Telemedicine uses digital technologies to provide healthcare services remotely, greatly improving patient access, especially during crises like the COVID-19 pandemic. This systematic review investigates telemedicine's effects on patient outcomes, access to care, and its role in the evolving healthcare landscape. Relevant studies were identified using MeSH terms and keywords through electronic databases and manual reference list screenings. The selected empirical studies, both quantitative and qualitative, examined telemedicine across various patient populations. The review categorized findings into themes related to patient outcomes and access to care. Telemedicine was found to be a transformative tool in chronic disease management, particularly in diabetes care. Significant improvements in patient health outcomes and cost savings were reported with telemedicine interventions. For example, telehealth platforms enhance diabetes management by increasing patient engagement and improving clinical metrics such as HbA1c levels. Additionally, telehealth services for diabetes-related foot disease (DFD) overcome geographical barriers, providing specialized care and improving patient access and satisfaction. In conclusion, telemedicine significantly improves patient outcomes, access, and satisfaction in chronic disease management, especially diabetes care. By overcoming geographical barriers and enhancing patient engagement, telehealth platforms have the potential to transform global healthcare delivery. Implementing these insights into practice can improve the accessibility and effectiveness of diabetes care worldwide, ensuring equitable and patient-centered healthcare solutions.

There is an epidemic of obesity in adults in rural America. It is estimated that about 19% of the population resides in rural areas, which encompasses 97% of America's total landmass. Although rural America makes up a fraction of America's total population, it has been estimated that the prevalence of obesity is approximately 6.2 times higher than in urban America. This illustrates an apparent disparity that exists between the rural population and urban populations that needs to be examined. The prevalence of obesity, especially in rural America, is a growing concern in the medical community in recent years. Obesity has been identified as a significant risk factor for cardiovascular disease, cancer, and type 2 diabetes mellitus, which are leading causes of morbidity and mortality in the US. To better understand the disparity in the prevalence of adult obesity between rural and urban America, researchers have identified risk factors that are associated with the high incidence and prevalence of obesity in the rural American adult population. Low income and lack of physical activity have been identified as factors that predispose rural Americans to increased risk of obesity, arguing that low-income Americans may not have access to the resources available to assist them in weight reduction. With rural Americans being at an income disadvantage, it creates a risk for obesity, which further predisposes them to chronic diseases such as hypertension, obstructive sleep apnea (OSA), diabetes, and coronary artery disease. As obesity continues to rise among the American population, the burden on the rural population is incredibly evident. Despite ongoing efforts by the US government and strategies implemented by the Common Community Measures for Obesity Prevention, there is still much to be done to tackle the epidemic. With an existing strategy in place, such as the 12 Common Community Measures for Obesity Prevention (COCOMO) strategies to fight obesity with physical activity, Americans are a step closer to conquering this epidemic. However, until other disparities such as income are addressed, rural Americans may continue to be severely impacted by the rising incidence of obesity and subsequent higher mortality rates from associated diseases.

A significant proportion of individuals with psychiatric disorders face dual challenges such as managing the symptoms and disabilities of their conditions and enduring stigma arising from misconceptions about mental illness. This stigma denies them quality-of-life opportunities, such as access to satisfactory healthcare services, better employment, safer housing, and social affiliations. This systematic review aims to evaluate the effect of stigmatization on psychiatric illness outcomes, particularly its influence on treatment adherence, treatment-seeking behavior, and care outcomes. We conducted a systematic review of 39 studies published between 2010 and 2024, focusing on the effects of stigmatization on psychiatric illness outcomes. The review utilized robust methodology following Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies from 2010 to 2024 obtained from databases such as PubMed, Embase, Google Scholar, Web of Science, and SCOPUS. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies, with most studies rated as moderate to high quality. The findings indicate that stigma in psychiatric illness is closely associated with several factors, including illness duration (mean effect size = 0.42, p < 0.05), frequency of clinic visits (mean reduction = 2.3 visits/year), and diagnosis of psychotic disorders (OR = 1.78, 95% CI: 1.20-2.65). Stigma manifests through misinformation, prejudice, and discrimination, leading to significant barriers to accessing and adhering to psychiatric treatment, thereby worsening health outcomes. It leads to delays in accessing healthcare, poor adherence to medication and follow-up, and negative psychiatric health outcomes, including disempowerment, reduced self-efficacy, increased psychiatric symptoms, and decreased quality of life. Also, stigma extends to caregivers and healthcare professionals, complicating care delivery. This review highlights the need for effective interventions and strategies to address stigma, emphasizing the importance of educational interventions to mitigate the adverse effects of public stigma. Understanding the multifaceted nature of stigma is crucial for developing targeted approaches to improve psychiatric care outcomes and ensure better mental health services for individuals with mental illnesses.

Cardiorenal syndrome (CRS) is a condition characterized by the intricate two-way relationship between the heart and kidneys, which can lead to acute or chronic dysfunction in these organs. The interplay between cardiorenal connectors and both hemodynamic and non-hemodynamic factors is crucial to understanding this syndrome. The clinical importance of these interactions is evident in the changes observed in hemodynamic factors, neurohormonal markers, and inflammatory processes. Identifying and understanding biomarkers associated with CRS is valuable for early detection and enabling intervention before significant organ dysfunction occurs. This comprehensive review focuses on the clinical significance of biomarkers in the diagnosis, prognosis, and management of CRS. Finally, it highlights the necessity for further advancements in managing this condition.

Background: Although research shows that digital health tools (DHT) are increasingly integrated with healthcare in the United States, very few studies have investigated the rural-urban differences in DHT adoption at the national level. Individuals in rural communities experience disproportionately greater rates of chronic diseases and face unique challenges in accessing health care. Studies have shown that digital technology can improve access and support rural health by overcoming geographic barriers to care. Objective: To evaluate the rates of ownership and preferences for utilization of DHT as a measure of interest among rural adults compared to their urban counterparts in the United States using a National Inpatient Survey. Methods: Data was drawn from the 2019 (n= 5438) iteration of the Health Information National Trends Survey (HINTS 5 cycle 3). Chi-square tests and weighted multivariable logistic regressions were conducted to examine rural-urban differences regarding ownership, usage, and use of digital health tools to interact with health care systems while adjusting for health-related characteristics and sociodemographic factors. Results: The ownership rates of digital health technology (DHT) devices, including tablets, smart phones, health apps, and wearable devices, were comparable between rural and urban residents. For tablets, the ownership rates were 54.52% among rural residents and 60.24% among urban residents, with an adjusted odds ratio (OR) of 0.87 (95% confidence interval {CI}: 0.61, 1.24). The ownership rates of health apps were 51.41% and 53.35% among rural and urban residents, respectively, with an adjusted OR of 0.93 (95% CI: 0.62, 1.42). For smartphones, the ownership rates were 81.64% among rural residents and 84.10% among urban residents, with an adjusted OR of 0.81 (95% CI: 0.59, 1.11). Additionally, rural residents were equally likely to use DHT in managing their healthcare needs. Both groups were equally likely to have reported their smart device as helpful in discussions with their healthcare providers (OR 0.90; 95% CI 63 - 1.30; p = 0.572). Similarly, there were similar odds of reporting that DHT had helped them to track progress on a health-related goal (e.g., quitting smoking, losing weight, or increasing physical activity) (OR 1.17; 95% CI 0.75 - 1.83; p = 0.491), and to make medical decisions (OR 1.05; 95% CI 0.70 - 1.59; p = 0.797). However, they had lower rates of internet access and were less likely to use DHT for communicating with their healthcare providers. Conclusion: We found that rural residents are equally likely as urban residents to own and use DHT to manage their health. However, they were less likely to communicate with their health providers using DHT. With increasing use of DHT in healthcare, future research that targets reasons for geographical digital access disparities is warranted.

Introduction Oral health has been linked to aspects of individual knowledge, attitude, and practices. In Nigeria, the increased prevalence of poor oral hygiene has been attributed behavioral factors. Behavioral aspects that include the increased intake of sugary foods and beverages, and lack of proper oral hygiene have been touted as the main causes of poor oral hygiene among university students. The knowledge of oral health is vital owing to its contribution to better oral health; however, unless students develop good oral habits and attitudes and subsequently put them into practice, very little will be realized with regard improvement in oral health and hygiene. Objective This research aimed to explore the knowledge, attitude, and practice of dental care among the University of Calabar students. Method This study was a descriptive cross-sectional study conducted between 2016 and 2017. A standardized questionnaire was used to collect data from 430 student participants in a university using a multi-stage random technique. An inferential statistical approach was adopted to test the relationships represented in the tables. Data were analyzed using the statistical package for social sciences, version 20.0. Result The study included 430 participants, 239 (55.6%) females and 191 (44.4%) males. The survey revealed that 94% of the 404 respondents agreed that poor dental care can cause dental diseases, while only 6% disagreed. Regarding excessive drinking of water, 91% of the respondents agreed that it cannot cause dental disease, 4.2% agreed it could, and 4.8% did not know. Furthermore, 60.2% of the 430 respondents acknowledged that genetic inheritance could cause dental disease, while 21.4% disagreed, and 18.4% did not know. Finally, 74.9% of the respondents knew that trauma to the teeth could cause dental disease, while only 9.3% thought that trauma could not cause illness to the teeth. Regarding attitude to dental care, 232 (54%) respondents agreed that visiting the dentist was necessary, while 164 (38.1%) strongly agreed. Only eight (1.9%) strongly disagreed, while five (1.2%) disagreed that visiting the dentist was necessary. Moreover, 82% of the respondents agreed that bad breath was associated with poor dental care, with 195 (45.3%) respondents strongly agreeing and 158 (36.7%) agreeing. However, 37 (8.6%) disagreed, and 16 (3.7%) strongly disagreed, while 24 (5.6%) were indifferent. As regards practice, most respondents used the up-down technique when brushing their teeth (62.8%), while 17.4% brushed left-right and 19.8% used both methods. Moreover, 67.4% of the respondents brushed twice daily, 26.5% brushed once daily, and only 6.1% brushed after every meal. About half of the students spent one to three minutes brushing their teeth (50.5%), while the other half spent more time. Over half of the students replaced their toothbrushes every three months (57.7%), with the most common reason for replacement being the fraying of bristles. However, the use of dental floss was found to be low. Conclusion The utilization of dental care facilities was low among most University of Calabar students, who did not see the need for dental clinic visits unless they had dental needs. The lack of dental visits was attributed to perceived high dental costs and a lack of time. Targeted interventions and educational programs that address these barriers could promote better oral hygiene practices among the students.