Search Results (585)

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

This study documents Black Wisconsinites’ birthing experiences and their proposed solutions to improve Black birthing people’s trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group program for Black birthing people (N = 25), asking about their pregnancy, birthing, and postpartum experiences and their ideas for building trust in healthcare. Using the Daughtering Method and Braun and Clarke’s method of reflexive thematic analysis, we coded the interview data and then iteratively collated the codes into themes and subthemes. Participants described experiencing medical racism, including healthcare trauma and provider bias, during pregnancy and delivery. They drew connections between those experiences and the distrust they felt toward healthcare providers and the healthcare system. They provided actionable strategies that individual providers and the healthcare system can take to build the trust of Black birthing people: employ more Black providers, listen to Black birthing people, exhibit cultural humility, engage in shared decision-making, build personal connections with patients, and spend more time with patients. This study connects Black birthing people’s experiences of medical racism to feelings of medical distrust and provides community-identified actionable suggestions to build trust and shape how we combat racial disparities in healthcare provision and health outcomes. Full article

Background: People with Parkinson’s disease (PwPD) often experience sleep disturbances and reduced physical activity. Altered sleep behavior and lower daily steps have been linked to disease severity and symptom burden. Although physical activity may influence sleep, few studies have examined the relationship between sleep parameters and daily steps in PD. This scoping review aimed to review current knowledge on sleep parameters and daily steps collected concurrently in PwPD and their potential association. Methods: A systematic search was conducted in five databases, PubMed, Web of Science, Sport Discus, Cochrane Library, and Scopus. Methodological quality was assessed using a customized quality checklist developed by Zanardi and collaborators for observational studies, based on Downs and Black’s work. Results: Out of 1421 records, five studies met the eligibility criteria and were included in the review. Four studies reported wearable-based measurements of both step count and sleep parameters, while one study reported wearable-based measurements of step count and self-reported sleep measures. Two studies examined the association between sleep parameters and step count. One study did not find any correlation between sleep and step count, whereas one study reported a positive correlation between daytime sleepiness and step count. Conclusions: This review highlighted the lack of research investigating the relationship between sleep parameters and step count as an indicator of physical activity in PwPD. Findings are inconsistent with a potential positive correlation emerging between daytime sleepiness and step count. Findings also pointed toward lower step count and reduced sleep duration in PwPD, as measured with wearable devices. Full article

The presence of hope significantly influences how youth interpret possibilities and commit to future-oriented action. This qualitative study investigates how fifteen Black emerging adults, ages eighteen to twenty-five, living in a major United States urban city on the East Coast, describe their aspirations, goal-setting strategies, and responses to personal and structural challenges. Participants were categorized as connected or disconnected based on their engagement in school, work, or training programs. Using Reflexive Thematic Analysis of interviews, the research identified key differences in agency, emotional orientation, and access to guidance between the two groups. Connected participants often described clear, structured goals supported by networks of mentorship and opportunity. Disconnected participants expressed meaningful hope, yet described fewer supports and greater uncertainty in achieving their goals. These findings highlight how consistent exposure to guidance and structured environments strengthens future orientation and internal motivation. These results deepen our understanding of how young people experience hope across diverse contexts and show that mentorship, intentional goal setting, and greater access to opportunity play a vital role in sustaining hopeful thinking during the transition to adulthood. Full article

Women disproportionately encounter negative affordances in urban environments—defined as features that severely restrict movement and impose harm. City venues are, thus, selectively permeable to women, though men face their own challenges, especially in intersectional contexts. The data in this study suggest that gender combines with ethnicity, socioeconomic status, and visible religious markers, making obstruction a shifting but nonetheless real phenomenon, much like a staircase genuinely impedes wheelchair access. Cultural context also matters: a Black woman may face one set of barriers in Paris, another in Seoul, with a Latin American woman encountering different ones in both. Building on these observations, the article argues that urban landscapes manifest gender-based political affordances—material configurations that reflect and reinforce social inequalities. As an affordance-based framework, the selective permeability model (1) draws on a well-supported theory of perception, where settings objectively present both favorable and hostile values relative to agents. The outlook (2) thereby challenges the stereotype that women’s spatial concerns are merely subjective. The position also (3) affirms that despite differences, people share bodily constraints and, hence, have largely overlapping values and experiences. The perspective accordingly avoids exaggerating divisions to the point of denying the mutual understanding that underlies empathetic norms. Full article

A growing knowledge base highlights the importance of accounting for a variety of social and structural determinants of health (SDOH) when understanding mental and behavioral health among adolescents and young adults. The objective of the current study is to examine patterns of self-reported SDOH deficits and characterize participant health indicators and social identity across classes. Data is from a cross-sectional national study of young people who were recruited through study advertisements on social media and surveyed online. Data were collected between June 2022 and October 2023. Eligibility included (1) ages 13–22 years, (2) living in the United States, and (3) proficient in English. Health indicators included suicide attempts, suicidal ideation, drug overdose, perceived likelihood of living to age 35, non-suicidal self-injury, recent alcohol use, and depression. Five classes of SDOH deficits were identified: (1) Economic Instability, (2) Low Overall SDOH Deficits, (3) High Social SDOH Deficits (adversity and discrimination), (4) High Economic SDOH Deficits, and (5) High Overall SDOH Deficits. Differences across class by health indicators and marginalized identity were found, with high proportions of gender minority and sexual minority youth in both the High Overall SDOH Deficit group and the High Social SDOH Deficit classes. Black youth were more likely to be part of the High Economic SDOH Deficits class. The findings encourage a public health approach that recognizes that improving the health of today’s young people must be connected to policies that reduce poverty, improve neighborhoods, and increase access to basic goods, services, and healthcare. Full article

People living with HIV (PLHIV) in under-resourced rural regions face intersecting social and structural barriers that intensify their vulnerability. This pilot study explored how overlapping marginalized identities and socioeconomic hardship shape experiences of discrimination among PLHIV in Southern Illinois. Twenty-two participants completed a community-informed survey that captured racial, sexual, and gender identities alongside indicators of stigma across healthcare, housing, employment, and community settings. The findings reveal that most participants experienced at least one form of discrimination, with the highest burden concentrated among those identifying as Black, Nonbinary, Gay/Lesbian, or low-income. Discrimination was particularly prevalent in healthcare and housing environments. Importantly, poverty and housing instability were not just common but appeared to amplify the experience of stigma, compounding the effects of identity-based marginalization. These results highlight the urgent need for integrated, affirming, and structurally responsive interventions tailored to the realities of multiply marginalized PLHIV in rural areas. Future research and services must consider the interplay of identity and economic precarity in order to promote equitable care and support. Full article

Proclaiming Our Roots (POR) began as an academic community-based research initiative documenting Afro-Indigenous identities and lived experiences through digital oral storytelling. Since its inception, Proclaiming Our Roots has grown into a grassroots social movement focused on self-determination, cultural reclamation, and resistance to colonial erasure. This paper explores Proclaiming Our Root’s evolution, from a research project to a grassroots social movement, analyzing how storytelling, relational accountability, and Indigenous, Black, and Afro-Indigenous governance have shaped its development. Drawing on Indigenous methodologies and grounded in Afro-Indigenous worldviews, we examine how POR mobilizes digital storytelling, community gatherings, and intergenerational dialog to give voice to Afro-Indigenous identity, build collective consciousness, and challenge dominant narratives that erase or marginalize Black, Indigenous, and Afro-Indigenous presence. Through a sharing circle involving Proclaiming Our Roots community members, advisory council members, and the research team, in this paper we identify key themes that reflect the movement’s transformative impact: Identity and Belonging, Storytelling as Decolonial Praxis, Healing, Spirituality and Collective Consciousness, and Resistance and Social Movement Building. We discuss how these themes illustrate Proclaiming Our Roots’ dual role as a site of knowledge production and political action, navigating tensions between institutional affiliation and community autonomy. By prioritizing Afro-Indigenous epistemologies and centering lived experience, POR demonstrates how academic research can be a foundation for long-term, relational, and community-led movement-building. In this paper, we want to contribute to broader discussions around the sustainability of grassroots movements, the role of storytelling in social change for Indigenous and Black Peoples, and the possibilities of decolonial knowledge production as epistemic justice. We offer a model for how academic research-initiated projects can remain accountable to the communities with whom we work, while actively participating in liberatory re-imaginings. Full article

Diabetes is one of the major non-communicable diseases whose physiological complications are linked with a higher risk of mortality amongst the adult age group of people living globally. This review article documents updated pharmacological evidence and insights into the antidiabetic mechanisms of green, black, white, oolong, and pu-erh teas via reported experimental and clinical models toward encouraging their use as a complementary nutraceutical in managing the biochemical alterations found in the onset and progression of diabetes. Peer-reviewed articles published in “PubMed”, “Google Scholar”, and “ScienceDirect” from 2010 and beyond that reported the antidiabetic, antilipidemic, and digestive enzyme inhibitory effects of the selected tea types were identified. The keywords used for the literature search comprise the common or scientific names of the tea and their corresponding bioactivity. Although teas portrayed different antidiabetic pharmacological properties linked to their bioactive components, including polyphenols, polysaccharides, and amino acids, the type of phytochemical found in each tea type depends on their processing. Green tea’s strong carbohydrate digestive enzyme inhibitory effect was linked with Ellagitannins and catechins, whereas theaflavin, a main ingredient in black tea, increases insulin sensitivity via enhancing GLUT4 translocation. Theabrownin in pu-erh tea improves FBG and lipid metabolism, while chemical components in white tea attenuate prediabetes-mediated reproductive dysfunctions by improving testicular tissue antioxidant capabilities. Based on the body of findings presented in this article, it is evident that integrating tea intake into daily food consumption routines could offer a promising practical solution to support human health and well-being against diabetes disease. Full article

The mRNA vaccine has protected humans from the Coronavirus disease 2019 (COVID-19) and has taken the lead in reversing the epidemic efficiently. However, the Centre of Disease Control (CDC) reported and raised the alarm of allergic or acute inflammatory adverse reactions after vaccination with mRNA-LNP vaccines. Meanwhile, the US Food and Drug Administration (FDA) has added four black-box warnings in the instructions for mRNA-LNP vaccines. Numerous studies have proven that the observance of side effects after vaccination is indeed positively correlated to the level of anti-PEG antibodies (IgM or IgG), which are enhanced by PEGylated preparations like LNP vaccine and environmental exposure. After literature research and review in the past two decades, it was found that the many clinical trial failures (BIND-014, RB006 fell in phase II) of PEG modified delivery system or PEGylated drug were related to the high expression of anti-PEG IgM and IgG. In the background of shooting multiple mRNA-LNP vaccines in billions of people around the world in the past three years, the level of anti-PEG antibodies in the population may have significantly increased, which brings potential risks for PEG-modified drug development and clinical safety. This review summarizes the experience of using mRNA-LNP vaccines from the mechanism of the anti-PEG antibodies generation, detection methods, clinical failure cases of PEG-containing products, harm analysis of abuse of PEGylation, and alternatives. In light of the increasing prevalence of anti-PEG antibodies in the population and the need to avoid secondary injuries, this review article holds greater significance by offering insights for drug developers. It suggests avoiding the use of PEG excipients when designing PEGylated drugs or PEG-modified nano-formulations and provides references for strategies such as utilizing PEG-free or alternative excipients. Full article

Background/Objectives: Mental disorders and diabetes-related distress (DRD) are under-addressed aspects of person-centered diabetes care. This study examines the burden of depression, anxiety, and DRD among adults with type 1 (T1D), latent autoimmune diabetes in adults (LADA), type 2 (T2D), and gestational diabetes (GD), and explores their experiences and barriers in receiving mental health services. Methods: This study uses quantitative data from the 2023/24 Diabetes, Distress, and Disparities (3D) Study, which is based at a large US medical center. The 3D Study consists of 573 adults with diabetes (51.3% with T1D or LADA, 43.5% with T2D, and 4.4% with current/past GD). Mental health assessments included the Patient Health Questionnaire-9 (depression), Generalized Anxiety Disorder-7 (anxiety), and Problem Areas in Diabetes-11 (DRD). Logistic regression was used to examine the prevalence of mental health concerns and behavioral service use. Results: Overall, 14.5% had clinically significant depression, 8.0% had anxiety, and 23.6% had elevated DRD. Symptoms of depression, anxiety, and DRD had a positive, non-linear relationship with poor glycemic control. Approximately 30% of those with clinically significant emotional health concerns did not receive any behavioral health services in the past 12 months. Black adults were less likely to receive behavioral health treatment than non-Hispanic Whites (Odds Ratio = 0.24, 95% CI: 0.07–0.77). Common reasons for not receiving behavioral health services included not knowing where to go, cost, and lack of accessible providers. Conclusions: Gaps in addressing the emotional health needs of people with diabetes persist. Healthcare systems need to integrate addressing psychosocial factors as part of person-centered diabetes care. Full article

Introduction: The health education curricula should explicitly recognize, define, and address the unique needs and health disparities faced by Black and LGBTQIA+ populations, as a means of ensuring that healthcare for these populations is both comprehensive and inclusive. Aim: To map scientific evidence and identify knowledge gaps regarding the health of Black and LGBTQIA+ populations within the global context of health education. Methods: A scoping review will be conducted following the JBI methodology. The articles will be retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, BVS, CINAHL, ERIC, Cochrane, BDTD, PQDT, EBSCO, and NDLTD. The search will be conducted without language or time restrictions. Two independent reviewers will screen the studies and extract data using a form specifically developed for this purpose. The concepts, definitions, structures, results, and applications of professional health education worldwide for the healthcare of Black and LGBTQIA+ populations will be summarized and discussed. Inclusion Criteria: Studies related to professional health training at both undergraduate and graduate levels, as well as other educational modalities that address the provision of healthcare for these populations, will be included. The results will be presented in both tabular and graphical formats, accompanied by a narrative summary. Protocol registered in the Open Science Framework (OSF). Full article

Research on fish skin artefacts’ dyeing practices among the Nivkh, Nanai, Ulchi, Udegei, Oroch, and Negidal Indigenous Peoples of the Amur River basin remains scarce. These fishing communities traditionally crafted fish skin garments, essential to their subsistence and spiritual life, adorning them with protective motifs. While artistic and cultural aspects of these belongings have been explored, their dyeing techniques remain understudied. This multidisciplinary research examines natural colourants in fish skin artefacts from international museum collections, using historical textual research, ethnographic records, Native Traditional Knowledge, and previous dye analysis by museum conservators. Findings reveal a restricted but meaningful palette of red, blue, yellow, and black colourants, sourced from plants, minerals, and organic materials. Early dyers extracted blue from indigotin-rich plants such as Polygonum tinctorium, or from Commelina communis petals. Red hues were obtained from Carthamus tinctorius petals, introduced through Silk Route trade networks, or from minerals like red ochre. Black was derived from carbon black, while riverine minerals were ground with dry fish roe diluted with water to create additional colour variations. This study first reviews fish skin use in Amur River Indigenous cultures, explores nineteenth-century dyeing materials and techniques, and finally considers broader implications for Indigenous material heritage. Full article

Background: Brazil’s Unified Health System (Sistema Único de Saúde—SUS) has played a crucial role in reducing health disparities by providing universal and free healthcare to a diverse population. However, the COVID-19 pandemic exposed significant barriers to healthcare access among vulnerable groups, particularly due to the intersection of multiple vulnerabilities. This study aimed to examine how intersectionality—specifically sex/gender, race/ethnicity, and education level—has influenced inequalities in healthcare service utilization among vulnerable populations during the COVID-19 pandemic in Brazil. Methods: This cross-sectional study is part of the “COVID-19 Social Thermometer in Brazil” project, conducted between May 2022 and October 2023 in Brazil’s state capitals and the Federal District, focusing on populations considered socially vulnerable during the pandemic. Participants were selected using sequential sampling and completed a structured questionnaire. Statistical analyses—performed using Excel, RStudio (version 4.3.2), and ArcGIS—included sociodemographic profiling, the construction of the Jeopardy Index (a measure of social vulnerability), and binary logistic regression to explore associations between Jeopardy Index and healthcare service utilization. Results: 3406 participants, the majority were men (60%), aged 30 to 59 years (65.1%), and identified as Black or Brown (72.2%). Most participants were concentrated in the Northeast (26.6%) and North (22.3%) macroregions. A high reliance on public healthcare services (SUS) was observed, particularly in the Southeast (96%). According to the Jeopardy Index, the most socially vulnerable groups—such as women, transgender individuals, Black people, and those with no formal education—were significantly more likely to rely on SUS (OR = 3.14; 95% CI: 1.34–7.35) and less likely to use private healthcare (OR = 0.07; 95% CI: 0.02–0.20), reflecting a 214% higher likelihood of SUS use and a 93% lower likelihood of private service utilization compared to the most privileged group. Conclusions: Our findings reveal that individuals experiencing intersecting social vulnerabilities face marked inequalities in healthcare access. Without SUS, these populations would likely have been excluded from essential care. Strengthening SUS and implementing inclusive public policies are critical to reducing disparities and ensuring equitable healthcare access for historically marginalized groups. Full article

This study predicts how sociodemographic trends—smaller family sizes, increased longevity, and marital patterns—could affect family care for people with dementia through 2060. By coupling dementia information from the Health and Retirement Study with a well-established kinship microsimulation model, we analyze the impact of demographic changes on the future care landscape, focusing on changes in race and gender differences in two key areas: (1) the availability of family caregivers for people with dementia, and (2) the likelihood of having a family member with dementia, among those without dementia. Our model projections suggest that future dementia cohorts will be more likely to have a living spouse than the current ones, with diminishing gender disparities due to increased male longevity. However, racial disparities will persist, particularly for Black women. The likelihood of older adults lacking spouses, children, and siblings will increase, but remain low. For potential caregivers, we predict an increased likelihood and longer duration of exposure to family members with dementia in future birth cohorts, particularly for Black individuals, potentially placing more people at risk of the adverse health and well-being outcomes associated with caregiving. Full article