Factors Associated With People's Accessibility to Mental Healthcare Services in Ukraine: Focusing on Household Head Vulnerability.

Objectives: This study examines the factors associated with access to mental healthcare services among people living in the government-controlled areas (GCAs) of Donetsk and Luhansk oblasts in Ukraine. Methods: The 2020 Ukraine Multi-Sector Needs Assessment conducted by REACH was subjected to frequency analysis, percentage analysis, and binary logistic regression to confirm the factors associated with accessibility to mental healthcare services among Ukrainian household heads. Results: Older household heads, heads with high accessibility to healthcare facilities, and those with low health expenditures were highly likely to have low access to mental healthcare services. Household heads' awareness of household members' medical assistance eligibility was significantly and positively associated with the former's mental healthcare accessibility. Conclusion: This study revealed the mental health vulnerability of people living in GCAs in Ukraine, in which the situation progresses from conflict to war. The need for mental healthcare, which is adversely affected by armed conflict, is expected to increase. Accordingly, further studies should clarify the demand for and methods to enhance mental healthcare services to ensure the timely provision of these services in the future.

A Pragmatic Randomized clinical trial: twice-weekly vs. thrice-weekly Incident hemoDialysis in Elderly patients (PRIDE): study protocol.

Background: The optimal frequency for hemodialysis in older adults with end-stage kidney disease (ESKD) has not been established. This study aims to investigate whether a twice-weekly dialysis schedule using an incremental approach can reduce hospitalization rates in the elderly with incident dialysis, compared with conventional thrice-weekly dialysis. Methods: We have designed a pragmatic randomized controlled trial to compare the effects of twice-weekly versus thrice-weekly hemodialysis in 428 ESKD individuals (dropout rate 20%) aged 60 years or older with residual kidney function (urine output, >500 mL/ day). The trial will be conducted across 18 referral hospital-based dialysis centers in Korea. Individual participants will be randomized to either a twice-weekly (with incremental approach) or thrice-weekly dialysis group and will be followed up for 24 months. The primary outcome of the study is all-cause hospitalization rate, while secondary outcomes include dialysis-specific hospitalization rates, mortality, quality of life, frailty, and cost-effectiveness. Participants have the flexibility to transfer to other dialysis centers as needed. The decision to increase dialysis frequency will be made by the treating physicians. The study is ongoing and will be completed in May 2026. Conclusion: This study will provide valuable insights into the benefits and risks of twice-weekly dialysis with an incremental approach in elderly with residual kidney function compared to thrice-weekly dialysis.

Association between traffic inflow and COVID-19 prevalence at the provincial level in South Korea.

OBJECTIVES: To analyze the relationship between traffic inflow and COVID-19 prevalence in South Korea for formulating prevention policies for novel infections. METHODS: We evaluated traffic inflow and new COVID-19 cases in 8 regions of Korea from January 1, 2020, to January 31, 2021. The toll collection system (TCS) traffic volume for 2019-2020 and traffic inflow trends were analyzed using independent samples t-test and nonlinear regression, respectively. The association between TCS traffic volume and new COVID-19 cases by city was analyzed using correlation analysis. RESULTS: Traffic inflow volume in 2020 decreased 3.7% from 2019. The TCS traffic inflow trend in the 8 provinces decreased during the first COVID-19 wave, gradually increased until the second wave, decreased after the second wave, and showed a sharp decrease in the third wave. There was a positive correlation between the traffic inflow volume and new cases in Busan-Gyeongnam and Jeonbuk, but not in Daegu-Gyeongbuk or Gangwon. CONCLUSIONS: A decrease in new COVID-19 cases in the regions was associated with increased traffic inflow volume. Therefore, the Korean government can establish preventive social distancing policies by identifying increases or decreases in traffic volume. These policies will also need to consider the distribution of vaccines in each area.