Search Results (342)

Breast cancer constitutes one of the oncological diagnoses with the greatest impact on women’s lives, with consequences that extend beyond active treatment into a survivorship period marked by profound transformations in identity, relationships, and well-being. This study aimed to explore the impacts that breast cancer produces on the everyday lives of survivor women in the municipality of Villarrica, La Araucanía Region. A qualitative methodology with a phenomenological orientation was employed, based on discourse analysis of three focus groups with 20 female breast cancer survivors between 35 and 70 years old. The analysis identified five categories: impact on everyday life and work, management of uncertainty and fear, transformation of self-care and life priorities, support networks and community, and barriers to accessing the healthcare system. The findings demonstrate the coexistence of posttraumatic growth and persistent psychological distress, together with structural inequities that limit access to comprehensive care during the survivorship period. It is concluded that cancer survivorship demands public policy responses that are continuous, multilevel, and integrative of a gender perspective, articulating individual, family, and community interventions from primary healthcare. Full article

Scoliosis is a complex three-dimensional spinal deformity that requires early detection, accurate radiological assessment, individualized treatment planning, and long-term monitoring. In recent years, artificial intelligence (AI) has emerged as a promising tool across multiple stages of scoliosis management, including screening, automated imaging analysis, deformity classification, prediction of progression, surgical planning, postoperative outcome assessment, and patient education. This narrative review summarizes current and emerging applications of AI in scoliosis, with particular emphasis on studies published after 2023. Deep learning algorithms, including convolutional neural networks, U-Net-based architectures, transformer models, and generative approaches, have demonstrated high accuracy in automated Cobb angle measurement, vertebral segmentation, coronal and sagittal parameter assessment, and radiation-free screening using surface topography or smartphone-based photographs. Machine learning models have also shown potential in predicting curve progression, treatment response, risk of postoperative complications, and patient-reported outcomes by integrating radiological, clinical, biomechanical, and, increasingly, multimodal data. In parallel, large language models and generative AI tools are being investigated for patient education, communication support, readability improvement, and research hypothesis generation. Despite these advances, important limitations remain, including limited external validation, dataset heterogeneity, potential algorithmic bias, insufficient interpretability, and incomplete integration into clinical workflows. Moreover, while AI systems show strong performance in automated measurement and screening tasks, their role in complex therapeutic decision-making, such as Lenke classification, fusion-level selection, and autonomous surgical planning, remains experimental. Overall, AI has the potential to improve the precision, efficiency, and personalization of scoliosis care; however, prospective multicentre studies, transparent reporting, explainable model design, and regulatory validation are essential before widespread clinical implementation. Full article

Plant-based healing practices integrate botanical resources, ritual speech, gesture, faith, spiritual mediation, protection, and social recognition within complex community systems of care. This cross-regional scoping review mapped the traceable literature on plant-based knowledge associated with benzedeiras, benzedores, rezadeiras, rezadores, and functionally analogous specialists. The formal scoping-review corpus comprised 54 records retrieved through structured database searches. A separate contextual layer of 132 supplementary records, identified through citation tracking and targeted searches using emic specialist terms, broadened interpretation but was not treated as methodologically equivalent to the PRISMA-derived corpus. Across the 186 analytical records, 74 harmonized specialist terms and 212 botanical entries associated with therapeutic, ritual, spiritual, or community-based practices were identified. The botanical matrix comprised 68 families and 166 genera, with Lamiaceae, Asteraceae, Solanaceae, and Fabaceae as the most represented families. The results reveal terminological diversity, regional asymmetries in documentation, and the predominance of broad labels alongside terms with greater emic density. Plants operate as pharmacological resources, ritual supports, spiritual mediators, instruments of protection, territorial markers, and performative elements of healing. These specialists should be understood as mediators of complex therapeutic systems. The findings represent the indexed and traceable supplementary literature analyzed and should not be interpreted as a comprehensive inventory of ritual healing traditions worldwide. Full article

High-throughput metagenomic sequencing and advances in mucosal immunology have refuted the traditional physiological concept of a sterile respiratory tract. The oral cavity has been recognized as a dynamic determinant of systemic health. As in other parts of the body, recent studies also suggest that pulmonary health may be linked to oral health. Under eubiotic conditions, the oral microbiome maintains local immunological homeostasis and colonization resistance. Oral dysbiosis, characterized by sequential shifts in microbial communities and the proliferation of the pathogenic red complex (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia), induces a state of chronic systemic inflammation, potentially involved in an infectious axis between the oral cavity and the lung. This review evaluates the tripartite systemic pathways of metastatic infection, metastatic injury, and metastatic inflammation that govern the translocation of oral pathobionts and their bioactive components, including lipopolysaccharides, outer membrane vesicles, and matrix metalloproteinases, to the lower respiratory tract via microaspiration and hematogenous circulation. The clinical implications across the chronic respiratory disease spectrum are examined, with a focus on how deficits in oral microbial diversity influence chronic obstructive pulmonary disease (COPD) pathogenesis, modulate the pulmonary virome and mycobiome, and stimulate maladaptive trained immunity. Furthermore, the contribution of biological aging is assessed, highlighting the roles of immunosenescence, inflammaging, and physiological reflex decline within the broader mucosal continuum. Finally, the clinical translation of this axis is analyzed, emphasizing the integration of saliva-based point-of-care nano-theranostics, metatranscriptomic profiling, and targeted interventions—such as professional oral biofilm management in intensive care settings and precision microbiome engineering—to preserve respiratory function and restore immune homeostasis. Full article

Given the growing pressures on Switzerland’s healthcare system, developing innovative approaches that put humanism at the heart of care practices seems essential to respond to patients’ complex needs and to support healthcare professionals’ well-being. Although several frameworks address humanistic care or interprofessional collaboration, few have been co-developed with healthcare professionals to guide the implementation of both dimensions at the organisational level. This article explores the development of an interprofessional healthcare model aimed at integrating humanistic values into a public hospital network in a French-speaking region of Switzerland. This community-based participatory action research involved healthcare professionals representing different hospital departments and a patient feedback unit. The study focused on the co-development of an organisational model through three iterative phases: initiation (identification of needs), diagnosis (analysis of current practices) and design (development of strategies and solutions). The model was based on the three overarching themes: Care for Others and Oneself, Constructive Interactions, and Professional Excellence. The resulting model provides an organisational framework for integrating humanistic values into interprofessional practice in a hospital setting. Its implementation and evaluation will be required to assess its effects on patient experience, professional well-being, and organisational practices. Full article

Climate change education has expanded in curricular, institutional and media arenas, yet it still faces a central challenge: turning scientific knowledge into educational practices that transform perceptions, decisions and participation. This article argues that the challenge cannot be addressed by merely adding content about the climate system, because the climate crisis is experienced in specific territories, affects communities unequally and activates emotions that can either enable or inhibit action. Through a critical integrative review and research-reflection approach, the article connects three bodies of scholarship that are commonly developed in parallel: territorial and place-based learning, climate justice, and emotional literacy. Its conceptual novelty lies not in claiming that these components are individually new, but in specifying territorial memory as the mediating mechanism through which scientific evidence, unequal vulnerability, affective experience and collective action are combined in teacher education. On this basis, it presents the TEJA Model—territorialization, experience, justice and action—as a heuristic framework for designing, analyzing and evaluating teacher-education sequences. Its practical contribution is a five-phase process and an operational matrix that translate nearby risks such as floods, droughts and wildfires into inquiry, deliberation, emotional care and feasible collective action. The model is presented as a testable conceptual proposal rather than a validated intervention. The article concludes that relevant climate education must be scientific, human, territorial and political: it should recognize vulnerability, begin from lived places and address unequal responsibilities and collective capacities for action. Full article

Background: This study explores physicians’ perceptions and satisfaction with Electronic Medical Record (EMR) systems in resource-limited healthcare settings, addressing a critical gap in research. It identifies key factors essential for optimizing EMR adoption and enhancing healthcare delivery. Methods: This study employed a facility-based mixed-method cross-sectional study comprising a quantitative survey of 249 physicians at St. Paul’s Hospital Millennium Medical College (SPHMMC), sampled through stratified random sampling techniques, with thematic analysis of semi-structured interviews of eight physicians, selected using criterion and stratified purposive sampling techniques. Quantitative data was analyzed using both binary and multivariable logistic regression, and qualitative data from semi-structured interviews was analyzed using thematic analysis. Results: The study reveals that 91% of physicians experience workflow disruptions due to EMR system use. Despite this, physicians were satisfied with efficiency gains associated with EMR systems, with 65.8% noticing improvements in their efficiency and 50.6% reporting reduced workloads. 78.7% of physicians expressed satisfaction with workflow integration. EMR communication tools were rated positively, with 92.0% satisfied with integration. Overall, 79.5% of St. Paul’s Hospital Millennium Medical College (SPHMMC) physicians are satisfied with the implemented EMR system, with factors such as ease of use, integration, confidence in navigation, sufficient technical support, and perceived effectiveness in facilitating patient care across departments affecting satisfaction. The qualitative study also highlighted the following themes: a disconnect between system functionality and resource availability, usability and functionality gaps affecting workflow, inadequate training and support, data security and privacy concerns, and mixed perceptions of the EMR system’s impact on patient care benefits and challenges. Conclusions: The study shows that while the EMR system at SPHMMC has a mixed perception among physicians, it has generally satisfied them, and this supports a multifaceted approach to enhance physician satisfaction and optimize EMR utilization at SPHMMC. This includes enhancing system usability, providing comprehensive training, ensuring readily available technical support, improving workflow integration, and strengthening data security measures. Full article

Background/Objectives: Nutritional impairment is common across the cancer care continuum and may negatively affect treatment tolerance, functional status, quality of life, and caregiver burden. Digital tools may offer new opportunities to extend nutritional care beyond conventional clinical encounters, but their application in oncology remains heterogeneous and poorly defined. This narrative review aims to describe the current landscape of digital nutritional care in oncology, focusing on quality of life and patient perspectives while also considering the emerging role of caregivers. Methods: We conducted a narrative review of the available evidence on digital nutritional and lifestyle interventions in cancer care, including mobile applications, web-based platforms, teleconsultations, SMS- or email-based communication, remote monitoring systems, and hybrid models. Results: Digital nutritional and lifestyle interventions have been evaluated across active treatment, postoperative recovery, and survivorship. Available studies indicate that these interventions are generally feasible and may improve nutritional status, dietary behaviors, and physical activity levels. However, quality-of-life outcomes remain heterogeneous and have not been consistently assessed across studies. Some interventions combining digital tools with personalization, professional feedback, behavioral support, or clinically actionable monitoring reported favorable patient-centered outcomes. However, heterogeneity across studies limits the interpretation of these findings and the identification of specific intervention features associated with effectiveness. Patient and caregiver perspectives further highlight the importance of usability, trust, access to reliable information, communication with healthcare professionals, and practical support in the home setting. Conclusions: Digital nutritional care has the potential to extend and strengthen the delivery of nutritional care. Rather than replacing conventional interventions, it should be implemented through hybrid, supervised, equitable, and clinically integrated models. Future studies should consistently assess quality of life and other patient-reported outcomes while also addressing caregiver needs, digital burden, psychological safety, and inequalities in access. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly being evaluated for ophthalmic diagnosis, screening, and triage, yet its role in paediatric eye care remains less established than in adult ophthalmology. This systematic review aimed to synthesise evidence on AI-enabled tools for paediatric ophthalmic diagnosis, screening, triage, surveillance, and referral, with an emphasis on diagnostic performance, safety, workflow integration, equity, and implementation readiness in primary, community, and primary care-relevant settings. Methods: A PRISMA-guided systematic review was conducted using MEDLINE, Embase, Web of Science, Scopus, and IEEE Xplore from inception to 30 March 2026. Eligible studies evaluated AI or machine-learning tools for children and adolescents aged 0–18 years in relation to paediatric eye conditions. Study selection and data extraction were undertaken independently by reviewers, with disagreements resolved by consensus or third-reviewer adjudication. Methodological and reporting quality was evaluated using an author-adapted six-domain rubric informed by APPRAISE-AI. Diagnostic-accuracy studies were assessed using an author-adapted QUADAS-2 framework incorporating QUADAS-AI-informed AI-specific considerations, the prediction-model study was assessed using PROBAST+AI, and the non-randomised treatment-effect study was assessed using ROBINS-I. The public dataset descriptor was evaluated separately using an author-developed dataset-quality, representativeness, and applicability framework. Because of clinical and methodological heterogeneity, findings were synthesised thematically. Results: Twelve empirical studies and one public dataset descriptor were included, covering retinopathy of prematurity, retinoblastoma, amblyopia risk, myopia, congenital cataract, and visual-acuity assessment. AI systems frequently demonstrated promising diagnostic or screening performance, including sensitivity-first detection of treatment-requiring retinopathy of prematurity, high discrimination for retinoblastoma activity, and strong myopia prediction using fundus images. Several studies supported feasibility in neonatal, school, and community workflows using smartphone-based imaging, task-shifted operators, tele-referral, and human-in-the-loop review. However, external and temporal validation, calibration, patient-level reporting, subgroup and fairness assessment, and economic evaluation were limited. Conclusions: AI-enabled tools show promise for supporting selected paediatric ophthalmic screening, triage, and surveillance pathways, particularly when combined with image-quality control, explicit escalation, and human oversight. However, confidence in the reported performance is limited by single-centre studies and enriched samples, small numbers of clinically important cases, heterogeneous analytical units, potentially optimistic aggregation procedures, limited external or temporal validation, incomplete calibration, and absent fairness analyses. Routine autonomous implementation remains premature. Full article

Background and Objectives: Despite substantial advances in surgical techniques, anesthesia, and perioperative care, postoperative complications remain a major source of morbidity, mortality, prolonged hospitalization, and healthcare utilization following adult cardiac surgery (CS). Increasing evidence suggests that many of these complications are influenced by modifiable perioperative factors that can be addressed through multidisciplinary care. Materials and Methods: A narrative review was conducted to synthesize current evidence regarding perioperative practices associated with the prevention of postoperative complications in adult CS. A comprehensive literature search of PubMed/MEDLINE, Scopus, and Web of Science identified studies published between January 2015 and April 2026, supplemented by landmark studies and relevant clinical guidelines. Results: The identified evidence was organized into four major domains: infection prevention practices, physiological optimization strategies, protocol adherence and patient safety measures, and organizational and human factors. The strongest evidence supports timely antimicrobial prophylaxis, standardized infection prevention bundles, perioperative glycemic control, maintenance of normothermia, and patient blood management as key interventions associated with improved postoperative outcomes. Surgical safety checklists, standardized perioperative pathways, and adherence to evidence-based protocols further contributed to improved patient safety and consistency of care. Emerging evidence also highlighted the importance of communication, teamwork, safety culture, workload management, and healthcare professionals’ knowledge in facilitating successful implementation of perioperative interventions. Conclusions: Prevention of postoperative complications following CS requires a multidisciplinary, systems-based approach integrating evidence-based clinical interventions with standardized perioperative protocols and effective organizational practices that facilitate consistent implementation of evidence-based perioperative care. Future research should focus on prospective evaluation of integrated perioperative strategies, development of practical risk-stratification models, and further investigation of organizational determinants influencing implementation and postoperative outcomes. Full article

Family-centred approaches are being increasingly recognized as integral to inclusive mental health care. Although substantial evidence-based exists for specific interventions particularly family intervention for psychosis, there is no synthesis that maps how family-centred approaches are conceptualized, implemented, and linked to inclusivity across diagnoses, service contexts, and levels of evidence. Existing reviews are largely disorder-specific or outcome-focused and do not examine family-centred care as a system-level strategy for inclusive practice. This scoping review aimed to map and synthesize the existing literature on family-centred approaches used to promote inclusive mental health care for individuals with psychiatric disorders. This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA-ScR reporting guidelines. Searches were conducted in PubMed, PsycINFO, CINAHL, Scopus, Embase, and Web of Science for English-language empirical studies published between 2000 and 2025. Studies involving individuals with psychiatric disorders and any form of family-centred, family-focused, or family-inclusive approach were eligible. Data were charted and analyzed thematically to map intervention types, reported outcomes, and implementation influences; the review did not evaluate intervention effectiveness. Twenty-four studies met the inclusion criteria. Only five themes emerged from this study. Across the literature, family involvement was associated with improved engagement, enhanced communication, and increased caregiver competence. Psychoeducation featured prominently in evidence-based interventions, while newer models emphasized shared decision-making and service co-production. Family-centred approaches are conceptualized in diverse ways across mental health services and are commonly linked to more inclusive and collaborative care. However, the strength of evidence varies substantially between intervention types. This review clarified how family-centred practices are situated across levels of evidence and service contexts, highlighting the need for greater precision in distinguishing established interventions from emerging practices and for system-level strategies to support consistent, culturally responsive family inclusion. Full article

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the abstracts from the 2026 Annual Conference, titled “A New Horizon: Expanding the Access and Impact of Psychosocial Oncology”. The 41st Annual CAPO Conference was held in St. John’s, Newfoundland from 8 June 2026 to 9 June 2026. As we stand at a new horizon in psychosocial oncology, we recognize the unprecedented opportunities to expand both the access to and the impact of comprehensive cancer care. This conference will explore innovative strategies for breaking down traditional barriers that have historically limited access to psychosocial support, including geographic isolation, resource constraints, cultural disparities, and systemic inequities in healthcare delivery. This expansion of reach and influence represents not merely growth in service numbers, but a fundamental transformation in how we conceptualize, design, and implement patient-centered psychosocial care across diverse communities and care settings. We will explore scalable solutions that amplify impact while maintaining the deeply personal, human-centered approach that defines excellence in psychosocial oncology. From telehealth innovations and peer support networks to community-based interventions and integrated care models, this conference will showcase evidence-based strategies that expand our collective ability to support individuals and families navigating the cancer journey, wherever they may be. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over one-hundred and fifty (150) abstracts were submitted for presentation as symposia, 20 min oral presentations, 10 min oral presentations, 90 min workshops and poster presentations. We congratulate all the presenters on their research work and contributions. Full article

Contemporary education policy requires state and local schools to align their curricula and establish school expectations based on college-readiness standards. However, these practices have generated more concerns than solutions. Test scores and grade point averages, which individually measure students’ college readiness, are often conflated with educators’ stereotypical beliefs about students’ prospects for postsecondary success. These stratifying dynamics of college readiness are particularly affecting communities that are historically excluded from higher education. To respond to these systems of exclusion, this qualitative study explores a community-based, collaborative model of college worthiness through coalition building in a predominantly working-class Latiné high school. Through a comprehensive analysis of interviews, observations, and artifacts, the study describes school leaders’ strategic utilization of multi-organizational coalitions to prepare students for college. The findings extend the literature by illuminating anti-deficit, communal approaches to advancing the Latiné educational pipeline. These coalitional practices include a focus on students’ wellness, developing trust and caring interpersonal relationships, and enacting positive expectations to foster college-going agency and self-determination. The implications of these findings are significant for school leaders who work to establish college access points as an integral component of social justice education. Full article

The COVID-19 pandemic produced a severe and heterogeneous burden across age groups, territories and epidemic phases in Spain. Older adults experienced disproportionately high rates of hospitalization, intensive care unit (ICU) admission and death, particularly during the early pandemic waves when vaccination was unavailable. However, the relationship between surveillance-confirmed cases and severe outcomes changed substantially over time, a phenomenon termed epidemiological decoupling. This study developed and applied a novel Older-adult COVID-19 Severity Decoupling Index (O-CSDI) to weekly COVID-19 surveillance data from the 17 Spanish autonomous communities and the two autonomous cities of Ceuta and Melilla. The integrated dataset covered January 2020 to July 2023 and comprised 3496 autonomous community–week observations and 143 variables obtained from four open-access surveillance sources: ISCIII-RENAVE, Datadista/Ministerio de Sanidad, Our World in Data and the MoMo excess mortality system. However, the primary incidence- and ratio-based O-CSDI analyses were restricted to March 2020–March 2022 because open-access individual event counts were no longer structurally comparable after the transition to reduced surveillance. Data from later periods were retained only for contextual vaccination and MoMo mortality indicators. The O-CSDI quantifies the degree to which reported COVID-19 incidence became disconnected from hospitalization, ICU admission and mortality in adults aged 60–69, 70–79 and ≥80 years. The primary version of the index was based on the death-to-case ratio, while complementary versions examined hospitalization-to-case, ICU-to-hospitalization and death-to-hospitalization transitions. Results showed progressive but heterogeneous decoupling across phases, territorial units and age strata, with the strongest decoupling observed during the Omicron BA.1/BA.2 period and the highest residual mortality burden in adults aged ≥80 years. All results were interpreted as ecological, descriptive indicators rather than individual-level risks or causal estimates. These findings provide a reproducible epidemiological tool for retrospective pandemic evaluation and preparedness in ageing populations. Full article

Background/Objective: With the rapid ageing of the global population, promoting mental health and well-being among older adults has become a key priority for healthcare systems. Social support is widely recognized as an important social determinant of health; however, the underlying psychological mechanisms through which it influences well-being in community-dwelling older adults remain insufficiently understood. This study aimed to examine the association between social support and subjective well-being among community-dwelling older adults in urban China and to determine whether psychological resilience mediates this relationship after adjusting for key sociodemographic factors. Methods: A cross-sectional study was conducted between May and July 2023 among 1227 older adults aged ≥ 65 years in three urban communities in Dongguan, China. Stratified cluster sampling was applied. Social support was assessed using the Lubben Social Network Scale (LSNS-6), psychological resilience using the Connor–Davidson Resilience Scale (CD-RISC-10), and well-being using the Elderly Well-Being Scale (EWBS). Pearson correlation and mediation analyses (PROCESS Model 4 with bootstrap resampling) were performed to examine the relationships among variables, adjusting for key sociodemographic factors. Results: A significant positive correlation emerged between social support and well-being (r = 0.410, p < 0.01), with psychological resilience exhibiting an even stronger correlation with well-being (r = 0.573, p < 0.01). Mediation analyses showed that psychological resilience partially mediated the social support–well-being relationship (indirect effect = 0.324, 95% CI: 0.262–0.391), explaining 38.5% of the total effect. Higher educational attainment and stable economic security (e.g., pension coverage) were significantly associated with better well-being outcomes. Conclusions: These findings suggest that social support is associated with better well-being both directly and indirectly through psychological resilience. From a healthcare perspective, community-based interventions that strengthen social networks and improve psychological resilience may represent effective strategies for promoting healthy ageing. Integrating psychosocial support and resilience-building programs into primary care and community health services could contribute to improving mental health and quality of life in ageing populations. Full article