BACKGROUND: Endocrine-disrupting chemicals (EDCs) interfere with hormonal systems, potentially causing metabolic, reproductive, and neurological issues, as well as hormone-related cancers. Found in everyday products, EDCs accumulate in body tissues over time, with adverse effects depending on the dose and duration of exposure. This study aims to explore behaviors related to EDC exposure among Saudi citizens to assess the need for further risk reduction interventions.
METHODS: This cross-sectional study employed a validated, self-administered online questionnaire to assess daily life behaviors associated with EDC exposure. A total of 563 participants were recruited using convenient sampling through online platforms.
RESULTS: The study revealed that a significant majority of participants were aged 18-25 years (48.67%, n=274). On average, participants scored 32.78 out of a maximum of 60 for potential EDC exposure, with scores ranging from 13 to 54 points. The majority (85.26%, n=480) fell into the moderate potential exposure category, while a small minority (4.26%, n=24) exhibited high potential risk based on their reported daily habits, predominantly among male participants (95.83%, n=23). A significant majority (72.65%, n=409) indicated a likelihood of adopting lifestyle changes to reduce exposure to harmful substances.
CONCLUSIONS: This study reveals diverse behavioral patterns linked to endocrine disruptor exposure among the general population in Saudi Arabia. Interestingly, the participants showed a positive attitude and willingness to change their risky behaviors. These findings underscore the necessity for educational programs and public health campaigns aimed at addressing gaps in knowledge. Encouraging the public to adopt behaviors that reduce exposure is essential to minimizing the potential long-term effects of EDCs.

The prevalence and severity of baseball-related injuries in the youth athlete population continue to escalate, despite efforts by health care professionals and sports organizations to quell this trend. This article reviews current research that has investigated the risk factors and possible prevention strategies for the most common injuries in young baseball players, including strengthening programs, pitch count guidelines, and throwing analysis.

Negative past experiences with vaccines or unfamiliar environments can be sources of stress during the COVID-19 vaccination procedure. We examined whether the perceived stressfulness of the vaccination procedure differ between mass vaccination centers and general practitioner (GP) practices. A survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474). Stress was low at all sites. The perceived stressfulness of the procedure was higher among younger participants and those in GP practices, and increased with longer waiting time at the site. Stress decreased with better comprehensibility of the procedure and higher satisfaction with patient education. Participants who expressed greater concern about the health risks of COVID-19 vaccines perceived the vaccination procedure as more stressful. Our findings indicate opportunities for improvements in future vaccination campaigns and highlight the important role of healthcare providers in mitigating stress by addressing individual concerns.

UNASSIGNED: Although vaccination confidence is declining globally, there is little detailed information from low- and middle-income countries about factors influencing routine vaccination behavior in these contexts.
UNASSIGNED: In mid-2022, we surveyed people who gave birth in Kenya between 2017-2022, and asked them about their children\'s vaccination history and about hypothesized correlates of vaccination per the Behavioural and Social Drivers of Vaccination model.
UNASSIGNED: Of 873 children in this sample, 117 (13%) were under-vaccinated (i.e., delayed or missing vaccine dose(s)) - and under-vaccination was more common among births during the COVID-19 pandemic (2020-2022) versus pre-pandemic (2017-2019). In multi-level multivariable models, children of respondents who expressed concerns about serious side effects from vaccines had significantly higher odds of missed vaccine dose(s) (aOR 2.06, 95 % CI 1.14-3.72), and there was a strong association between having more safety concerns now versus before the COVID-19 pandemic (aOR missed dose(s) 4.44, 95 % CI 1.71-11.51; aOR under-vaccination 3.03, 95 % CI 1.28-7.19). People with greater trust in health workers had lower odds of having a child with missed vaccine dose(s) (aOR 0.85, 95 % CI 0.75-0.97). People who reported higher patient-centered quality of vaccination care had much lower odds of having children with delayed or missed vaccine dose(s) (aOR missed dose(s) 0.14, 95 % CI 0.04-0.58; aOR under-vaccination 0.27, 95 % CI 0.10-0.79).
UNASSIGNED: These findings highlight potential strategies to improve vaccine coverage: greater focus on patient-centered quality of care, training healthcare workers on how to address safety concerns about vaccines, and building trust in the health care system and in health workers.

UNASSIGNED: To characterize the impact of rural patients\' travel time to obtain healthcare on their reported utilization of preventive healthcare services and personal health outcomes.
UNASSIGNED: Online survey data from rural adults ages 50+ years living in the Northeastern United States were collected from February to August 2021. Study measures included self-reported travel time to obtain healthcare, use of preventive healthcare, and health outcomes. The associations between travel time with use of preventive care and health outcomes were assessed using linear, Poisson, and logistic regression analyses controlling for demographic variables.
UNASSIGNED: Our study population included 1052 rural adults, with a mean travel time of 18.5 min (range: 0-60). Travel time was greater for racial/ethnic minority participants and for higher-income participants (both P < .05), but it was not associated with use of preventive healthcare. Greater travel time was associated with poorer mental health and more comorbidities, including cancer and diabetes (all P < .05).
UNASSIGNED: Travel time varied by patient demographic factors, and it was associated with mental health and comorbidities. There was no association between travel time and preventive care use, suggesting that other barriers likely contribute to suboptimal use of these services within rural communities. Further research is needed to elucidate the causal pathways linking travel time to mental health and comorbidities within rural communities, as increased travel may exacerbate intrarural health disparities.

UNASSIGNED: The study determined the effects of corporate wellness programs (CWP) on Filipino workers\' physical, occupational, socio-emotional, intellectual, and spiritual wellness.
UNASSIGNED: The study looked into the components of a CWP, its forms of communication, the respondents\' level of participation, motivation, and their physical, occupational, socio-emotional, intellectual, and spiritual well-being to determine their wellness status during the pandemic. The study utilized an online survey to examine questions related to the efficacy of such programs, descriptive statistics, correlation analysis to assess the respondents\' socio-demographic profiles, and point biserial correlation to test the association of CWP to their wellness status.
UNASSIGNED: The research showed that 90% of the respondents participated in their organization\'s CWP, contradicting most studies that state CWP suffers from a low participation rate. CWP initiatives are mostly publicized through electronic mail, printed in memos, then posted on the bulletin board, and shared through the company website and social media. In addition, the study showed that overall wellness mean scores were higher in employees who were aware of their wellness programs than those who were not and in participating vis-à-vis non-participating employees.
UNASSIGNED: The study\'s six assumptions showed positive results, indicating that CWPs are beneficial in improving employees\' overall wellness. However, the per paradigm and overall wellness scores were weakly associated with participation and awareness status based on the point biserial correlation. No adverse effects were recorded in the study. In addition, the study discovered that employees were active in personal wellness initiatives, leading to high scores in their wellness dimensions. The study showed different individual wellness initiatives implying that employees were also proactive about their total well-being.

UNASSIGNED: This study aimed to assess the awareness of genitourinary cancers risk factors among adults in Poland and to identify factors associated with public awareness of risk factors for genitourinary cancers.
UNASSIGNED: This cross-sectional survey was carried out between 1 and 4 March 2024 in a nationwide sample of 2,165 adults in Poland. Quota sampling was used. Data were collected using computer-assisted web interview (CAWI) method.
UNASSIGNED: Regardless of the type of cancer (kidney, bladder, or prostate cancer), a family history of cancer was the most recognized risk factor indicated by over half of respondents. Over one-third were aware that chemical exposure increases the risk for bladder cancer (39.4%) or prostate cancer (34.2%). Smoking was recognized as a risk factor for kidney cancer by 40.6% of respondents. Female gender, having higher education, being occupationally active and the presence of chronic diseases were the most important factors (p < 0.05) associated with a higher level of awareness of genitourinary cancers risk factors.
UNASSIGNED: This study revealed gaps in public awareness of genitourinary cancers risk factors among adults in Poland, especially lifestyle-related and workplace-related risk factors.

UNASSIGNED: Data modernization efforts to strengthen surveillance capacity could help assess trends in use of preventive services and diagnoses of new chronic disease during the COVID-19 pandemic, which broadly disrupted health care access.
UNASSIGNED: This cross-sectional study examined electronic health record data from US adults aged 21 to 79 years in a large national research network (PCORnet), to describe use of 8 preventive health services (N = 30,783,825 patients) and new diagnoses of 9 chronic diseases (N = 31,588,222 patients) during 2018 through 2022. Joinpoint regression assessed significant trends, and health debt was calculated comparing 2020 through 2022 volume to prepandemic (2018 and 2019) levels.
UNASSIGNED: From 2018 to 2022, use of some preventive services increased (hemoglobin A1c and lung computed tomography, both P < .05), others remained consistent (lipid testing, wellness visits, mammograms, Papanicolaou tests or human papillomavirus tests, stool-based screening), and colonoscopies or sigmoidoscopies declined (P < .01). Annual new chronic disease diagnoses were mostly stable (6% hypertension; 4% to 5% cholesterol; 4% diabetes; 1% colonic adenoma; 0.1% colorectal cancer; among women, 0.5% breast cancer), although some declined (lung cancer, cervical intraepithelial neoplasia or carcinoma in situ, cervical cancer, all P < .05). The pandemic resulted in health debt, because use of most preventive services and new diagnoses of chronic disease were less than expected during 2020; these partially rebounded in subsequent years. Colorectal screening and colonic adenoma detection by age group aligned with screening recommendation age changes during this period.
UNASSIGNED: Among over 30 million patients receiving care during 2018 through 2022, use of preventive services and new diagnoses of chronic disease declined in 2020 and then rebounded, with some remaining health debt. These data highlight opportunities to augment traditional surveillance with EHR-based data.

BACKGROUND: The original \'BETTER\' (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40-65 years and a \"Prevention Practitioner\" (PP), who empowered the participant to set achievable prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities (BETTER HEALTH) in Canada. Our objective was to conduct a review of guidelines in preparation for adapting the \'BETTER HEALTH\' approach for younger adults aged 18-39 years living with lower income, a group known to have earlier mortality due to a higher prevalence of preventable chronic diseases than their peers with higher income.
METHODS: We searched multiple electronic databases and grey literature for clinical practice guidelines on prevention/screening and included those that met the following criteria: published in English from 2008-2020 in Canada or any of the following countries (Australia, Ireland, New Zealand, Scotland, United States and England); and addressed prevention or screening. We assessed quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and extracted data (publication details, recommendations, and Quality/Level of evidence as reported by authors) from sources with overall scores of 5 or higher. Final recommendations were compiled after harmonization with input from diverse stakeholders (co-investigators, PPs, and the Community Advisory Committee).
RESULTS: We included a total of 85 guidelines, and developed a final list of 42 recommendations for 18-39 year-olds across 21 topics. Specific recommendations fell under the following topics: cancers, cardiovascular disease, diabetes, obesity, lifestyle (alcohol; healthy nutrition/physical activity); healthy relationships and healthy sexuality, immunization, oral health, social determinants of health, and substance use.
CONCLUSIONS: We identified evidence-based guidelines on individual-level prevention/screening actions for adults 18-39 years old and relevant for those living with lower income which will directly inform development and implementation of the BETTER LIFE intervention.

OBJECTIVE: The integration of these preventive guidelines with Electronic Health Records (EHRs) systems, coupled with the generation of personalized preventive care recommendations, holds significant potential for improving healthcare outcomes. Our study investigates the feasibility of using Large Language Models (LLMs) to automate the assessment criteria and risk factors from the guidelines for future analysis against medical records in EHR.
METHODS: We annotated the criteria, risk factors, and preventive medical services described in the adult guidelines published by United States Preventive Services Taskforce and evaluated 3 state-of-the-art LLMs on extracting information in these categories from the guidelines automatically.
RESULTS: We included 24 guidelines in this study. The LLMs can automate the extraction of all criteria, risk factors, and medical services from 9 guidelines. All 3 LLMs perform well on extracting information regarding the demographic criteria or risk factors. Some LLMs perform better on extracting the social determinants of health, family history, and preventive counseling services than the others.
CONCLUSIONS: While LLMs demonstrate the capability to handle lengthy preventive care guidelines, several challenges persist, including constraints related to the maximum length of input tokens and the tendency to generate content rather than adhering strictly to the original input. Moreover, the utilization of LLMs in real-world clinical settings necessitates careful ethical consideration. It is imperative that healthcare professionals meticulously validate the extracted information to mitigate biases, ensure completeness, and maintain accuracy.
CONCLUSIONS: We developed a data structure to store the annotated preventive guidelines and make it publicly available. Employing state-of-the-art LLMs to extract preventive care criteria, risk factors, and preventive care services paves the way for the future integration of these guidelines into the EHR.