In March 2020, the World Health Organization (WHO) announced that COVID-19 (novel coronavirus) reflected a global pandemic. Early epidemiological analyses demonstrated that boys and men have similar rates of COVID-19 infection to girls and women. However, boys and men appear to be disproportionately impacted with respect to severity and mortality, including those from marginalised or minority backgrounds. Yet, considerations of sex and gender, and their relationship to health and social inequities, have been absent from recent COVID-19 policy and practice pandemic responses. This evidence-based commentary discusses the nexus between COVID-19, equity, and boys and men’s health from a broad public health perspective. Using scholarship about intersections between race and gender; and poverty, social determinants of health, and gender; we explain why a health equity lens is important to address the health and social inequities boys and men face during pandemics. This contribution provides guidance about future global public healthpandemic responses for society’s most vulnerable groups of boys and men.

/pdf/covid-19-equity-and-men-s-health-using-evidence-to-inform-40xgxs01m8.pdf

COVID-19, Equity and Men’s Health: Using Evidence to Inform Future Public Health Policy, Practice and Research Responses in Pandemics

Abstract The metaverse is an alternative digital world, accessed by means of dedicated audiovisual devices. In this parallel world, various forms of artificial intelligence meet, including individuals in the form of digital copies of real people (avatars), able to interact socially. Metaverse in medicine may be used in many different ways. The possibility to perform surgery at a distance of thousands of miles separating the patient from the surgeon, who could have also the possibility to visualize in real-time patient’s clinical data, including diagnostic images, obviously is very appealing. It would be also possible to perform medical treatments and to adopt pharmacological protocols on human avatars clinically similar to the patients, thus observing treatment effects in advance and significantly reducing the clinical trials duration. Metaverse may reveal an exceptional educational tool, offering the possibility of interactive digital lessons, allowing to dissect and to study an anatomical apparatus in detail, to navigate within it, not only to study, but also to see the evolution of the pathological process, and to simulate in advance surgical or medical procedures on virtual patients. However, while artificial intelligence is now an established reality in the clinical practice, the metaverse is still in its initial stages, and to figure out its potential usefulness and reliability, further developments are expected.

The metaverse in medicine

Background: Digital health media, such as health and wellbeing smartphone apps, could offer an accessible and cost-effective
way to deliver health and wellbeing interventions. A key component of the effectiveness of these apps is user engagement.
However, engagement with health and wellbeing apps is typically sub-optimal. Previous studies have identified multiple factors
that influence engagement, however, most of these studies were conducted on specific populations or focused on apps targeting a
particular behaviour. Understanding factors that influence engagement with a wide range of health and wellbeing apps can help
inform the design and development of more engaging apps.
Objective: The aim of this study was to explore users’ experiences of and reasons for engaging and not engaging with a wide
range of health and wellbeing apps.
Methods: A sample of adults in the UK (N=17) interested in using a health or wellbeing app took part in a semi-structured
interview to explore experiences of engaging and reasons for not engaging with these apps. Participants were recruited via social
media platforms. Data were analysed with the framework approach, informed by the Capability, Opportunity, Motivation –
Behaviour (COM-B) model and the Theoretical Domains Framework, two widely used frameworks that incorporate a
comprehensive set of behavioural influences.
Results: Factors appearing to influence the capability of participants to engage with health and wellbeing apps included available
user guidance, statistical and health information, reduced cognitive load, well-designed reminders, self-monitoring features,
features that help to establish a routine, features that allow retaining the app for a potential precipitating event in the future
(‘safety netting’) and features that offer a first step in the behaviour change process (‘stepping stone’). Tailoring, peer support
and embedded professional support were identified as important factors that appeared to enhance users’ opportunity for
engagement with health and wellbeing apps. Feedback, rewards, encouragement, goal setting, action planning, self-confidence
and commitment were judged to be motivation factors affecting engagement with health and wellbeing apps.
Conclusions: Multiple factors were identified across all components of the COM-B model that may be valuable for enhancing
the engagement of health and wellbeing apps. Engagement appears to be influenced primarily by features that provide user
guidance, promote minimal cognitive load and support self-monitoring (capability), provide embedded social support
(opportunity), and goal setting with action planning (motivation). We provide recommendations for policy makers, industry,
health care providers and app developers on how to increase engagement. Clinical Trial: Not applicable.

Perceptions of factors influencing engagement with health and wellbeing apps: a qualitative study using the COM-B model and Theoretical Domains Framework as an analytical framework

The United States is home to 47 million foreign-born individuals, which currently represents over 14% of the U.S. population. With greater length of U.S. residence, immigrants experience increased risk for chronic disease including selected cancers; yet, they are less likely to access preventive health care services and undergo cancer screening. As a result, there have been concerted efforts to address disparities in cancer screening in immigrant populations. This minireview describes current progress in promoting participation in cancer screening among U.S. immigrants and explores potential opportunities for improving impact. Of the 42 studies included in the review, the majority targeted Asian and Latino immigrant populations and included some form of culturally specific educational programming, often delivered in-person by community health workers and/or using a multimedia format. Twenty-eight of the 42 studies also offered navigation assistance to help overcome logistical and access barriers to care, and these studies yielded somewhat greater increases in screening. Yet, despite considerable effort over the past 20+ years, screening rates remain well below national goals. Opportunities to harness digital health tools to increase awareness and engagement, evaluating nonclinic-based screening paradigms to promote greater participation, and increasing efforts to address the needs of other immigrant subgroups are likely to have beneficial outcomes. Together, these strategies may help reduce inequities in access and uptake of cancer screening in U.S. immigrant populations.See all articles in this Special Collection Honoring Paul F. Engstrom, MD, Champion of Cancer Prevention.

https://cancerpreventionresearch.aacrjournals.org/content/canprevres/13/3/253.full.pdf

Addressing Disparities in Cancer Screening among U.S. Immigrants: Progress and Opportunities.

Social support, especially from peers, has been found to contribute to successful weight loss and long-term weight loss maintenance. Peer support groups may represent a particularly effective intervention technique for weight loss. This review focuses upon peer support weight loss interventions with the objective of identifying common elements of successful programs. Peer support interventions often consist of expert-led educational content, supplemented by peer-led activities or discussion. Peer groups may provide support to individuals who have little social support in their normal lives. Interventions are often designed for pre-existing groups, especially high-risk groups such as women from ethnic minorities. Men are underrepresented in weight loss programs and often perceive “dieting” as feminine. However, several peer programs for male sports fans have successfully resulted in weight loss and fostering support for healthy lifestyle among male peers. In addition to professionally created peer support groups, many online weight loss communities are created and moderated by peers. Online communities allow participants to share peer support similar to in-person formats. Many peer support interventions show significant short-term weight loss. Group members frequently report that peer support was critical to their weight loss success. A sense of community among likeminded individuals with similar goals was frequently cited. Online peer support groups are becoming increasingly prevalent, may fulfill similar needs to in-person groups, and have additional advantages in accessibility, and access to a larger peer network, and may facilitate long-term adherence.

/pdf/peer-support-groups-for-weight-loss-3fvvncl326.pdf

Peer Support Groups for Weight Loss

Objectives The purpose of this study was to explore new ways of creating value in the medical field and to derive recommendations for the role of medical institutions and the government. Methods In this paper, based on expert discussion, we classified Internet of Things (IoT) technologies into four categories according to the type of information they collect (location, environmental parameters, energy consumption, and biometrics), and investigated examples of application. Results Biometric IoT diagnoses diseases accurately and offers appropriate and effective treatment. Environmental parameter measurement plays an important role in accurately identifying and controlling environmental factors that could be harmful to patients. The use of energy measurement and location tracking technology enabled optimal allocation of limited hospital resources and increased the efficiency of energy consumption. The resulting economic value has returned to patients, improving hospitals’ cost-effectiveness. Conclusions Introducing IoT-based technology to clinical sites, including medical institutions, will enhance the quality of medical services, increase patient safety, improve management efficiency, and promote patient-centered medical services. Moreover, the IoT is expected to play an active role in the five major tasks of facility hygiene in medical fields, which are all required to deal with the COVID-19 pandemic: social distancing, contact tracking, bed occupancy control, and air quality management. Ultimately, the IoT is expected to serve as a key element for hospitals to perform their original functions more effectively. Continuing investments, deregulation policies, information protection, and IT standardization activities should be carried out more actively for the IoT to fulfill its expectations.

/pdf/usage-of-the-internet-of-things-in-medical-institutions-and-26xg5g70.pdf

Usage of the Internet of Things in Medical Institutions and its Implications

Human papillomavirus (HPV) vaccination protects against six types of cancer—cervical, anal, oropharyngeal, penile, vulvar, and vaginal. In the United States (U.S.), HPV vaccination coverage in college students remains low, especially in the Mid-South region, despite the highest risk of HPV infections and disease burden. However, few studies have assessed HPV vaccination among college students here. This study examined factors associated with HPV vaccination among college students in the Mid-South and explored preferred strategies for promoting vaccination. A mixed-methods design comprising a cross-sectional, self-report online survey and dyadic virtual interviews was conducted. Simple random sampling was performed to recruit a total of 417 undergraduate students aged 18–26 from March to May 2021; convenience sampling was performed to recruit three sex-matched dyads of a total of six (four female and two male) undergraduates from survey respondents who had not completed the HPV vaccine series in May 2021. Binary logistic regression analyses showed HPV vaccine knowledge and perceived barriers to vaccination were factors contributing to coverage for both female and male students, while perceived risks of HPV and vaccine hesitancy were factors only among female students. Findings from the qualitative content analysis identified college students’ perceived barriers to the vaccination at multiple levels and preferred strategies for vaccination promotion, corroborating the findings from the survey study. The findings provide implications that benefit the development of tailored interventions aimed at facilitating catch-up vaccination among college students in the Mid-South region. There is an urgent need for further research and the implementation of effective strategies that address the identified barriers and improve HPV vaccine uptake in this population.

/pdf/factors-associated-with-college-students-human-17bc5ylx.pdf

Factors Associated with College Students’ Human Papillomavirus (HPV) Vaccination and Preferred Strategies for Catch-Up Vaccine Promotion: A Mixed-Methods Study

Introduction: For Korean Americans (KAs), colorectal cancer (CRC) screening rates remain lower than the national target. This study aimed to examine factors predicting decisional stage of CRC screening adoption among older KAs using the precaution adoption process model. Method: Convenience sampling was employed to recruit KAs aged 50 to 75 years from the Atlanta metropolitan area in the United States. A total of 433 KAs completed a cross-sectional survey that collects information on sociodemographics, CRC screening history, a physician's recommendation, knowledge, self-efficacy, and decisional balance pertaining CRC screening, and precaution adoption process model stage. Results: Higher scores of decisional balance (odds ratio [OR] = 1.34), having a physician's recommendation (OR = 8.61), and having regular annual medical checkups (OR = 4.44) were significantly associated with higher decisional stage compared with lower stage, controlling for other variables. Discussion: Intervention research should incorporate consideration of individuals' decisional stage to move KAs forward from not engaging the screening to maintaining regular participation in CRC screening.

Analyzing Factors Associated With Decisional Stage of Adoption for Colorectal Cancer Screening Among Older Korean Americans Using Precaution Adoption Process Model.

BACKGROUND
Hospitalized patients undergoing surgery or procedures may experience negative symptoms. Music is a nonpharmacological complementary approach and is used as an intervention to reduce anxiety, stress, and pain in these patients. Recently, music has been used conveniently in clinical situations with technology devices, and the mode of providing music is an important factor in technology-based music interventions. However, many reviews have focused only on the effectiveness of music interventions.


OBJECTIVE
We aimed to review randomized controlled trials (RCTs) of technology-based music interventions for reducing anxiety and pain among patients undergoing surgery or procedures. We examined the clinical situation, devices used, delivery methods, and effectiveness of technology-based music interventions in primary articles.


METHODS
The search was performed in the following 5 electronic databases: PubMed, MEDLINE (OvidSP), CINAHL complete, PSYCINFO, and Embase. This systematic review focused on technology-based music interventions. The following articles were included: (1) RCTs, (2) studies using interactive technology (eg, smartphones, mHealth, tablets, applications, and virtual reality), (3) empirical studies reporting pain and anxiety outcomes, and (4) English articles published from 2018 to 2023 (as of January 18, 2023). The risk of bias was assessed using the Cochrane Risk of Bias tool version 2.


RESULTS
Among 292 studies identified, 21 met the inclusion criteria and were included. Of these studies, 9 reported that anxiety scores decreased after music interventions and 7 reported that pain could be decreased before, during, and after procedures. The methodology of the music intervention was important to the results on anxiety and pain in the clinical trials. More than 50% (13/21, 62%) of the studies included in this review allowed participants to select themes themselves. However, it was difficult to distinguish differences in effects depending on the device or software used for the music interventions.


CONCLUSIONS
Technology-based music interventions could help reduce anxiety and pain among patients undergoing surgery or procedures. The findings of this review could help medical teams to choose a practical methodology for music interventions. Future studies should examine the effects of advanced technology-based music interventions using smart devices and software that promote interactions between medical staff and patients.

Technology-based Music Intervention to Reduce Anxiety and Pain among Patients Undergoing Procedures: Systematic Review of Literature (Preprint)

Treating intermittent claudication secondary to peripheral arterial disease

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