Search Results (64)

Agrarian women are at the forefront of rural livelihoods increasingly affected by the frequency and severity of climate change impacts. However, their household livelihood resilience (HLR) remains limited due to gender-blind policies, scarce sex-disaggregated data, and inadequate consideration of gender-specific needs in resilience-building efforts. Grounded in participatory feminist research, this study employed a multi-method qualitative approach, including semi-structured interviews and oral history narratives, with 60 women in two climate-vulnerable provinces. Data were analyzed through thematic coding, CATWOE (Customers, Actors, Transformation, Worldview, Owners, Environmental Constraints) analysis, and descriptive statistics. The findings identify nine major climate-related events disrupting livelihoods and reveal a limited understanding of HLR as a long-term, transformative concept. Adaptation strategies remain short-term and focused on immediate survival. Barriers to HLR include financial constraints, limited access to agricultural resources and technology, and entrenched gender norms restricting women’s leadership and decision-making. While local governments, women’s associations, and community networks provide some support, gaps in accessibility and adequacy persist. Participants expressed the need for financial assistance, vocational training, agricultural technologies, and stronger peer networks. Strengthening HLR among agrarian women requires gender-sensitive policies, investment in local support systems, and community-led initiatives. Empowering agrarian women as agents of change is critical for fostering resilient rural livelihoods and achieving inclusive, sustainable development. Full article

Background/Objectives: Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) constitute effective strategies to combat the increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) implemented various elements of AMC surveillance and AMS to different extents. The limited quantity and quality of data from post-Soviet countries make it difficult to assess health system performance; therefore, this region is a blind spot in global AMR monitoring. This systematic review assesses and characterises AMC surveillance and AMS implementation in post-Soviet countries. Methods: Evidence was compiled via a search in PubMed, Google Scholar, Embase, CyberLeninka, and Scopus. The eligibility criteria included AMC surveillance- and AMS-related papers in human health within defined regions and timelines. Some literature from the official websites of international and national health organisations was included in the search. Results: As a result of the searches, screening, and critical appraisal, three peer-reviewed publications and 31 documents were selected for analysis. Eleven out of fifteen countries with updated national action plans for combating antimicrobial resistance have defined AMC surveillance and AMS as strategic objectives. All 15 examined countries submitted antimicrobial consumption data to international networks and reported the existence of approved laws and regulations on antibiotic sales. However, disparities exist in the complexity of monitoring systems and AMS implementation between high-income and low-income countries in the region. Conclusions: This review provides key insights into the existing AMC surveillance and AMS implementation in former Soviet countries. Although the approach of this review lacks quantitative comparability, it provides a comprehensive qualitative framework for national-level AMC surveillance and AMS system assessment. Full article

Wipe-out is defined as a sudden, unexplained, and irreversible loss of residual central vision following glaucoma surgery, typically in eyes with advanced visual field damage and severely compromised optic nerves. The purpose of this review is to critically assess the current incidence, risk factors, pathophysiological mechanisms, and clinical relevance of “wipe-out”, a rare but devastating complication of glaucoma surgery characterized by sudden, unexplained central vision loss postoperatively. A comprehensive literature review was conducted, analyzing key peer-reviewed studies from electronic databases (PubMed, Medline, and Google Scholar) published up to 2025. The data from the literature published prior to the year 2000 suggest that wipe-out incidences range broadly from <1% to 13%. Contemporary prospective studies and large-scale reviews indicate a significantly lower current incidence, frequently below 1%. Identified risk factors include severe preoperative visual field loss (especially split fixation), older age, immediate postoperative hypotony, and compromised optic nerve head perfusion. The proposed mechanisms involve acute vascular insults, ischemia–reperfusion injury, and accelerated apoptosis of already vulnerable retinal ganglion cells. Modern MIGS and refined trabeculectomy techniques exhibit notably lower wipe-out risks compared to historical data. The literature emphasizes preventive management, including careful patient selection, incremental intraocular pressure reduction, and minimally invasive anesthetic approaches. Although wipe-out syndrome represents a serious complication, its incidence in modern glaucoma surgery is minimal. The considerable benefits of contemporary surgical approaches—particularly MIGS—in preserving vision clearly outweigh this very low risk. Ophthalmologists should remain vigilant but confident in the safety and efficacy of modern glaucoma surgical techniques, emphasizing proactive intervention to prevent blindness rather than avoiding necessary surgery in consideration of the minimal risk of wipe-out. Full article

Ensuring mathematics education for all learners, including students with blindness learning in mainstream classrooms, is crucial. This exploratory research aims to clarify the characteristics of geometric learning among students with blindness and to identify the factors contributing to the challenges faced by this population. The Van Hiele theory of geometric thought served as a reference framework. Qualitative data were gathered through group interviews with specialists in the field of education for students with blindness and analyzed using inductive analysis. Participants affirmed that students with blindness progress through Van Hiele levels of geometric thought in a manner similar to sighted students, suggesting that much of the learning can take place alongside sighted peers in mainstream classrooms. However, they also highlighted the unique challenges these students face in reaching level 0, a level where students recognize shapes without a formal understanding of their properties or attributes. Among the reasons for these challenges were that for these particular students, subskills, such as bimanual exploration, hand coordination, and cognitive integration, are required to reach level 0. The study also identified the necessity for specialists in visual impairment education to guide students using appropriate tasks and learning materials that reflect the characteristics of haptic perception. Since level 0 serves as a gateway to both basic and advanced geometry, the findings underscore the importance of providing differentiated support that targets these subskills early in students’ schooling. To ensure meaningful geometry instruction, mainstream teachers are encouraged to collaborate with specialists in visual impairment education, who can guide the selection of appropriate learning tools and support the development of the subskills. Full article

Objective: The purpose of this review is to examine the potential role of donanemab-azbt in the treatment and management of early-stage Alzheimer’s disease (AD), with a focus on its efficacy, safety, and clinical relevance based on data from key clinical trials. Data Sources: A comprehensive literature search of PubMed was conducted using relevant keywords such as “donanemab”, “Alzheimer’s disease”, “Kisunla”, “TRAILBLAZER clinical trials”, and “amyloid-related imaging abnormalities (ARIA)”. Additional data were extracted from clinical trial records (clinicaltrials.gov), conference abstracts, and product monographs. Study Selection and Data Extraction: Only English-language studies conducted in human populations were included. Clinical trials and peer-reviewed studies detailing the efficacy, safety, and mechanistic insights of donanemab-azbt were prioritized. Data Synthesis: Key findings from the TRAILBLAZER series of clinical trials highlighted the potential of donanemab-azbt in slowing cognitive and functional decline in early-stage AD: (1) TRAILBLAZER-ALZ (Phase 2): This trial focused on participants with intermediate levels of tau protein. Results demonstrated a statistically significant slowing of cognitive and functional decline. (2) TRAILBLAZER-ALZ 2 (Phase 3): A large-scale, randomized, double-blind, placebo-controlled study confirmed the efficacy of donanemab-azbt in reducing amyloid plaque accumulation and cognitive decline. Key results included a 35% slowing of decline on the Integrated Alzheimer’s Disease Rating Scale (iADRS) and a 36% slowing on the Clinical Dementia Rating-Sum of Boxes (CDR-SB). Additional secondary outcomes showed improvements in activities of daily living and reduced risk of disease progression. (3) TRAILBLAZER-ALZ 3: This ongoing trial is evaluating donanemab’s potential in delaying or preventing Alois Alzheimer in cognitively normal individuals with amyloid plaques, broadening the scope of early intervention strategies. (4) TRAILBLAZER-ALZ 4: A head-to-head comparison with aducanumab revealed superior amyloid plaque clearance with donanemab. (5) TRAILBLAZER-ALZ 5: Currently recruiting, this trial aims to evaluate safety and efficacy across diverse populations with varying tau levels and comorbidities. (6) TRAILBLAZER-ALZ 6 (Phase 3b): This trial investigates modified dosing regimens to reduce ARIA while maintaining efficacy, particularly in populations with genetic risk factors like ApoE ε4 homozygotes. Relevance to Patient Care and Clinical Practice: Donanemab-azbt represents a promising treatment option for patients with early-stage AD. It specifically targets and reduces amyloid beta plaques, a hallmark of the disease, potentially slowing progression and preserving cognitive function. However, its administration requires careful patient selection, including genetic testing for ApoE ε4 status, to mitigate risks of ARIA. Furthermore, the findings emphasize the importance of close monitoring during treatment. Conclusions: Donanemab-azbt offers a new avenue for managing early-stage AD, showing promise in reducing amyloid burden and slowing cognitive decline. While its efficacy and safety have been demonstrated in clinical trials, further research is essential to validate long-term outcomes, assess effectiveness across diverse populations, and refine dosing strategies to minimize side effects. With continued investigation, donanemab-azbt could significantly impact the clinical landscape of AD treatment. Full article

Background: Onchocerciasis, or river blindness, is one of the neglected tropical diseases (NTDs) that the WHO has set out to eliminate. To reach this elimination target, a number of challenges must be met, and the essential measures set out in the road map for NTDs 2021–2030 must be implemented. More than 99% of infected people live in 31 countries in sub-Saharan Africa. Our objective was to assess the impact of onchocerciasis interventions in Africa. Methodology: A systematic peer review of the existing literature following the PRISMA guidelines was performed between November 2021 and April 2022. We selected studies on onchocerciasis control measures in Africa since the implementation of the first Onchocerciasis Control Programme (OCP) measures in 1974. All scientific articles indexed in the PubMed, Scopus, Embase, and CENTRAL databases written in Spanish, English, French, German, and Portuguese were considered. The study protocol was registered in the PROSPERO database. Results: A total of 63 articles met the inclusion criteria and were finally selected. Publications were found from 19 out of 31 African endemic countries. The main intervention retained in the different published studies was mass distribution of ivermectin (n = 51). According to our results, 11 African countries have managed to interrupt transmission of onchocerciasis in at least one area in the country; 11 countries have not achieved this goal, while 1 country has managed to eliminate the disease, but it has resurged. Conclusions: Control interventions showed a positive impact on the fight against onchocerciasis, demonstrating that these activities are effective. Nevertheless, they were not sufficient to achieve the proposed goals for a variety of reasons. Therefore, different aspects should be considered in order to fulfil the targets proposed by the WHO to be reached in 2030. Full article

Background: If left untreated, glaucoma—the second most common cause of blindness worldwide—causes irreversible visual loss due to a gradual neurodegeneration of the retinal ganglion cells. Conventional techniques for identifying glaucoma, like optical coherence tomography (OCT) and visual field exams, are frequently laborious and dependent on subjective interpretation. Through the fast and accurate analysis of massive amounts of imaging data, artificial intelligence (AI), in particular machine learning (ML) and deep learning (DL), has emerged as a promising method to improve the early detection and management of glaucoma. Aims: The purpose of this study is to examine the current uses of AI in the early diagnosis, treatment, and detection of glaucoma while highlighting the advantages and drawbacks of different AI models and algorithms. In addition, it aims to determine how AI technologies might transform glaucoma treatment and suggest future lines of inquiry for this area of study. Methods: A thorough search of databases, including Web of Science, PubMed, and Scopus, was carried out to find pertinent papers released until August 2024. The inclusion criteria were limited to research published in English in peer-reviewed publications that used AI, ML, or DL to diagnose or treat glaucoma in human subjects. Articles were chosen and vetted according to their quality, contribution to the field, and relevancy. Results: Convolutional neural networks (CNNs) and other deep learning algorithms are among the AI models included in this paper that have been shown to have excellent sensitivity and specificity in identifying glaucomatous alterations in fundus photos, OCT scans, and visual field tests. By automating standard screening procedures, these models have demonstrated promise in distinguishing between glaucomatous and healthy eyes, forecasting the course of the disease, and possibly lessening the workload of physicians. Nonetheless, several significant obstacles remain, such as the requirement for various training datasets, outside validation, decision-making transparency, and handling moral and legal issues. Conclusions: Artificial intelligence (AI) holds great promise for improving the diagnosis and treatment of glaucoma by facilitating prompt and precise interpretation of imaging data and assisting in clinical decision making. To guarantee wider accessibility and better patient results, future research should create strong generalizable AI models validated in various populations, address ethical and legal matters, and incorporate AI into clinical practice. Full article

Ensuring equitable educational opportunities for blind and visually impaired (BVI) students in Saudi Arabian higher education remains challenging despite legislative and institutional efforts. This paper proposes a system to assist BVI students independently during exams, aiming to create an inclusive exam environment that minimizes distractions and facilitates their participation alongside peers. Key contributions include the development of a secure platform, ensuring exam confidentiality, and fostering confidence and active engagement among BVI individuals. The study highlights the importance of integrating innovative assistive technologies and implementing rigorous policies to overcome systemic barriers and improve support mechanisms for BVI students in educational settings. Full article

Background: The proportion of the population aged 65 years or older is increasing. Typically, physical activity and health decline with age, which is why action to promote active ageing is a major public health priority, particularly due to health inequalities in older adults. The aim of this study is to assess the effectiveness and cost-effectiveness of the Walk with Me peer-led walking intervention for older adults. Methods: This study is a two-arm, assessor-blind, randomised controlled trial. The intervention is a 12-week peer-led walking intervention based on social cognitive theory. Participants in the control group will receive information on active ageing and healthy nutrition. The study will target 348 community-dwelling older adults, aged 60 years or over living in areas of socio-economic disadvantage communities. Trained peer mentors will deliver the intervention. The primary outcome will be a mean between-group change in moderate-to-vigorous physical activity at 12 months from baseline, measured using an Actigraph accelerometer. Secondary outcomes will include quality of life, mental wellbeing, blood pressure, BMI and waist circumference. An embedded process evaluation will involve focus groups and participant diaries. Discussion: Evidence-based, cost-effective interventions to promote physical activity in older adults living in socio-economically disadvantaged communities are needed to address health inequalities. Full article

In recent years, postbiotics have increased in popularity, but the potential relevancy of postbiotics for augmenting exercise performance, recovery, and health is underexplored. A systematic literature search of Google Scholar and PubMed databases was performed with the main objective being to identify and summarize the current body of scientific literature on postbiotic supplementation and outcomes related to exercise performance and recovery. Inclusion criteria for this systematic review consisted of peer-reviewed, randomized, double-blind, and placebo-controlled trials, with a population including healthy men or women >18 years of age. Studies required the incorporation of a postbiotic supplementation regimen and an outcome linked to exercise. Search terms included paraprobiotics, Tyndallized probiotics, ghost biotics, heat-killed probiotics, inactivated probiotics, nonviable probiotics, exercise, exercise performance, and recovery. Only investigations written in English were considered. Nine peer-reviewed manuscripts and two published abstracts from conference proceedings were included and reviewed. Supplementation periods ranged from 13 days to 12 weeks. A total of 477 subjects participated in the studies (n = 16–105/study) with reported results spanning a variety of exercise outcomes including exercise performance, recovery of lost strength, body composition, perceptual fatigue and soreness, daily logs of physical conditions, changes in mood states, and biomarkers associated with muscle damage, inflammation, immune modulation, and oxidative stress. Early evidence has provided some indication that postbiotic supplementation may help to support mood, reduce fatigue, and increase the readiness of athletes across several weeks of exercise training. However, more research is needed to further understand how postbiotics may augment health, resiliency, performance, and recovery. Future investigations should include longer supplementation periods spanning a wider variety of competitive athletes and exercising populations. Full article

(1) Background: The COVID-19 pandemic has generated 771 million confirmed cases. Of these patients, 60% have developed persistent symptoms including pain. This pain is a complex symptom that needs comprehensive therapeutic strategies to address it holistically. The main objective of this study will be to evaluate the early impact of the Pain Informed Movement (PIM) program in patients with post-COVID-19 conditions experiencing new-onset persistent pain. (2) Methods: A randomized, single-blind clinical trial will be performed. Patients will be randomly assigned (1:1) to the experimental or control group. The experimental group will undergo a PIM program consisting of low-intensity functional exercises, pain neuroscience education, and relaxation techniques. The control group will receive no intervention. (3) Results: The results will be published as a peer-reviewed article. (4) Conclusions: This study will provide a basis for future research to support the implementation of comprehensive therapeutic approaches in the care of patients with post-COVID-19 persistent pain. Full article

The aim of this study was to assess the effects of guayusa extract and Nordic Lion’s Mane (LM) on cognition. Using a randomized, double-blind, placebo-controlled, crossover design, we examined the effects of a single dose of 650 mg guayusa extract (AMT: AmaTea^® Max) vs. 1 g Nordic-grown Lion’s Mane (LM) vs. placebo (PL). Participants attended three testing visits consisting of neuropsychological tests (Go/No-go, N-Back, and Serial 7 s tasks) assessing performance, subjective assessments of cognitive perception, and vital signs. Each assessment was measured at baseline (pre-ingestion) and 1 and 2 h post ingestion. AMT significantly (p ≤ 0.05) improved the number of attempts during Serial 7s, total score, number of correct responses, total number of responses, and reaction time during N-Back and improved Go stimulus reaction time, but it reduced the percentage of correct responses in the No-go stimulus response during Go/No-go. LM significantly (p ≤ 0.05) improved the number of attempts during Serial 7s and reaction time during N-Back and improved Go stimulus reaction time in Go/No-go. AMT improved mental clarity, focus, concentration, mood, and productivity at 1 and 2 h (p < 0.05); the ability to tolerate stress at 1 h; and had greater ratings than LM and PL for mental clarity, focus, concentration, and productivity. PL improved focus and concentration at 1 h from baseline (p ≤ 0.05). AMT and LM improved subjective ratings of “happiness compared to peers” and “getting the most out of everything” (p < 0.05); however, this occurred earlier in LM (i.e., 1 h post ingestion). AMT uniquely elevated blood pressure from baseline. AMT significantly improved cognitive performance and self-perceived cognitive indices of affect over a 2 h period and perceptions of happiness 2 h post ingestion. In comparison, LM helped improve working memory, complex attention, and reaction time 2 h post ingestion and perceptions of happiness over a 2 h period. Full article

Alcohol is the recreational drug most frequently consumed, and its high frequency of use can lead to worsening social, psychological, and domestic issues. The age group most susceptible to alcohol dependence is 18- to 24-year-old youths, demanding interventional tools to target early involvement risks. Ayahuasca seems to be a promising therapeutic tool since evidence suggests it presents potential for the treatment of depression, anxiety, and substance abuse, among other disorders. This study aimed to analyze subjective reports of university students with harmful alcohol use participating in a single-blind study evaluating the effects of one ayahuasca dose (1 mL/kg). Twenty-one days after ayahuasca administration, semi-structured interviews were conducted (n = 6) to identify peer psychological elements linked to its therapeutic potential. Subsequently, content analysis methodology was employed to define the main categories: Self-perception of experience, Positive Impacts (PI), Substances Use Pattern (SUP), Insights (I), Visual Effects, Transient Derealization, and Sleep Pattern. Among these, the most pertinent categories for this study were PI, SUP, and I, as, together, they suggest a potential link between insights and/or positive emotions and reduced alcohol consumption due to their internal transformation potential, which could be linked to a decrease in consumption. Full article

Homes in which families are experiencing stressful and challenging circumstances can foster a social space that engenders violent behaviours in parents, inadequate childcare, and the exposure of children to criminal and antisocial behaviours at an early age in addition to many other negative social and health consequences throughout their development. Family Skills Training offers a combination of parenting knowledge, skill building, competency enhancement, and support to strengthen family protective factors, such as communication, trust, problem-solving skills, and conflict resolution. Through over a decade-long experience piloting evidence-based family skills packages globally, we developed a universal open-source family skills package, “Family UNited” (FU), designed for families with children aged 8 to 15 years living in low- and middle-income countries (LMIC). The current study aims to explore the efficacy, fidelity, and acceptability of FU in Trentino and Parma, Italy. We plan to conduct a multi-site, non-blinded, two-armed, cluster-randomised controlled trial to assess efficacy in 160 families: the intervention group receiving FU and the waitlist/control group only receiving FU after the completion of all data collection points. We will prospectively collect outcome data, assessing changes in parenting skills and family adjustment in caregivers, children’s behaviour, resilience capacities, and attitudes towards peer violence. To assess programme delivery, fidelity, feasibility, and acceptability we will include an embedded process evaluation. This study aims to evaluate the improvement in parenting skills, child well-being, and family mental health after participation in FU, compared to no intervention. Even though this trial is to be conducted in a high-income country, such results complement the existing piloting experience in LMIC. with impact-related measures encouraging the adoption of such approaches globally and beyond the EU borders. Full article

A high incidence and prevalence of neurodegenerative diseases and neurodevelopmental disorders justify the necessity of well-defined criteria for diagnosing these pathologies from brain imaging findings. No easy-to-apply quantitative markers of abnormal brain development and ageing are available. We aim to find the characteristic features of non-pathological development and degeneration in distinct brain structures and to work out a precise descriptive model of brain morphometry in age groups. We will use four biomedical databases to acquire original peer-reviewed publications on brain structural changes occurring throughout the human life-span. Selected publications will be uploaded to Covidence systematic review software for automatic deduplication and blinded screening. Afterwards, we will manually review the titles, abstracts, and full texts to identify the papers matching eligibility criteria. The relevant data will be extracted to a ‘Summary of findings’ table. This will allow us to calculate the annual rate of change in the volume or thickness of brain structures and to model the lifelong dynamics in the morphometry data. Finally, we will adjust the loss of weight/thickness in specific brain areas to the total intracranial volume. The systematic review will synthesise knowledge on structural brain change across the life-span. Full article