Search Results (197)

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

The majority of Australians who die each year do so in an acute hospital setting and are cared for during the end of their life by a multidisciplinary team comprising nurses, medical staff, and allied health staff. Despite the range of professional disciplines that services this patient group, the experiences of the staff providing this end-of-life care is not well understood. This study sought to explore the experiences of multidisciplinary staff providing this care at an acute hospital in Sydney, Australia and to identify the barriers that affect the end-of-life care provided. Data were collected through an online survey from a multidisciplinary sample group. A combination of statistical analysis and thematic analysis was used to analyse the data with four key themes emerging. These themes included the implications for staff working in end-of-life care, communication gaps in the acute hospital setting, recognition of the dying process, and improvement of end-of-life care through further education. This study highlighted the challenges experienced by healthcare staff in the end-of-life context, with recommendations provided for increased education and training. The need for staff to receive training with a focus on end-of-life skill development, professional confidence, and preparedness for end-of-life conversations was highlighted. Full article

Introduction: Falls pose a significant health risk to older adults, with a reported prevalence of 31.6% among Saudi older adults. Medication-related falls are a preventable cause of morbidity and mortality. This study aimed to assess fall risk, evaluate knowledge of fall-risk-increasing drugs, and examine the impact of pharmacist counseling on community-dwelling older adults in Jazan, Saudi Arabia. Methods: A cross-sectional survey was conducted from December 2023 to March 2024 among 391 community-dwelling individuals aged ≥60 years in Jazan, Saudi Arabia. Fall risk was assessed using the Arabic Stay Independent screening tool, which remains unvalidated in Arabic-speaking populations. Participants answered demographic questions and reported any pharmacist counseling on medication in the past six months. Knowledge of prescription and over-the-counter fall-risk-increasing drugs was evaluated. Multivariable logistic regression and ordered probit models were used to analyze factors associated with fall risk and drug knowledge. Results: Approximately 57% of the participants were at risk of falling. Only 11.5% demonstrated good knowledge of prescription fall-risk-increasing drugs, whereas 24.6% showed good knowledge of over-the-counter fall-risk-increasing drugs. Age (OR, 1.07; 95% CI, 1.00–1.14; p = 0.05), arthritis (OR, 5.73; 95% CI, 2.51–13.06; p < 0.001), obesity (OR, 6.00; 95% CI, 2.33–15.46; p < 0.001) and diabetes (OR, 2.79; 95% CI, 1.38–5.64; p = 0.004) were associated with increased fall risk. Those who received pharmacist counseling had a greater likelihood (95% CI, 0.020–0.167; p = 0.01) of being in the very likely category of willingness to discuss medication changes. Conclusions: The findings highlight the role of pharmacist counseling and recommend improving fall prevention through medication reviews for arthritis and diabetes patients, standardized counseling protocols, and implementation of the Stay Independent screening tool for risk assessment in older adults. Full article

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support needs following treatment at a UK hospital and explore how and when TYAs prefer to receive support. This study involved two phases: Phase 1 involved semi-structured interviews with 16 TYAs, 1–6 years post-treatment, aged 16–25 years at time of treatment completion and examined their experiences of support services, and preferences for future care. Phase 2 consisted of co-design workshops with eight TYAs and feedback from five healthcare/allied professionals (HCAPs) to refine and develop recommendations. Phase 1 findings revealed six key themes: (1) survivorship as disrupted continuity; (2) negotiating legitimacy and relational safety in help seeking; (3) support offered vs. support sought: pathways of referral and self-initiation; (4) emotional readiness as context dependent and non-linear; (5) support as an ecosystem, not a moment; and (6) personalised autonomy in support engagement. Phase 2 findings informed recommendations that emphasise the importance of flexible, personalised, and accessible post-treatment support, with pathways of care/support that can adapt to TYAs changing needs and preferences over time. Full article

We pilot-tested movement breaks lasting < 1 min at the University of Southern Denmark (SDU) with an initiative called PauseNørd. Our mixed-methods feasibility study explored the acceptability, practicality, expansion, and limited efficacy of the PauseNørd breaks (PN breaks) via observation, questionnaires, and short interviews. Three groups of students tested lectures with and without the PN breaks. The PN breaks were well accepted by students and lecturers, and they were practically easy to implement. Suggestions to improve practicality related to timing and frequency. Potential barriers to expansion were identified in relation to student familiarity with exercise and lecturer comfort in leading the breaks. Preliminary data on effectiveness indicated that the PN breaks could support alertness, concentration, enjoyment, motivation, positive mood, and the social interactions within the class. The learning from the pilot study will be used to inform future PN research. Full article

Background/Objectives: Type 2 diabetes (T2D) prevalence is rising worldwide. Despite numerous efforts to address the condition, many initiatives fall short due to limited consumer engagement. Involving people with lived experience in healthcare design is increasingly recognized as an effective strategy for improving diabetes management. Aim: To understand the unmet needs of people with T2D in self-managing their condition through the establishment of a Consumer Reference Group (CRG). Methods: The CRG was established using a standardized approach advised by Monash Partners, with specific terms of reference for consumer engagement. A face-to-face training workshop was conducted to develop consumers’ capacity to co-design T2D interventions. Two focus groups were held to explore consumers’ unmet needs and propose potential solutions. An inductive thematic analysis was performed. Results: Ten adults (three females/seven males; 58–78 years old) with T2D participated. Four main themes emerged: (1) misinformation; (2) limited guidance; (3) challenges in self-management; and (4) gaps in prevention and screening. Participants reported difficulties in maintaining motivation, balancing T2D management with other life commitments, and addressing mental health concerns. They reported feeling misinformed and inadequately supported by healthcare professionals and diabetes organizations, often relying on conflicting sources of information. Participants from culturally and linguistically diverse (CALD) backgrounds noted a lack of tailored dietary information. Proposed solutions included better training for primary care providers, reinforcing the role of diabetes nurse educators, expanding mental health support, and collaborating with CALD communities to provide culturally appropriate dietary information. Conclusions: These insights are critical for developing consumer-driven interventions that are responsive to the real-world needs of people living with T2D. Full article

Background/Objectives: The prevalence of obesity is high among children living with disability. The present study aimed to examine the perceptions of parents and caregivers of children living with disability regarding children’s energy balance related behaviors (EBRBs) and their determinants. Methods: Parents/caregivers of children living with disability (n = 45) from Thessaly, Crete and Attica Regions of Greece, participated in semi-structured interviews between November and December 2023. The interviews were recorded, transcribed and transferred to N-VIVO software. The results were analyzed according to the framework of the socio-ecological model, using deductive thematic analysis. Results: Parents/caregivers reported that eating habits of children living with disability and their physical activity levels were poorer compared to the general population. At an individual level, certain disabilities may affect children’s food preferences and parents’ ability to prepare healthy foods. At a familial level, financial difficulties may influence healthy eating, whereas some parents/caregivers act as children’s role models to encourage them to be physically active. Home food environments may also influence children’s eating patterns and peer influence on their EBRBs. At a community level, lack of trained personnel, available amenities/equipment and food education initiatives and the availability of unhealthy foods in school canteens were described as major barriers to healthy EBRBs. At an organizational level, lack of accessible/safe facilities, the marginalization/stigma that children living with disability may experience and lack of dietitians/nutritionists in health centers were named as the main factors influencing children’s EBRBs. Conclusions: The findings of this study highlight the importance of designing multi-sectoral policy interventions to promote healthy EBRBs and tackle obesity in children living with disability in Greece. Full article

There has been a growing interest globally in vegan and vegetarian diets over the last decade for a combination of health, ethical, environmental, spiritual, and social reasons. In line with this popularity, research examining the role of plant-based food sources, including vegan and vegetarian diets, in supporting skeletal muscle remodeling and anabolism in humans has also received considerable attention. The emergence of the microbiota-gut–muscle axis, a bidirectional pathway where the gut microbiota impacts skeletal muscle and vice versa, has been suggested as a potential mediator of food and nutrition’s influence on the mechanistic processes that regulate muscle mass and function. Considering inherent nutritional differences between vegan, vegetarian, and omnivorous diets related to the fiber and macronutrient content, presence of anti-nutritional factors, and diverse food and supplemental sources for obtaining protein, it stands to reason that the regulation of the microbiota–gut–muscle axis via diet-induced changes in gut microbiota composition and function may be dissimilar. However, whether this translates into differential effects on the skeletal muscle is unclear. This review article aims to provide a contemporary perspective for how variations in gut microbiota linked to vegan, vegetarian, and omnivorous diets may be a potential mechanism for influencing protein metabolism in skeletal muscle mass via a purported microbiota-gut–muscle axis. Full article

Aim: Mobile health (mHealth) applications have been reported to be effective in improving glycaemic control and cardiometabolic health, but mainly as part of shorter-term intervention studies. The aim of this study is to examine the effect of the ongoing Defeat Diabetes mHealth low-carbohydrate diet (LCD) intervention on clinical markers and cardiometabolic risk after 6 months of intervention. Methods: Data were collected via primary care physicians as part of routine T2D monitoring. These included HbA1c (primary outcome), blood pressure, blood lipids, and markers of kidney and liver function. Anthropometrics, as well as changes in the prescription of diabetes, hypertension, and dyslipidaemia medication, were also recorded. Calculated variables, total cholesterol to HDL-c, triglyceride to HDL-c, and waist to height ratios, were analysed to examine changes in cardiometabolic risk profile. Three-day food records were used to assess dietary intake and intervention adherence. Univariate regression models examined changes from baseline to 6 months. Results: Ninety-four participants remained in the study out of the ninety-nine at baseline (mean age 59 ± 11 years, 55 females). After 6 months of intervention, there were significant reductions in HbA1c by −1.0% (95% CI: −1.3 to −0.6), as well as in the liver enzymes ALT (−9.3 U/L 95% CI −16.3 to −2.4) and GGT (−18.8 U/L 95% CI: −31.4 to −6.3) across the cohort. In addition, there was a significant reduction in cardiometabolic risk, as measured by the calculated variables and a decrease in waist circumference (−4.6 cm 95% CI: −8.9 to −0.2). Conclusions: People with T2D receiving LCD education and resources through the Defeat Diabetes mHealth app (version 3.3.8) improved their glycaemic control after 6 months of intervention. Cardiometabolic risk profile and liver function also showed significant improvement. These findings indicate that the use of an LCD digital app is a valuable adjunct in the management of T2D. Full article

Background/Objectives: The study had two objectives: first, to assess the intra- and inter-day reliability of a novel eye tracking device (EyeGuide Focus) in healthy adults; and second, to explore its applicability in measuring fatigue associated with physical strain, pre- and post-rugby match. These objectives were investigated in a two-part study. Methods: For Part A, 20 healthy participants (M_age ± SD = 30 ± 7 years) completed morning and afternoon testing with the EyeGuide Focus over two consecutive days (Day 1 and Day 2) and one day a week later (Day 8). For Part B, 12 female participants (M_age ± SD = 25 ± 5 years) completed EyeGuide Focus measurements pre- and post-rugby union match. Results: The results indicate moderate-to-high intra-day and inter-day reliability (ICCs 0.58–0.79). Fatigue induced by a rugby union match did not significantly alter EyeGuide Focus scores (p > 0.05), suggesting stability in measurements despite physical exertion. Conclusions: The sensitivity of the EyeGuide Focus to minor variations in fatigue warrants further investigation as a tool to aid monitoring and performance. Full article

Background: A Mediterranean-style dietary pattern (MDP) is embedded across coronary heart disease (CHD) and type 2 diabetes (T2D) clinical guidelines. However, MDP evidence has not consistently been translated into practice. This study aimed to develop, integrate and evaluate implementation strategies to support clinicians in translating MDP evidence into routine care for CHD and T2D in the local context of a public health service. Methods: This study documents the implementation and evaluation phases of a broader knowledge translation project guided by the Knowledge-to-Action cycle. Multi-disciplinary clinicians in the cardiology and diabetes services of two large metropolitan hospitals and a post-acute community service were targeted. Strategies were prioritised utilising theory and stakeholder engagement and included facilitation, building a coalition, the engagement of clinical champions and local opinion leaders, educational meetings, consensus discussions, sharing local knowledge, consumer consultation, and the development and distribution of education materials. Surveys were conducted with clinicians and patients of targeted services to evaluate the reach, acceptability, feasibility, adoption and perceived sustainability of MDP in practice. Results: In total, 57 clinicians (7 dietitians, 29 nurses/diabetes educators, 15 doctors and 6 other allied health professionals) and 55 patients completed post-implementation evaluation surveys. The majority of clinicians agreed an MDP is appropriate to recommend in their clinical setting (95%), and most of the time/always their advice (85%) aligns. Education sessions were attended by 65% of clinicians, of which the majority indicated improved knowledge (100%) and change in practice (86%). Factors deemed most important to maintaining an MDP approach in practice were hard-copy education materials (85%) and access to a dietitian (62%). Of the patients who had received care from a dietitian of targeted services (n = 32, 58%), 100% recalled having discussed ≥1 MDP topic and 89% received education material. Of the patients who had received dietary advice from non-dietetic clinicians (n = 33, 60%), 67% recalled having discussed ≥1 MDP topic and 70% received education material. Conclusions: Targeted and theory-informed implementation reached the majority of surveyed clinicians and patients, and positively influenced the adoption, acceptability and feasibility of an MDP approach in routine care. Ongoing sustainability strategies are crucial with rotating clinician roles. Full article

Background: This study aimed to evaluate the impact of different set volumes and durations of isometric conditioning activity (ICA) (a single 9 s set vs. three 9 s sets, totaling 27 s) on countermovement jump (CMJ) performance in highly trained male volleyball players. Understanding these effects is essential for optimizing warm-up protocols, particularly before competitions or high-intensity training sessions, to maximize performance outcomes. Methods: The 14 participants completed three conditions: one set of ICA (9 s) and three sets of ICA (27 s), each involving maximal isometric contractions in the half-back squat position, as well as a control condition without ICA. Approximately 3 min pre-ICA and at 3, 6, and 9 min post-ICA, the CMJ performance was assessed. Results: The results showed a significant interaction between CMJ height (p = 0.002) and relative peak power (p = 0.004) with the three-set condition. Post hoc comparisons indicated a significant increase in CMJ height at 3 min (p = 0.018; effect size [ES]: 0.868) and 6 min (p = 0.044; ES: 0.808), and a relative peak power output at 3 min (p = 0.005; ES: 0.874) and 6 min (p = 0.034; ES: 0.745) post-ICA compared to pre-ICA. No significant interactions or main effects were found for the modified reactive strength index or CMJ contraction time. Conclusions: The findings suggest that a three-set ICA with a total duration of 27 s may acutely improve CMJ height and relative peak power output in highly trained volleyball players. Full article

Age-related hearing loss is becoming more prevalent as the aging population continues to rise worldwide. Left untreated, hearing loss is a significantly under-reported concern that negatively impacts quality of life including mental health, cognition, and healthcare communication. Since many older adults may not report hearing concerns to their primary physicians, allied healthcare providers (AHPs) have an important role in recognizing communication challenges due to potential hearing loss, screening for hearing issues, and making referrals as needed. Moreover, AHPs may need to address hearing loss, at least temporarily, to provide their services when communication problems are present. The purpose of this study was to examine knowledge and practice patterns of AHPs regarding hearing loss among their patients. Results of a national survey indicated that many AHPs understand the negative implications of unaddressed hearing loss and the importance of hearing screening, but they are unsure of who, when, and how to address it. Consequently, immediate and innovative solutions are offered to AHPs to enhance communication with patients who might have unaddressed hearing loss. Moreover, findings can be used to develop training and policies to ensure that professionals are well positioned to address the complex needs of individuals with unaddressed hearing loss. Full article

Background/Objectives: Chronic pain is common following a stroke and is associated with increased disability. Yet, little is known about the chronic pain experience in the stroke population. This study aimed to identify and explore the features and neuropathic symptoms of chronic pain in individuals with longstanding stroke. Methods: This observational study utilized an online survey that was developed for individuals who have had a stroke (>3 months). Data sought included participant demographics, medical history, and details of the stroke(s). Participants who reported experiencing chronic pain completed the Numerical Rating Scale for Pain, the Neuropathic Pain Symptom Inventory, and body maps to indicate region(s) of pain. Results: A total of 533 individuals with longstanding stroke participated. Chronic pain was reported as being experienced by 60% of participants and was more frequently experienced by individuals who reported being female (p = 0.002). Moderate or severe pain intensity was commonly reported (mean = 5.98, SD = 1.89). Individuals with chronic pain post-stroke reported a range of neuropathic symptoms rather than a common pain experience, with combinations of spontaneous, paroxysmal, and evoked pains in addition to pain associated with paraesthesia/dysaesthesia. Pain involving the upper limb was the most common region (shoulder 39%, hand and forearm 38%), followed by the lower limb (foot 30%, leg 29%). Having multiple strokes was associated with a higher frequency of chronic pain (p = 0.01), as was peripheral vascular disease (p < 0.001) and lipid disorders (p = 0.001). Conclusions: These findings highlight the varied nature of chronic pain experienced by individuals following a stroke, while also detailing stroke and medical history associated with chronic pain. It builds on existing knowledge of chronic pain post-stroke and provides new insight into the neuropathic symptoms experienced. This knowledge has the potential to assist in the development of tailored interventions based on addressing pain symptomatology and health literacy. Full article