorder, feeling afraid, etc. Several correlates of mental health problems were reported, including older age, being female, illiteracy, experiences of torture, sexual violence, unemployment, food insecurity, statelessness, lack of healthcare access, unhygienic campsites, and preexisting health problems, etc. There were significant gaps in community-level intervention studies, however, Group Integrated Adapt Therapy (IAT-G) and Mental Health and Psychosocial Support (MHPSS) services are widely used. The available evidence suggests a huge burden of mental health disorders with several biopsychosocial factors that may assist in better policymaking and implementation of multilayered approaches, like improving healthcare access, training healthcare providers, more community-based intervention studies, and introducing tele-mental health services for Rohingya refugees.
In case of a disease, the family system can function as a burden or a resource and support system. The genogram (a visual depiction of the patient’s family relationships and other relevant information) helps the doctor to get a clear understanding of symptoms, life events, and diseases across three generations. The different phases of the family dialogue are: joining, context and mission clarification, questions about family dynamics and psychological resources and challanges, treatment planning, and conclusion of the interview. The following communication techniques can proof to be useful tools in conducting a family interview: direct disease-related questions, indirect or circular questions, and hypothetical questions.
This review aims to synthesize the current literature on how Community Health Workers (CHWs) are leveraging Artificial Intelligence (AI). By examining how CHWs are interacting with AI in healthcare settings, it seeks to propose novel research opportunities and identify critical challenges that, when addressed, can effectively enhance cardiovascular health outcomes for adults with limited health literacy. Most of the studies were conducted outside the United States. Very few presented empirical findings, addressed literacy, or discussed implications for cardiovascular disease. We identified several opportunities for researchers and policymakers around CHW+AI efforts in cardiovascular health and health literacy. These opportunities range from testing their ability to bridge communication gaps in written and spoken language to improving CHWs skills related to AI literacy (e.g., ability to understand and effectively use AI tools), health literacy (e.g., the ability to find, understand, and use information and services to make informed health-related decisions), and understanding of strategies to promote cardiovascular health. However, more work needs to be done in the United States, and integrating AI introduces critical challenges that still have not been addressed.
Psoriatic arthritis (PsA) is a chronic inflammatory disease with a heterogeneous presentation including peripheral joint arthritis, axial inflammation, enthesitis, dactylitis, and psoriatic skin and nail changes. A substantial proportion of patients develop structural joint damage that can be monitored using standard radiographs. In patients with PsA, structural damage progression has been associated with significant impairment of physical function, health-related quality of life, and work productivity. Tumor necrosis factor inhibitors were the first biologic therapies approved for patients with PsA and have demonstrated efficacy in reducing the rate of structural damage progression in these patients. More recently, biologics targeting the interleukin (IL)-23p19 subunit (guselkumab and risankizumab) and IL-17 (secukinumab, ixekizumab, and bimekizumab) have been approved to treat patients with active PsA and are the subject of this review, with a focus on guselkumab. In separate phase 3, randomized, controlled studies, participants with active PsA treated with guselkumab, secukinumab, ixekizumab, and bimekizumab exhibited less structural damage progression in comparison with placebo. Both guselkumab and risankizumab inhibit the IL-23p19 subunit; however, to date, only guselkumab has demonstrated statistically significant efficacy in inhibiting structural damage progression in this patient population.
BACKGROUND:Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract illness (LRTI) in older adults. RSV prefusion F (RSVpreF) is a bivalent stabilized prefusion F vaccine containing RSV-A and RSV-B antigens. In this phase 3 trial in persons aged ≥60 years, RSVpreF demonstrated vaccine efficacy (VE) of 88.9% and 77.8% against RSV-associated LRTI with ≥3 symptoms at the end of RSV seasons 1 and 2, respectively. We describe final safety and efficacy results and present immunogenicity data. METHODS:This study was conducted over 2 RSV seasons. Participants were randomized (1:1) to RSVpreF 120-µg or placebo. A secondary objective was to describe RSVpreF immunogenicity 1 month post-vaccination and before season 2 visits in participants from the United States and Japan. RESULTS:One-month post-vaccination neutralization titer geometric mean fold rise (GMFR) was 12.1 for combined RSV-A/RSV-B. Geometric mean titers decreased at the preseason 2 visit but remained substantially higher than baseline (RSV-A/RSV-B GMFR = 4.7). One month post-vaccination, GMFRs for RSV-A/RSV-B neutralizing responses were 12.0 to 13.0 for subgroups stratified by age (60-69, 70-79, ≥80 years). RSV-A/RSV-B GMFRs in participants with prespecified chronic conditions were generally similar to those without (range, 11.4-14.4). A consistent favorable safety profile and durable VE were seen through 2 RSV seasons. CONCLUSIONS:High RSV neutralizing titers were observed 1 month after RSVpreF vaccination in persons aged ≥60 years, with similarly robust responses across subgroups. These immune responses corresponded with high RSVpreF VE against RSV-associated LRTI. RSVpreF had a favorable safety profile over 2 seasons. Clinical Trials Registration. NCT05035212; EudraCT, 2021-003693-31.
