There are limited data about how South Asian (SA) patients, their caregivers and their physicians make decisions about treatment, in particular advanced therapies. The study aimed to explore how SA people with inflammatory bowel disease (IBD), their family members and clinicians experience and perceive treatment-related decision-making with the aim of identifying strategies to improve treatment decision-making in Canada.

A descriptive qualitative study with in-depth semi-structured interviews.

Canada.

Adults residing in Canada, who self-identified as SA, had received treatment or cared for someone who received treatment for IBD from a gastroenterologist in Canada, and who spoke and understood English, Hindi and/or Punjabi were eligible to participate in the study. Clinician participants (eg, nurses, gastroenterologists, colorectal surgeons) were eligible if they had experience treating SA patients with IBD.

Data from 1:1, semi-structured interviews were analysed using deductive and inductive thematic analysis.

The length of time spent in Canada played a central role in patient perspectives on decision-making around IBD treatment. First or second-generation SA people, residency status, family and community involvement, universal factors like stigma, medication costs and preferences for non-pharmacological treatments influenced decision-making. Patient and caregiver participants reported high satisfaction with treatment-related decision-making processes, while clinician participants self-reported lesser satisfaction.

Clinicians and researchers working with SA patients in chronic disease specialties can use these findings to meet the healthcare needs and reduce disparities in optimal treatment for this patient population.

N/A.

This study describes the prototype testing and clinical validation of the Fit-Frailty App, a fully guided, interactive mobile health (mHealth) app to assess frailty and sarcopenia. This multi-dimensional tool is freely available on the App Store and considers medical history, physical performance, cognition, nutrition, daily function and psychosocial domains. To guide management, a total frailty score and clinical summary of underlying "risk flags" are provided. Our objectives were to examine usability, feasibility, criterion and construct validity.

Cross-sectional

Outpatient geriatric medicine clinic

Community-dwelling older adults, age 65 years or older

The primary outcome of the clinical validation study was criterion validity. A research nurse administered the Fit-Frailty App during a routine clinic appointment. Clinicians simultaneously completed a paper-based frailty index (FI) tool with similar items from a comprehensive geriatric assessment (FI-CGA). Total scores for both assessments were computed using the cumulative deficits frailty index scoring method. Intraclass and Pearson correlation coefficients and 95% CIs were calculated to examine criterion validity. Secondary outcomes were construct validity, feasibility (eg, completion rates, safety occurrences, resources) and usability (eg, ratings on ease of use, time to complete the app).

In the clinical validation study (n=75, mean age 79.2, SD=7.0, 53% female), the mean total Fit-Frailty App score was 0.33 (SD=0.13) with 73% of our sample considered frail or severely frail. The app presented comparable results to FI-CGA (moderate to good validity; ICC=0.65, 95%CI=0.50–0.76) with a strong association between the measures (r=0.74, 95%CI=0.62–0.83). In our prototype and clinical cohorts, the app had a 100% completion rate with no safety occurrences and had high usability ratings.

The Fit-Frailty App is a feasible and valid tool that can be used in research and clinical settings to comprehensively assess frailty and sarcopenia by non-geriatricians and could assist with developing targeted interventions.

The association between smoking and patients with schizophrenia has been established through epidemiological studies on various populations. This behaviour not only increases the risk of medical comorbidities associated with smoking, but it can also interfere with treatment and ultimately worsen prognosis. This study aims to determine if nicotine use affects the cumulative number of psychiatric hospitalisations in patients with schizophrenia.

This is a retrospective cohort study using 2018–2023 electronic medical record data.

Data was collected at an inpatient psychiatric hospital in Central California.

There were a total of 825 patients with diagnoses of schizophrenia or schizoaffective disorder who were admitted to the mental health hospital between 2018 and 2023.

The primary outcome of interest was the number of psychiatric hospitalisations observed among the patients who were smokers versus those who were non-smokers. Our secondary objective was to determine the prevalence of certain medical comorbidities between these two groups.

60.7% of patients had a lifetime smoking history. Accounting for matching, patients who smoked had significantly (p

Patients with schizophrenia and a lifetime smoking history had significantly more hospitalisations compared with patients with schizophrenia who were non-smokers. This can inform disease course in vulnerable populations with a greater propensity to self-medicate with substances. However, further research should be conducted to investigate other factors that can affect this relationship.