Search Results (7,395)

School-based health centers (SBHCs) provide accessible, comprehensive healthcare to students, particularly in underserved communities, and play a critical role in addressing reproductive health needs. Despite their benefits, the availability of SBHCs remains limited across the U.S., with ongoing debates regarding their role in educational settings, especially concerning reproductive health services. This study assessed public opinion regarding reproductive health services in SBHCs within middle and high schools in Duval County, Florida. A representative sample of 605 adults was surveyed using a Random-Digit-Dialing approach, and data were weighted for analysis. Overall, support for reproductive health services was high, with 68–74% of respondents in high school and 49–57% in middle school favoring services such as STI testing and treatment, pregnancy testing, and providing condoms. Significant differences in support levels are noted across demographic groups, particularly by age and race. The findings indicate strong community support for implementing reproductive health services in SBHCs, highlighting their potential to improve access to essential health services for adolescents. This research provides valuable insights for policymakers to advocate for the expansion of SBHCs to include comprehensive reproductive health services, addressing health disparities among youth. Full article

Background/Objectives: Smartphone-based leisure reservation platforms increasingly shape how individuals participate in leisure, yet little is known about how such technology-mediated engagement influences users’ awareness of multidimensional health benefits. The purpose of this study is to investigate how regular users of smartphone-based leisure reservation platforms perceive multidimensional health benefits associated with their leisure activities. Methods: Based on a constructivist/interpretivist approach, this study applied Interpretative Phenomenological Analysis (IPA). Ten participants with at least one year of platform use completed semi-structured interviews. Data were analyzed through iterative coding and theme development, with trustworthiness ensured through member checking, peer debriefing, and triangulation. Results: Participants reported three dimensions of health awareness. (1) App-enabled accessibility as a catalyst for physical health awareness (i.e., physical health benefits) included improved vitality and increased motivation to maintain exercise routines. (2) App-based planning and anticipation in supporting mental well-being (i.e., mental health benefits) involved stress reduction, emotional recovery, enjoyment, and heightened self-care awareness. (3) Platform-mediated social encounters and the construction of social health (i.e., social health benefits) reflected expanded social networks, strengthened interpersonal relationships, and a greater sense of belonging fostered through shared leisure experiences. Conclusions: Smartphone-based leisure platforms play a meaningful role in enhancing users’ awareness of multidimensional health benefits. By improving accessibility, diversifying leisure options, and facilitating social interaction, these platforms support holistic well-being. The findings contribute to understanding technology-mediated leisure and offer practical implications for designing digital leisure services that promote physical, mental, and social health. Full article

Background/Objectives: The COVID-19 pandemic profoundly disrupted gastric cancer care, reducing access to screening, delaying diagnosis, and altering therapeutic pathways worldwide. Beyond clinical challenges, it exposed structural weaknesses in healthcare systems but also accelerated innovation. Methods: We conducted a narrative review supported by a structured literature search (PubMed/MEDLINE, Scopus, Web of Science; 1 January 2014–30 November 2025), with a narrative synthesis of observational studies, registry analyses, and meta-analyses addressing COVID-19–related changes in gastric cancer epidemiology, diagnosis, treatment, vaccination, and telemedicine. A PRISMA-style flow diagram was used to illustrate study selection. Results: Elective endoscopy volumes fell by up to 80%, leading to diagnostic backlogs and increased proportions of advanced-stage gastric cancer. Surgical postponements, modified chemotherapy and radiotherapy schedules, and reduced molecular/genetic testing further compromised outcomes. Conversely, vaccination, telemedicine, capsule endoscopy, and adaptive triage frameworks enabled partial recovery of services. Geographical variations were observed in the recovery of gastric cancer care services, with regions that had established screening infrastructure generally resuming activity more rapidly, whereas others experienced ongoing delays and diagnostic backlogs. Conclusions: This review integrates epidemiological, diagnostic, and therapeutic evidence to demonstrate how COVID-19 redefined gastric cancer care. By highlighting regional disparities and outlining a conceptual model for oncologic resilience, it provides an innovative framework for future crisis preparedness. The lessons of the pandemic—digital health integration, flexible treatment protocols, and international collaboration—represent a foundation for more robust, equitable gastric cancer management in the post-pandemic era. Full article

People with intellectual disabilities are disproportionately affected by diet-related health inequalities. This Perspective outlines a dual challenge: (1) intrinsic vulnerabilities—cognitive limitations, health-literacy constraints, and comorbidities—that impair individuals’ ability to make healthy dietary choices, and (2) extrinsic neglect—insufficient support in care environments, inadequate nutrition-related training among informal caregivers and support staff, and structural gaps in policy and services. We argue that this “double jeopardy” undermines nutritional equity and proposes strategies for person-centered nutrition education, caregiver empowerment, supportive food environments, and inclusive policy frameworks. Greater interdisciplinary collaboration and tailored research are urgently needed to ensure nutritional health as a right for people with intellectual disabilities. Full article

Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article

Background: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) experience a high burden of human papillomavirus (HPV) infection and related diseases, yet data on HPV vaccination among this group in Brazil remain limited. Aims: The aims of this study were to estimate the prevalence of complete HPV vaccination and to identify factors associated with vaccination completion among MSM using PrEP in Brazil. Methods: We conducted a cross-sectional online survey between May and September 2025 among MSM aged ≥18 years, residing in Brazil and currently using oral PrEP. Participants were recruited through virtual snowball sampling and targeted advertisements on social media and a gay geosocial networking application. Data were collected using a structured, self-administered questionnaire hosted on REDCap^®. Complete HPV vaccination was defined as self-reported receipt of all doses recommended according to the participant’s age and clinical condition. Sociodemographic characteristics, relationship patterns, sexual behaviors, lubricant use during sexual activity, and history of sexually transmitted infections (STIs) were assessed. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CIs) were estimated using Poisson regression with robust (sandwich) variance. Results: A total of 872 MSM using PrEP were included, of whom 59.4% reported complete HPV vaccination. In adjusted analyses, complete vaccination was more frequent among participants reporting both steady and casual partners (aPR = 1.90; 95% CI: 1.36–2.65) or only casual partners (aPR = 1.72; 95% CI: 1.24–2.39), those reporting lubricant use during sexual activity (aPR = 1.41; 95% CI: 1.23–1.61), and those with a diagnosis of chlamydia and/or gonorrhea in the previous 12 months (aPR = 1.22; 95% CI: 1.08–1.36). Conclusions: Although HPV vaccination coverage among MSM using PrEP in Brazil is higher than that reported for MSM in general, it remains incomplete in a population with regular contact with specialized health services. Integrating systematic assessment and delivery of HPV vaccination into PrEP care may help increase vaccination completion and reduce missed opportunities for prevention. Full article

As population aging accelerates, the mounting burden on informal family caregivers in areas lacking formal care systems threatens the sustainability of elder care. This study aims at evaluating how the rural living environment and external connectivity jointly alleviate caregiver burden and exploring whether regional accessibility serves as a substitute for local infrastructure deficits. Guided by Ecological Systems Theory, we analyzed a cross-sectional dataset of 327 matched caregiver-recipient dyads from rural China using multivariate regression and mediation models. Results indicate that a favorable local environment reduces burden both directly and indirectly through improved recipient health. Crucially, county-level accessibility moderates this relationship via a substitution effect, where the marginal relief from local environmental improvements is most potent in isolated areas but diminishes where external access is convenient. Dimension-specific analyses show that developmental and physical strains are particularly sensitive to these factors. We conclude that sustaining informal care requires a dual-pathway strategy: prioritizing local “soft” assets like community safety and cultural activities while enhancing regional connectivity to service hubs. Ultimately, this research provides empirical evidence and a theoretical framework for enhancing rural informal care sustainability through environmental optimization, thereby advancing Sustainable Development Goals regarding health, reduced inequalities, and sustainable communities. Full article

Background: Considering the significant impact on quality of life and the chronic nature of temporomandibular dysfunction (TMD), seeking healthcare is also part of the reality of individuals with this disorder. However, cultural differences and similarities in the experiences of individuals with TMD have not yet been investigated. This study aimed to describe and compare the experiences, beliefs, and sociocultural factors of Brazilian and Spanish individuals with TMD, focusing on their perceptions of the disorder, diagnostic pathways, information-seeking behaviors, and treatment expectations. Methods: A descriptive qualitative study was conducted. A purposive sample of 50 participants (25 Brazilian, 25 Spanish), aged 18–50 and diagnosed with TMD according to DC/TMD criteria, was recruited. Data were obtained through semi-structured interviews and analyzed using thematic analysis. Results: Six themes emerged, revealing both similarities and differences between the groups. Brazilian participants reported uncertainty about which professional to consult and difficulty accessing specialized care. In contrast, Spanish participants frequently sought physical therapists as their first option and identified them as primary sources of information. Beliefs about TMD etiology varied across samples. Treatment expectations also differed. Brazilians emphasized the difficulty of obtaining effective care, while Spanish participants perceived physiotherapy as being limited to muscular disorders. Perceptions of occlusal splint effectiveness showed variation between the groups. Conclusions: These findings underscore the necessity of culturally sensitive approaches to patient care that address not only clinical aspects, but also the sociocultural context that influences health behaviors. Full article

Ants act as keystone species in terrestrial ecosystems, providing important ecosystem services. The large-scale production and application of GO constitute a predominant contributor to its inevitable environmental dispersion. Most GO toxicity studies have focused on plants, animals, and microorganisms, with limited research on ground-dwelling ants. In the study, we used Camponotus japonicus as a model to investigate the toxic effects of GO on ants by integrating physiological characteristics, gut microbiota and transcriptome profiling. Results showed that GO exposure induced mitochondrial dysfunction, as evidenced by mitochondrial ROS accumulation and elevated mitochondrial membrane permeability. Physiological assessments revealed that GO exposure induced oxidative stress. Specifically, GO treatment significantly suppressed superoxide dismutase (SOD) and catalase (CAT) activities, while enhancing peroxidase (POD) and carboxylesterase (CarE) activities and increasing the levels of malondialdehyde (MDA) and trehalose. Gut microbiota analyses showed that GO remarkably reduced the relative abundance of beneficial bacterial symbionts (e.g., Candidatus Blochmannia) and destabilized the whole community structure. Furthermore, transcriptome profiling revealed 680 differentially expressed genes (DEGs) in the ants after GO exposure, most of which were significantly enriched in pathways associated with oxidative phosphorylation. This study suggests that GO may compromise ant-mediated ecosystem function and provides a reference for understanding the environmental risks of GO. Our findings also offer new insights for protecting the ecosystem services of ants. Full article

Purpose: This study examined the relationships among fear of cancer recurrence (FCR), unmet healthcare needs, and quality of life (QOL) among breast cancer survivors post-treatment, particularly within the Thai cultural and healthcare context, where limited research has been conducted. Methods: A cross-sectional descriptive correlational design with purposive sampling was used. A total of 122 breast cancer survivors, 1–5 years prior, were recruited from the Breast Clinic and Chemotherapy Unit at the National Cancer Institute. Instruments included a demographic questionnaire, the FCR Inventory Short Form, the Cancer Survivors’ Unmet Needs measure, and the EORTC QOL-C30 with the breast cancer module (QLQ-BR23). Cronbach’s α ranged from 0.82 to 0.92. Data were analyzed using descriptive statistics, Spearman’s rank correlation, and Pearson’s correlation coefficient. Results: Participants reported moderate levels of FCR (M = 13.39, SD = 4.50), low unmet healthcare needs (M = 25.63, SD = 14.82), and moderate overall QOL (M = 54.82, SD = 0.22). FCR was negatively correlated with overall QOL (r = −0.248, p <0.01) and functional QOL (r = −0.242, p < 0.01). Unmet healthcare needs were also negatively correlated with overall QOL (r = −0.261, p < 0.01). Multiple linear regression analysis revealed that both FCR and unmet healthcare needs had a significantly negative relationship with overall QOL (p < 0.05). Conclusions: FCR and unmet healthcare needs independently impair QOL among breast cancer survivors. Early, culturally appropriate survivorship care in Asian contexts is essential to address these needs and improve QOL. Full article

The use of interpreter services is an important component of medical care. It is critical for medical students to practice this during training. It is known that simulation and role play provide important opportunities for students to practice skills. This scoping review maps the experience that medical students around the world have practicing with interpreter services in a simulated environment. We searched within three major databases (PubMed, ERIC, and SCOPUS) using a wide range of search terms for publications from the past 15 years. This scoping review was conducted according to PRISMA-ScR guidelines. Of the 1341 studies initially obtained from search terms, 22 were ultimately found to meet inclusion criteria. There is variability in curricula offered including when in medical school, what other specialties are involved, and how the education is conveyed. Most publications lacked longitudinal follow-up and assessment of learner competence was limited. Review articles, a prevalence study, and proof of concept studies also serve to demonstrate the breadth of publications on this subject. This is an area of important consideration within medical education today. Many studies highlight the relative scarcity of formal programs as well as a lack of consistency. Where programs do exist, the importance of including simulation is highlighted. Full article

Expanding longevity, together with a decrease in mortality, leads to an increase in the older population worldwide. In this review, ageing and older adults, as well as psychosocial and advanced technological interventions, will be discussed. Older adults are associated with an increased incidence of multimorbidity and disability; thus, they have a higher demand for health services than younger individuals. Challenges in welfare services and inadequate family and community-based care support negatively impact the psychosocial and economic wellbeing of older people. Active ageing and successful ageing are crucial aspects for a better quality of life in this age group, as there is a complex interplay of different domains and disease types that influence quality of life in older adults. Additionally, promoting the social participation of older adults is vital for improving their quality of life. Furthermore, the use of technology in older adults has a positive impact on their quality of life; however, aside from the promotion and implementation of technological interventions, challenges persist at all levels of acceptance and use. A better understanding of these challenges and implementing measures to overcome them will have a significant impact on the technological acceptance of older adults and their use in daily life activities, resulting in more favourable quality of life outcomes. Full article

Background: Language barriers remain a major obstacle to equitable healthcare access for immigrants and refugees across Europe. Greece, as both a transit and host country, faces persistent challenges in providing linguistically and culturally appropriate care. Methods: This study presents a narrative literature review synthesizing international, European, and Greek evidence on the effects of limited language proficiency, professional interpretation, and intercultural mediation on healthcare access, patient safety, satisfaction, and clinical outcomes. Peer-reviewed studies and selected grey literature were identified through searches of PubMed, Scopus, Web of Science, and CINAHL. Results: The evidence consistently demonstrates that the absence of professional interpretation is associated with substantially higher rates of clinically significant communication errors, longer hospital stays, increased readmissions, and higher healthcare costs. In contrast, the use of trained medical interpreters and intercultural mediators improves comprehension, shared decision-making, patient satisfaction, and clinical outcomes. Comparative European data from Italy, Spain, Germany, and Sweden show that institutionalized interpretation systems outperform Greece’s fragmented, NGO-dependent approach. Greek studies further reveal that limited proficiency in Greek is associated with reduced service utilization, longer waiting times, and lower patient satisfaction. Conclusions: This narrative review highlights the urgent need for Greece to adopt a coordinated, professionally staffed interpretation and intercultural mediation framework. Strengthening linguistic support within the healthcare system is essential for improving patient safety, equity, efficiency, and the integration of migrant and refugee populations. Full article

The COVID-19 pandemic exacerbated structural, social, economic, and racial inequalities affecting immigrant, refugee, and asylum-seeking men—vulnerable populations often overlooked in men’s health research. This study investigated the health conditions of immigrant, refugee, and asylum-seeking men during the COVID-19 pandemic. A scoping review was conducted following Joanna Briggs Institute guidance, and a qualitative lexical analysis (text-mining of standardized study syntheses) was performed in IRaMuTeQ using similarity analysis, descending hierarchical classification, and factorial correspondence analysis. We identified 93 studies published between 2020 and 2023 across 35 countries. The evidence highlighted vaccine hesitancy, high epidemiological risks (infection, hospitalization, and mortality), barriers to accessing services and information, socioeconomic vulnerabilities, psychological distress (e.g., anxiety and depression), and structural inequalities. Findings were synthesized into four integrated thematic categories emphasizing the role of gender constructs in help-seeking and gaps in governmental responses. Most studies focused on immigrants, with limited evidence on refugees and especially asylum seekers; therefore, conclusions should be interpreted cautiously for these groups. Overall, the review underscores the urgency of multisectoral interventions, universal access to healthcare regardless of migration status, culturally and linguistically appropriate outreach, and gender-sensitive primary care strategies to support inclusive and resilient health systems. Full article

(1) Background: The climate impact of health care work has raised interest in climate-conscious health care practice. Medications contribute significantly to the carbon footprint; there has been insufficient work describing climate-conscious medication therapy management practices that could be useful to address climate change caused by health care work. (2) Methods: This exploratory qualitative research study focused on climate-conscious medication therapy management practices. A semi-structured interview protocol was used. A total of 17 primary care pharmacists were interviewed (following informed consent) to the point of thematic saturation. A constant-comparative analysis was undertaken to identify and categorize themes. The research was undertaken based on a protocol approved by the University of Toronto Research Ethics Board. (3) Result: Three main themes emerged: (a) There is insufficient evidence currently available to guide climate conscious medication therapy management; (b) seven specific climate-conscious medication therapy management strategies were identified as being most likely to be acceptable by primary care pharmacists; (c) medication therapy management services focused on climate adaptation strategies for patients should be expanded; (4) Conclusions: As medications become the primary intervention used in health care, climate-conscious medication therapy management becomes more essential than ever. Further work in providing evidence to guide climate-conscious prescribing decisions is needed. Full article