Background: The use of thiazide diuretics is associated with skin cancer risk; however, whether this applies to all skin cancer types is unclear. Methods: In this meta-analysis, we searched multiple electronic databases and gray literature up to 10 April 2022, with no language restrictions, to identify relevant randomized controlled trials (RCTs) and non-randomized studies (cohort, case-control) that investigated the association between thiazide diuretics and skin cancer. The primary outcomes of interest were malignant melanoma and non-melanoma skin cancer (basal cell carcinoma [BCC], squamous cell carcinoma [SCC]). Secondary outcomes included other skin cancers (lip cancer, Merkel cell carcinoma, malignant adnexal skin tumors, oral cavity cancer, and precursors of skin cancer). We used a random-effects meta-analysis to estimate pooled adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Thirty non-randomized studies (17 case-control, 13 cohort, no RCTs) were included. Thiazide diuretic users had a higher risk of malignant melanoma (17 studies; n = 10,129,196; pooled adjusted OR, 1.10; 95% CI, 1.04–1.15; p < 0.001; strength of evidence, very low; very small harmful effect), BCC (14 studies; n = 19,780,476; pooled adjusted OR, 1.05; 95% CI, 1.02–1.09; p = 0.003; strength of evidence, very low; very small harmful effect), and SCC (16 studies; n = 16,387,862; pooled adjusted OR, 1.35; 95% CI, 1.22–1.48; p < 0.001; strength of evidence, very low; very small harmful effect) than non-users. Thiazide diuretic use was also associated with a higher risk of lip cancer (5 studies; n = 161,491; pooled adjusted OR, 1.92; 95% CI, 1.52–2.42; p < 0.001; strength of evidence, very low; small harmful effect), whereas other secondary outcomes were inconclusive. Conclusions: Thiazide diuretics are associated with the risk of all skin cancer types, including malignant melanoma; thus, they should be used with caution in clinical practice.

In light of the coronavirus disease 2019 (COVID-19) pandemic and the enormous amount of uncertainty caused by it, mental health issues have become a great concern. Evidence regarding the effects of psychological resilience on the Thai population is scarce. We evaluated psychological resilience during the first wave of the COVID-19 pandemic and its association with the risk of mental health outcomes, such as depression, anxiety, stress, and health-related well-being. This cross-sectional study was a part of the HOME-COVID-19 project, which conducted an online survey of 4004 members of the general population in Thailand using the Brief Resilience Coping Scale. Logistic regression was performed to identify the association between psychological resilience and mental health issues and well-being. Groups with prevalence rates of 43.9%, 39.2%, and 16.9% were classified as low, moderate, and high resilient copers, respectively. Using high resilient copers as a reference group, the low resilient copers had a higher chance of having mental health adversities. The adjusted odds ratio (OR) was 1.89 (95% confidence interval [CI], 1.39–2.56; p < 0.001) for depression, 2.13 (95% CI, 1.45–3.14; p < 0.001) for anxiety, 4.61 (95% CI, 3.30–6.45; p < 0.001) for perceived stress, and 3.18 (95% CI, 2.31–4.38; p < 0.001) for low well-being. For the medium resilient copers, only low well-being was found to be statistically significant (OR, 1.60; 95% CI, 1.16–2.20; p = 0.004). It is important that resilience be considered in the development of strategies for managing the COVID-19 pandemic to prevent or reduce adverse mental health outcomes.

Background: Fear of COVID-19 leads to stress and may result in various kinds of mental health problems. Many factors are associated with an individual’s perception of stress, including neuroticism and perceived social support. This study aimed to examine the role of neuroticism and perceived social support as mediators of fear of COVID-19 on perceived stress. Methods: Data from 3299 participants aged ≥18 years from the HOME-COVID-19 survey in 2020 were used for analysis. Measurements used included the Fear of COVID-19 and Impact on Quality of Life Scale, the Perceived Stress Scale-10, the Neuroticism inventory and the Multidimensional Scale of Perceived Social Support-12. A parallel mediation model within a structural equation modeling framework with 5000 bootstrapping sampling was used to test the mediating effect. Results: Fear of COVID-19 had a direct effect on perceived stress (B = 0.100, 95% CI = 0.080–0.121, p < 0.001), whereas neuroticism, but not perceived social support, partially mediated the relationship between fear of COVID-19 and perceived stress (B = 0.018, 95% CI = 0.000–0.036). Among all types of social support, only perceived support from friends was a significant mediator (B = 0.016, 95% CI = 0.006–0.025). Conclusions: Neuroticism and perceived support from friends are critical factors in the relationship between fear of COVID-19 and perceived stress.

Coronavirus disease 2019 (COVID-19)-related public stigma is a major challenge, with scarce available evidence. This study aimed to determine the disparities and factors associated with COVID-19-related public stigma in the Thai population. We conducted a cross-sectional study involving a voluntary online survey in Thailand from 21 April 2020 to 4 May 2020. We invited 4004 participants to complete a series of questionnaires, including the validated COVID-19 public stigma scale and questions on relevant COVID-19-related psychosocial issues. Multinomial logistic regression was performed to investigate the factors associated with COVID-19-related public stigma. The prevalence of COVID-19-related public stigma was 24.2% (95% confidence interval [CI], 22.2–26.2) for no/minimal, 35.5% (95% CI, 33.4–37.6) for moderate, and 40.3% (95% CI, 38.2–42.4) for high. We observed disparities in the prevalence of COVID-19-related public stigma according to participant characteristics and psychosocial factors. Using the no/minimal group as a reference group, the six predominant risk factors significantly associated with a moderate and high degree of COVID-19-related public stigma were middle-aged or older adults, male, divorced/widowed/separated, current quarantine status, moderate/severe fear of COVID-19, and medium/high perceived risk of COVID-19. Additional risk factors significantly related to a high degree of COVID-19-related public stigma were religion (Buddhist), region of residence (non-capital city), and exposure to COVID-19-related information. Disparities in COVID-19-related public stigma due to sociodemographic and psychosocial issues are frequent in the Thai population. To reduce public stigmatization, early identification of vulnerable groups and the development of tailored mitigation strategies should be implemented during the pandemic.

Background: This study aimed to investigate the prevalence of social anxiety symptoms (SASs) and its associated factors among middle-aged teachers in secondary education schools. Methods: A cross-sectional survey was conducted from December 2023 to March 2024 among 341 secondary education schoolteachers aged 45–59 in Chiang Mai, Thailand, involving an online survey. Effects of psychosocial variables on SASs were investigated, including attachment anxiety, attachment avoidance, neuroticism and extraversion personality traits, loneliness, perceived social stress, job burnout, and anxiety and depression. Multiple linear regression was used to identify predictors of SASs. Results: This study found that 98 out of 341 (28.7%) teachers presented SASs. Multiple linear regression analysis showed that marital status (β = 0.103, 95% CI [0.437, 3.404]), income (β = 0.087, 95% CI [0.049, 3.758]), extraversion (β = −0.179, 95% CI [−0.573, −0.198]), attachment anxiety (β = 0.165, 95% CI [0.106, 0.359]), attachment avoidance (β = 0.145, 95% CI [0.066, 0.243]), depression (β = 0.242, 95% CI [0.248, 0.862]), loneliness (β = 0.182, 95% CI [0.099, 0.580]), and perceived social stress (β = 0.235, 95% CI [0.131, 0.373]) were significant predictors of SASs, explaining 51.1% of the variance. Conclusion: This study discovered a relatively high prevalence of SASs among middle-aged secondary schoolteachers.

Background: Hereditary angioedema (HAE) is a rare genetic disease that can lead to potentially life-threatening airway attacks. Although novel therapies for HAE treatment have become available over the past decades, a comparison of all available treatments has not yet been conducted. As such, we will perform a systematic review and network meta-analysis to identify the best evidence-based treatments for the management of acute attacks and prophylaxis of HAE. Methods: This study will include both parallel and crossover randomized controlled trials that have investigated prevention or treatment strategies for HAE attacks. We will search electronic databases, including Medline, Embase, PubMed, Cochrane Library, Scopus, and CINAHL, from inception with no language restrictions. Potential trials will be supplemented through a gray literature search. The process of study screening, selection, data extraction, risk-of-bias assessment, certainty assessment and classification of treatments will be performed independently by a pair of reviewers. Any discrepancy will be addressed through team discussion. A two-step approach of pairwise and network meta-analysis will be performed. The summarized effect estimates of direct and indirect treatment comparisons will be pooled using DerSimonion–Laird random-effects models. The incoherence assumption, in terms of the consistency of direct and indirect effects, will be assessed. An evidence-based synthesis will be performed, based on the magnitudes of effect size, evidence certainty, and ranking of treatment effects, with respect to treatment benefits and harms. Discussion: This systematic review and network meta-analysis will summarize evidence-based conclusions with respect to the ratio of benefits and harms arising from interventions for the treatment of acute attacks and prophylaxis of HAE. Evidence from this network estimate could promote the rational use of interventions among people living with HAE in clinical practice settings. PROSPERO registration number: CRD42021251367.