Search Results (347)

Osteoarthritis (OA) remains a major contributor to pain and disability; however, the current management is largely reactive, focusing on symptoms rather than preventing irreversible cartilage loss. This review first examines the mechanistic foundations for pharmacological chondroprotection—illustrating how conventional agents, such as glucosamine sulfate and chondroitin sulfate, can potentially restore extracellular matrix (ECM) components, may attenuate catabolic enzyme activity, and might enhance joint lubrication—and explores the delivery challenges posed by avascular cartilage and synovial diffusion barriers. Subsequently, a practical “What–How–When” framework is introduced to guide community pharmacists in risk screening, DMOAD selection, chronotherapeutic dosing, safety monitoring, and lifestyle integration, as exemplified by the CHONDROMOVING infographic brochure designed for diverse health literacy levels. Building on these strategies, the P4–4P Chondroprotection Framework is proposed, integrating predictive risk profiling (physicians), preventive pharmacokinetic and chronotherapy optimization (pharmacists), personalized biomechanical interventions (physiotherapists), and participatory self-management (patients) into a unified, feedback-driven OA care model. To translate this framework into routine practice, I recommend the development of DMOAD-specific clinical guidelines, incorporation of chondroprotective chronotherapy and interprofessional collaboration into health-professional curricula, and establishment of multidisciplinary OA management pathways—supported by appropriate reimbursement structures, to support preventive, team-based management, and prioritization of large-scale randomized trials and real-world evidence studies to validate the long-term structural, functional, and quality of life benefits of synchronized DMOAD and exercise-timed interventions. This comprehensive, precision-driven paradigm aims to shift OA care from reactive palliation to true disease modification, preserving cartilage integrity and improving the quality of life for millions worldwide. Full article

Background/Objectives: Perceived physical literacy (PPL) appears to be a relevant strategy for combating the prevalent sedentary lifestyle among young people. Therefore, understanding their PPL levels will facilitate the implementation of appropriate strategies for this purpose. Therefore, this study aimed to analyze the differences in PPL considering the sex dimension (i.e., males and females) and the age-group (i.e., early compulsory secondary education, late compulsory secondary education and baccalaureate). Methods: Seven-hundred-and-four Spanish students (age = 14.3 ± 1.6 years old) belonging to three different Spanish secondary schools voluntarily participated in this study. To assess adolescents’ perceptions of their physical literacy, the Spanish Adolescents’ Perceived Physical Literacy Assessment (S-PPLI) was used. This instrument consists of nine items equally distributed across three categories: self-perception and self-confidence, self-expression and communication with others, and knowledge and understanding. Results: Males obtained higher scores in all the indicators of PPL, except for items 1, 8 and 9, compared to their female counterparts (p < 0.05), while the oldest age-group reported higher scores in the indicators of knowledge and understanding category compared to students in the early years of compulsory secondary education (p < 0.01). Conclusions: Programs based on increasing the PPL should be implemented specifically for females. Also, similar programs must be included into scholar curriculums from the beginning of secondary education, with the aim of promoting improvements in the health and physical condition of Spanish adolescents. Full article

This entry explores the multifaceted intersections of gender and digital technologies, offering a comprehensive analysis of how structural inequalities are reproduced, contested, and transformed in digital contexts. It is structured into six interrelated sections that collectively address key dimensions of gendered digital contexts. It begins by addressing the gender digital divide, particularly in the Global South, emphasizing disparities in access, literacy, and sociocultural constraints. The second section examines gendered labor in the tech industry, highlighting persistent inequalities in Science, Technology, Engineering, and Mathematics (STEM) education, employment, and platform-based work. The third part focuses on gender representation in digital spaces, revealing how algorithmic and platform design perpetuate biases. The fourth section discusses gender bias in AI and disinformation, underscoring the systemic nature of digital inequalities. This is followed by an analysis of online gender-based violence, particularly its impact on marginalized communities and participation in digital life. The final section considers the potentials and limitations of digital activism in advancing gender justice. These sections collectively argue for an intersectional, inclusive, and justice-oriented approach to technology policy and design, calling for coordinated global efforts to create equitable digital futures. Full article

African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care. Full article

Despite the importance of financial literacy, particularly in sustaining and improving rural agriculture, it is documented in the literature that little is known about financial literacy, particularly in rural communities in developing countries. Responding to the calls for research to address this gap, the current study investigates how financial literacy relates to access to funding, innovative service adoption, and sustainable food production among agricultural food producers in Nigeria’s rural communities. A probability sampling technique was used to draw 460 samples from registered rural farmers in the Central Bank of Nigeria’s Anchored Borrower’s Programme for food production in Edo State, Nigeria. Quantitative data were collected using a structured questionnaire. The hypotheses were tested using regression analysis, while descriptive statistics were deployed to analyse the demographic data of the respondents. The outcomes suggest that financial literacy has significant links with access to funding, innovative service adoption and sustainable food production among agricultural food producers in Nigerian rural communities. Based on the outcomes, it is concluded that financial literacy significantly influences sustainable food production in Nigerian rural communities. As such, there is a need for the Nigerian government and financial authorities to embark on a financial literacy drive to increase financial literacy, particularly in light of ever-evolving disruptive financial technologies. Full article

This study explores digital inequality as a socio-spatial phenomenon within the context of smart inclusion, focusing on the Regional Unit of Xanthi, Greece—a region marked by ethno-cultural diversity and pronounced urban–rural contrasts. Using a mixed-methods design, this research integrates secondary quantitative data with qualitative insights from semi-structured interviews, aiming to uncover how spatial, demographic, and cultural variables shape digital engagement. Geographic Information System (GIS) tools are employed to map disparities in internet access and ICT infrastructure, revealing significant gaps linked to geography, education, and economic status. The findings demonstrate that digital inequality is particularly acute in rural, minority, and economically marginalized communities, where limited infrastructure intersects with low digital literacy and socio-economic disadvantage. Interview data further illuminate how residents navigate exclusion, emphasizing generational divides, perceptions of technology, and place-based constraints. By bridging spatial analysis with lived experience, this study advances the conceptualization of digitally inclusive smart regions. It offers policy-relevant insights into how territorial inequality undermines the goals of smart development and proposes context-sensitive interventions to promote equitable digital participation. The case of Xanthi underscores the importance of integrating spatial justice into smart city and regional planning agendas. Full article

In modern medical education, a robust understanding of statistics is essential for fostering critical thinking, informed clinical decision-making, and effective communication. This paper explores the synergistic value of early and continued statistical education for medical students and residents, particularly in relation to the expanding field of sports supplementation and its impact on athletic performance. Early exposure to statistical principles enhances students’ ability to interpret clinical research, avoid cognitive biases, and engage in evidence-based practice. Continued statistical learning throughout residency further refines these competencies, enabling more sophisticated analysis and application of emerging data. The paper also addresses key challenges in integrating statistics into medical curricula—such as limited curricular space, student disengagement, and resource constraints—and proposes solutions including interactive learning, case-based teaching, and the use of public datasets. A unique emphasis is placed on connecting statistical literacy to the interpretation of research in sports science, particularly regarding the efficacy, safety, and ethical considerations of sports supplements. By linking statistical education to a dynamic and relatable domain like sports performance, educators can not only enrich learning outcomes but also foster lasting interest and competence in quantitative reasoning. This integrated approach holds promise for producing more analytically proficient and clinically capable physicians. Full article

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. Full article

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

Introduction: Visual impairment impacts millions of people around the world, with the vast majority of problems being treatable. Disadvantaged communities are unable to utilize the same resources to treat these problems due to a lack of knowledge or resources, in addition to the presence of barriers preventing access. The objective of this paper is to assess eye health awareness and evaluate the barriers for individuals from disadvantaged communities in order to inform future interventions and increase access to care. Methods: This is a pilot study utilizing an online anonymous questionnaire designed to assess the demographics, eye health awareness, and access to eye care of community-based patients. A comprehensive literature review was also conducted using PubMed, Scopus, and Google Scholar to evaluate barriers to eye care and methods to improve community health outcomes. The primary goal was to improve understanding of eye health awareness and access in order to inform future strategies that can help in improving eye health awareness and service availability. Results: The results indicated that 61.2% of respondents believed that eye exams are very important, and only 7.7% of participants believed that regular eye exams are not important. The majority of participants (75%) agree that regular eye exams help prevent serious eye conditions and 84.5% believe that eye health can affect quality of life. 35.6% of participants reported they had their eyes checked by a healthcare professional within the last year, while 21.2% reported never having an eye exam. Although the majority of participants found access to eye care services in their community somewhat or very easy, 8.6% and 9.5% of participants found access difficult and very difficult, respectively. Even though 45.6% of participants reported not facing any barriers regarding access to eye care, the cost of services, long waiting times, and lack of nearby eye care providers were often cited as barriers from the remainder of the participants. Moving forward, local interventions such as mobile eye clinics, public health workshops, and telehealth are viable options to obtain an understanding of the community’s health status in addition to creating opportunities to educate and provide health screenings. Conclusion: The results indicate that although there is awareness of the importance of eye health for the majority of participants, there is still a sizable minority who have insufficient understanding. Barriers to healthcare such as cost, waiting times, and proximity to providers are common problems that are preventing many from seeking eye care. Future interventions should be created to increase access and literacy amongst the community through telehealth, mobile eye clinics, and public health workshops. Additional efforts should be taken by healthcare stakeholders to enhance care delivery, implement policies, and improve awareness. Full article

Indigenous people possess unique health literacy issues and challenges with preventing infectious diseases. This research assessed the baseline knowledge and misinformation in the Semai indigenous subgroup in Perak state, Malaysia, and the impact of a culturally adapted health education intervention. A single-group pre-test/post-test design was used with 156 participants ranging from 7 to 69 years old, predominantly children. The survey addressed key issues of head lice, intestinal parasites, tuberculosis (TB), handwashing, and germ transmission. An interactive, multi-station health education session in the local language produced a significant increase in overall knowledge (mean score increased from 3.17 to 3.83 out of 5, p < 0.0001), with the largest increase among the adult group aged 31–50 years. This was most notable for handwashing knowledge, which had the greatest increase, and misconceptions about intestinal worms and head lice remained. Differences in outcome by age suggest the need for targeted educational strategies, particularly for teenagers and elderly individuals who achieved less gain. The results support the effectiveness of culturally tailored, community-based health education in promoting the awareness of disease among indigenous communities. The drawbacks are convenience sampling, the child dominance of the sample, and the short-term follow-up. Future emphasis should be placed on long-term, community-based intervention using culturally tailored content and digital media. Full article

Digital skills are increasingly vital for enhancing employability, as they equip individuals to meet the evolving demands of the modern workforce. Therefore, this paper examines the impact of digital skills on employability, focusing on the influence of both basic and above-basic levels of information and data literacy, communication and collaboration, problem-solving, digital content creation, and safety skills, considered key components of digital competence. The research employs regression analysis using secondary data extracted from the Eurostat database. Based on data from 32 European countries, the findings indicate that three proxies for digital skills, communication and collaboration, digital content creation, and safety, significantly and positively influence employability. The contribution of this paper to the existing literature on digital skills and employability is twofold. First, by evaluating the influence of five categories of digital skills across different proficiency levels on employment rates, the study sheds light on which specific digital skills have the most substantial impact on employability in today’s labor market. Second, the findings provide a foundation for formulating recommendations aimed at enhancing the digital capabilities of the labor force. Full article

Background/Objectives: Artificial intelligence (AI) offers opportunities to enhance healthcare accessibility for people with disabilities (PwDs). However, their application in Saudi Arabia remains limited. This study explores PwDs’ experiences with AI technologies within the Kingdom’s Vision 2030 digital health framework to inform inclusive healthcare innovation strategies. Methods: Semi-structured interviews were conducted with nine PwDs across Riyadh, Al-Jouf, and the Northern Border region between January and February 2025. Participants used various AI-enabled technologies, including smart home assistants, mobile health applications, communication aids, and automated scheduling systems. Thematic analysis following Braun and Clarke’s six-phase framework was employed to identify key themes and patterns. Results: Four major themes emerged: (1) accessibility and usability challenges, including voice recognition difficulties and interface barriers; (2) personalization and autonomy through AI-assisted daily living tasks and medication management; (3) technological barriers such as connectivity issues and maintenance gaps; and (4) psychological acceptance influenced by family support and cultural integration. Participants noted infrastructure gaps in rural areas, financial constraints, limited disability-specific design, and digital literacy barriers while expressing optimism regarding AI’s potential to enhance independence and health outcomes. Conclusions: Realizing the benefits of AI for disability healthcare in Saudi Arabia requires culturally adapted designs, improved infrastructure investment in rural regions, inclusive policymaking, and targeted digital literacy programs. These findings support inclusive healthcare innovation aligned with Saudi Vision 2030 goals and provide evidence-based recommendations for implementing AI healthcare technologies for PwDs in similar cultural contexts. Full article

This qualitative study examines how children living in a public housing neighborhood engage in multimodal, embodied meaning-making to restory their community. Focusing on two participants and in partnership with The Kids Club, this paper explores children’s spatial reclamation through embodied and spatialized literacies, complicating stories where children assert whose stories matter and why. Drawing on nexus analysis and narrative inquiry, this study conceptualizes the body as central to cognition and comprehension through texts in action. The sisters spatially reclaim neighborhood narratives via walking tours, heart maps, and photographs that function as multimodal action texts. These practices invite a rethinking of comprehension beyond traditional textual modes, illuminating how children navigate and transform literacy landscapes. This work contributes to conversations about equity in literacy environments and calls on educators and researchers to honor children’s multimodal literacy practices as vital forms of critical comprehension, storytelling, and belonging. Full article

Objective: Although the negative effects of polypharmacy on older adults are well-documented, studies exploring its relationship with frailty and quality of life within the framework of community-based rehabilitation (CBR) remain scarce. In this context, the aim of this study was to compare frailty and quality of life levels between older adults with and without polypharmacy and to examine the relationship between these parameters from a CBR perspective. The ultimate purpose of this study was to determine the usefulness of CBR. Method: A total of 120 community-dwelling older adults (60 with polypharmacy, 60 without polypharmacy), aged 65–75 years (mean age = 68.18 ± 3.50), were included in a community-based assessment carried out under the coordination of Lokman Hekim University in Ankara, Turkey. The use of five to nine medications was taken as a reference for those with polypharmacy, and the use of less than two medications was taken as a reference for those without polypharmacy. The quality of life of the older adults in the study was assessed with the Nottingham Health Profile (NHP), and frailty was assessed with the Edmonton Frailty Scale (EFS). In line with CBR principles, the findings were interpreted with a focus on promoting community-wide strategies to support older adults. Results: The study found a statistically significant difference in NHP and EFS results between older adults with and without polypharmacy (p < 0.05). In addition, a statistically significant relationship was found between NHP and all subdomains of NHP and EFS (p < 0.05). Conclusion: Older adults with polypharmacy had higher levels of frailty and lower quality of life, and an increase in frailty was significantly associated with a decrease in quality of life in both groups. These findings highlight the importance of community-level preventive interventions to support healthy aging. Within the framework of CBR, strategies such as creating accessible physical activity areas at the neighborhood level; organizing informative seminars on frailty, quality of life, medication use and health literacy in collaboration with volunteer health professionals and local authorities; and creating volunteer support networks to increase social interaction can contribute to the control of these symptoms in older adults. Full article